“I have symptomatic PVCs. When do they become dangerous?”
About 1 and a half years ago I developed symptomatic PVCs (right lower ventricle). I have had a failed ablation. When should I worry about these? Can they become dangerous?
20 Answers
PVC's by and large are not dangerous, they can be uncomfortable, but they are not "dangerous" for the most part. The only people whom we send for ablation, are the ones who have thousands of them per day. Otherwise, we either reassure the patient that they are not dangerous, or we place the patient on a medication to cut the frequency down, if they are very bothersome to the patient. If you have no other cardiac issues and want to explore a medication, drugs such as flecainide or propafenone work very well for PVC's, typically.
When they are frequent
Yes
When they are symptomatic
The best specialist to answer your question is the electrophysiologist, these are the cardiologist who has undergone 2 additional years of training after cardiology fellowship. They deals with electrical problems of the heart. There are three of them on staff in Good Samaritan Hospital in Dayton, OH:
Dr. Abdul Wase, Dr. Kravitz, and Dr. Kossam
I am a heart surgeon. When our patient has electrical problems, we consult the electrophysiologist.
Dr. KH Lim
Dr. Abdul Wase, Dr. Kravitz, and Dr. Kossam
I am a heart surgeon. When our patient has electrical problems, we consult the electrophysiologist.
Dr. KH Lim
If there are runs of PVCs. You are already in the right hands, you have an electrophysiologist who did the ablation. If not contraindicated, magnesium tablets do help in some people.
Good question. It depends somewhat on exactly what your symptoms are. Have you ever passed out? It also depends on how many PACS you have and how many of them run together. Have you had a King of Hearts study? I would assume that you have since you've seen an electrophysiologist. If your symptoms are severe and other heart disease has been ruled out (blocked arteries, blocked or leaky valves, then there are a number of medicines that can be prescribed by your doctor.
I hope this answer has been helpful to you.
I hope this answer has been helpful to you.
Yes I would be concerned!
Sounds like arrhythmogenic RV...!
Life threatening complex ventricular arrhythmias may correlate with this
Sounds like arrhythmogenic RV...!
Life threatening complex ventricular arrhythmias may correlate with this
PVC"s are generally NOT dangerous. IF you have "ventricular tachycardia", that is a different thing and could be dangerous. You need to discuss with your cardiologist.
It depends on the location of the triger focus of the pvc, with most pvc from right ventricle depending upon the location can be ablated. But usually thease can be suppressed with medication. These can become a problematic depending upon how many a patient has in 24 hour period and can affect heart function.
PVC could mean different things in different patients population. In a young otherwise healthy person , they could be very benign and should essentially not be treated if the patient is truly asymptomatic with absence of any underlying structural Heart disease. An Echocardiography study with an event monitor and lab work should be done to rule out thyroid abnormalities or any electrolytes abnormalities. On the other hand , there are certain uncommon conditions that can occur in young patients especially female , where there is a very significant number of these PVC s that can be very symptomatic with an increased frequency. RVOT tachycardia is one of those conditions that can be treated by a curative Radiofrequency Ablation of these PVC that can be arising from the Right Ventricular outflow tract of the Right Ventricle.
If you are otherwise free of symptoms and have a normal stress test without evidence of ischemia and the PVCs decrease,dont worry.if they drive you crazy try betablockers
Juan P. Montoya
Cardiothoracic Surgeon
PVC are extra beats that your ventricle takes. When they become symptomatic (which is usually when they are more frequent or have a bunch in a row) is when one should worry because you can go into whats called ventricular tachycardia which is dangerous. Having said that, if you are managed medically by an electrophysiologist (a cardiologist specialized in heart rhythm) then he certainly would know better than me how to manage as I am not a cardiologist and I don't treat these types of conditions. I am a cardiac surgeon. I am happy to help though in any way.
Maybe a second ablation will be necessary based on symptoms. I would ask your cardiologist. Hope this helps!
Maybe a second ablation will be necessary based on symptoms. I would ask your cardiologist. Hope this helps!
Julia G. Ansari
Cardiologist
If the burden of PVC (when you do a holter, they can estimate the burden of PVC) is >35% and you develop cardiomyopathy (heart failure) due to excessive beats, it is time to try to eliminate and attempt another ablation.
Assume you are a low risk individual, normotensive, non-diabetic with LDL below 70, I will recommend a maximal stress test. If it is normal , the most I will recommend is coronary CT calcium score. If it is blow 100, I will recommend Metoptolol succinate starting dose 25 mg po daily to keep resting heart rate at 65 beats/min.
I know these can be bothersome. Single PVCs are rarely dangerous. They can sometimes be related to other things (e.g., low potassium or magnesium). Have you had an MRI of the right ventricle to check for RV dysplasia? That is fatty displacement of the right ventricle and may be dangerous, requiring an implantable defibrillator. Beta blockers and calcium channel blockers may be useful, but many times they fail to control the PVCs or their symptoms. Also, consider the EP physicians may vary on their skill at ablating the PVCs (second opinion, especially at a known center, e.g., Dr. Andrew Epstein or Dr. Neal Kay - UAB).
Juan P. Montoya
Cardiothoracic Surgeon
PVCs can mean different things such as an electrolyte imbalance or a focal area in your ventricle that is shooting off signals. It can be something to not worry about, unless it causes symptoms or you have long runs of PVCs which means you can go into ventricular tachycardia, which is life threatening. Your best bet is to consult a cardiologist specialized in rhythm disorders (an electrophysiologist), that is his specialty. Hope this helps!
Naji Kholaif
Cardiologist
Depends on how many they are.. if they are less then 5000/day on medications and so far your Left ventricle ejection fraction is normal (EF) then it is unlikely to be a problem
You should ask your electrophysiologist since he knows the case and the
anatomy.
anatomy.
They are only of concern if your heart is diseased, low electrolytes( magnesium, potassium, calcium, liver, renal issues). Also, make sure no sleep apnea, or to deal with all your risk factors. If your heart is strong, PVCs are benign, but look into the above listed causes.
