PVCs after Ablation

[Divermon]

I was diagnosed with pvcs 2 years ago and went through a catheter ablation which left me symptom free for close to 2 years.  6 months ago they started up again and I was put on a 30 day halter monitor.  My cardiologist said that since the pvcs originated extremely close to my sinoatrial node, he may not have gotten it all the first time, BUT also that sometimes pvcs can start in a totally different area then the first time.  He wouldn't know for sure without an EP study.  I had the study done last Wednesday and he was not able to produce the pvcs, but said that he had to sedate me very deeply since my legs kept moving, and that my heart may have just been too "relaxed" for it to "perform".  He put me on 25 mg of metoprolol and said if that does not help we may need to do another study in a few months.  I've been having pvcs on and off all day today.  

My question - has anyone else experienced this?  Has anyone gone through an ablation and had to have a second one at a later time?  

[Divermon]

Well 2 years ago I was having very fast, irregular beats - sometimes they would start in my sleep and wake me up.  One day I was driving and they started and I felt like I was going to faint, so I pulled over and called an ambulance.  I spent a few days in the hospital with my heart rate spiking up to 120 bpm and then would drop to 50, and race back up again.  The cardiologist scheduled me for an ablation.  He told me I had pvcs and mitral valve prolapse, I don't remember svt, but some of my symptoms then do resemble that, so maybe that's why he did it.  

When it started again 6 months ago, the heart rate wasn't as wild, but I did get the dizzy feeling and shortness of breath.  He did the EP test last week but couldn't find the pathway so no ablation.  He put me on the medicine, 25mg per day.  My heart rate is normally low (50-55 bpm when it's not acting up) so he didn't want to put me on meds before that would leave me feeling sluggish.  Maybe that's why he started with such a low dose right now, so my body can get used to it.  But I'm still having the skipped beat sensation and the pounding, and faster then normal heart rate when it starts up.   It's only been a week, so I'm guessing my body will have to adjust before I see any real "results".  

I was talking about the AV node, just copied the wrong reference name from another site :)

[Bromley]

Hi. One possible misconception here.  PVC's don't originate near the SA node. You might have PAC's, or you might be talking about the AV node, rather than the SA node.  

Also, its unusual to get an ablation for PVC's unless you have a lot of 'em. Did you actually have an ablation for SVT?  May be will want to ask some questions.  Best of luck.

[tom_h]

I had an ablation for SVT, but my PVC's were unaffected.  They come in clusters, and then are gone for hours, perhaps days.  I continue to take Metoprolol today.  It isn't clear to me if your dose is 25mg. daily or if that's for each dose.  25mg. Is a very low dose.  You have a large amount of adjustment that you can play with.  I'm currently on 125mg daily, and have gone as high as 200mg.  So with your cardiologist, you could increase it see if a higher dose could help.  PVC's are a tough one, and I wish you the best in beating them down.

[Tannie74]

Hi, I'm sorry to hear your troubles. I too have days where I get constant PVCS! They scare me to no end! I too had symptom free 2 yrs, but from toprol, and cardizem. I also had an EP study. They saw my pvcs, but did not perform the ablation. They were searching for an extra pathway, which I did not have. I always felt some form of relief that there was something they could do, if they get real bad.....now, I'm not so sure. The EP test was very scarey for me, I can't imagine getting another one. My cousin has pvcs too, she has 16,000 a day...when started on toprol they stopped. It took 100mgs, and shes a tiny little thing, but your body will adjust. I too have had sucess with the meds, I think maybe I may need a tweek, or maybe change brands. Your not alone, I know how horrible they are,hang in there!