Post PVC ablation

[JohnDavid11]

I am a 35 year old male suffering from PVC's. I am in good shape, run 30-40 miles a week, with no health issues. I was first diagnosed with PVC's 6 months ago. After several ECG's, stress echocardiogram and multiple visits I was told my heart was in great shape. Holter monitor revealed approx. 20,000 pvc's per day. I would regularly experience, tightness of the chest, become lightheaded and over all feel pretty terrible. My EP recommended cath ablation said he could "cure" me. So I consented. The ablation went well and post op NO PVC's. I continued to be symptom free for approx 2 weeks, when they slowly started up again. Just a few here and there for the 3rd week then progressively more as the weeks passed. After 5 weeks post ablation I was instructed by the EP's office to wear a holter monitor, which showed approx 4500 PVC's and 500 PAC's. I have not had my recheck with the Doc yet, but needless to say I am very disappointed. I am curious if there is anyone else out there with a similar situation. Is it normal to have PVC's reoccur (inflammation of the heart) or is this just a botched procedure (morphology showed PVC's are coming from the same origin RVOT). Thanks

J.D.

[MichelleP_3811]

Is that where they ablated, the RVOT?  I am not really sure if it would be that the ablation was botched or that there were multiple spots.  I know that after my AVNRT ablation I had a lot of pvc and pacs generally around the amount you were having and I suspect it was from an irritated heart.  They eventually went away so I would try to not overly worry at this point.  It is a significant drop than what you were experiencing.  I would try to avoid caffeine, deal with stomach issues like acid reflux and make sure you are drinking lots of water and see if it helps.  Are you still running 30-40 miles a week?  I don't know but suspect my work outs were prolonging my recovery from my ectopic activity so maybe just ease up a bit.  Keep running but maybe jog slower and not as far and see if it helps.  I do think pushing too hard and getting dehydrated can affect mine.  In any event I was having thousands after my svt ablation but it took 2 years and they have finally settled to a few hundred to none a day so I barely notice them.  You may never be totally free from them but I would hope with a bit more time away from the ablation things might settle down.  If not a second ablation may fix it for good.  What did your EP say?

[JohnDavid11]

EP said to give it another month, then wear a holter monitor again. After 3 months he feels confident we will know if the PVC's are here to stay. However, he did seem fairly surprised to hear I was still having them. He must not have checked the chart and came into the room assuming I was cured, only to become a bit befuddled I was having 4500 a day still. Really no good explanation just wait and see.

[MichelleP_3811]

Sometimes that is all we can do.  Wait and see.  Please keep us posted.

[Tomshi1965]

That *****! I am currently experiencing 20K PVCs per day and am going to a new EP on Friday for a second opinion about possible ablation. Lucky for me I live near UCSF where they created the procedure, so hopefully they know what they are doing. I have had it and want my life back! I am worried that ablation will not work as I see stories like yours. I am not sure if mine are multifocal or not...I know that makes the ablation less successful. I think I may start having my lattes and red wine again as it doesn't seem to matter...the damn things come any way!!!!  I hope yours go away again!

[MichelleP_3811]

Best of luck with your ablation.  Please keep us posted on how it went.

[Tomshi1965]

Thanks! The day before I visited the new EP, my PVCs stopped! All of the sudden! They think the BB finally kicked in at the increased dose (been taking 25mg of Metoprolol unsuccessfully and had it increased to 50mg 2x per day 2 weeks ago). Problem was that since I had no PVCs, they could not check where they were coming from. EP said that with the amount I was having the ablation would be an option for me, but if I was tolerating the meds I could keep on this plan and see what happens. He also said that at the number I was having, cardiomyopathy was over time a possibility...but stressed that this was not in any way a certainty!

As of yesterday...they are back! Not as frequent as before, but have been coming off and on all day/night. I had my first EP send an older EKG to the new doc so he could maybe figure out where they are coming from. Not sure why I was never told this before???  Anyway, still considering ablation but am scared of it as I have TONS odd anxiety issues!!!!  Thanks for the comment and good wishes!!!