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What Do Recurrent PVCs After Catheter Ablation Indicate?
Question: Hello Doctor , I'm a 23 year old guy and I have had a catheter Ablation for Benign RVOT- PVCs 10 - 11 months ago . I first got diagnosed with PVCs at the age of 16 but after some time they did not bother me until two years ago when I started feeling heavy heart beats and flutters at night , I went to the ER and I had PVCs on my ECG, later I met a cardiologist And I have had a normal Echo , Stress test , Bloods , and Cardiac MRI , they first put me on Beta Blockers but they failed , after it was anti - arrythmetic drug which reduced the numebr of my PVCs but did not stop fix the problem , I was having frequent 12 000 - 15 000 PVCs a day. After couple of months They offered me ablation and I had that done and it has been 10 months post ablation , so far I have had several holter Monitor Tests and they show isolated PVCs and PACs one time I had triplet PACs and and bigemany PVCs . I had my last Holter two months ago and the results were 6 PACs as 19 PVCs . 10 months after ablation and I still get Them daily , I have had days when I did not feel any but I have days like TODAY when I feel them and they are very very very scary , they feel strong and this is my first question what does make some of them feel stronger than others ??
having a sexual intercourse brings them on for me , why does that happen ? I have stopped having sex as I fear that I might upset or irritate my heart and cause mg arrythmia to return and by the way what is the chance of my PVCs coming back after 10 months of succesful ablation ??
Sometimws I also get them when bending down or laying on sides , eating . If the doctor burned some places in my heart during ablation where does these PVCs come from now ? PLEASE doctor try to explain this to me if you can it's not enough for me to hear ,, don't worry about them " as they scare me so so so much . Thank You !
having a sexual intercourse brings them on for me , why does that happen ? I have stopped having sex as I fear that I might upset or irritate my heart and cause mg arrythmia to return and by the way what is the chance of my PVCs coming back after 10 months of succesful ablation ??
Sometimws I also get them when bending down or laying on sides , eating . If the doctor burned some places in my heart during ablation where does these PVCs come from now ? PLEASE doctor try to explain this to me if you can it's not enough for me to hear ,, don't worry about them " as they scare me so so so much . Thank You !
Brief Answer:
Explanation
Detailed Answer:
Hello and welcome to HealthCare Magic! Thank you for your question. I am Dr. Meriton and I went through your query.
I am sorry for your condition. Radiofrequency ablation has a 75-80% rate of success, according to the statistics brought to us by various studies. It is not uncommon that there will be need for another process of ablations, especially when the subject is young and active.
Now, let us go step by step through your direct questions.
First, premature ventricular contractions (PVC) or, medically termed, extrasystoles, are used to describe the electrical impulse generated elsewhere in the cardiac muscle (in the right ventricular outflow tract focus, in your case) and not from the natural pacemaker of it (the sinus node). What happens next? Heart makes a short pause after the extrasystole to "reset" and let the sinus node take over and start doing what it naturally does. The heartbeat generated right after this pause is more forceful and this produces the feeling of heart jumping out of the throat or chest, shortness of breath - this is the palpitation.
Second, sexual intercourse is a form of moderate to vigorous physical activity, depending on the duration and intensity. I would like to point out that every human being experiences extrasystoles during life, but in benign amounts. They are triggered by physical activity, psychological stress, various neurohormonal changes in the organism that happen in a dayspan etc. To explain the other question, that these are also triggered when you bend over to tie your shoelaces, in this case, there are changes of the pressure within the ribcage, which happen while bending over, holding your breath, deep breath, or rolling on your bed while sleeping, and these changes in pressure trigger extrasystoles. It is almost practically impossible to "burn" all the foci of them, and with the next ablation you will again feel amelioration. The focus, I assume, is again in the right ventricular outflow tract. My opinion is that you should not worry and be scared, because there is a solution to this problem.
I hope I was thorough and clarifying with my answer. If you have follow-up questions, I would be happy to help. Just take it easy, be optimistic and good luck with the procedure.
Wish you a good health and best regards,
Dr. Meriton
Explanation
Detailed Answer:
Hello and welcome to HealthCare Magic! Thank you for your question. I am Dr. Meriton and I went through your query.
I am sorry for your condition. Radiofrequency ablation has a 75-80% rate of success, according to the statistics brought to us by various studies. It is not uncommon that there will be need for another process of ablations, especially when the subject is young and active.
Now, let us go step by step through your direct questions.
First, premature ventricular contractions (PVC) or, medically termed, extrasystoles, are used to describe the electrical impulse generated elsewhere in the cardiac muscle (in the right ventricular outflow tract focus, in your case) and not from the natural pacemaker of it (the sinus node). What happens next? Heart makes a short pause after the extrasystole to "reset" and let the sinus node take over and start doing what it naturally does. The heartbeat generated right after this pause is more forceful and this produces the feeling of heart jumping out of the throat or chest, shortness of breath - this is the palpitation.
Second, sexual intercourse is a form of moderate to vigorous physical activity, depending on the duration and intensity. I would like to point out that every human being experiences extrasystoles during life, but in benign amounts. They are triggered by physical activity, psychological stress, various neurohormonal changes in the organism that happen in a dayspan etc. To explain the other question, that these are also triggered when you bend over to tie your shoelaces, in this case, there are changes of the pressure within the ribcage, which happen while bending over, holding your breath, deep breath, or rolling on your bed while sleeping, and these changes in pressure trigger extrasystoles. It is almost practically impossible to "burn" all the foci of them, and with the next ablation you will again feel amelioration. The focus, I assume, is again in the right ventricular outflow tract. My opinion is that you should not worry and be scared, because there is a solution to this problem.
I hope I was thorough and clarifying with my answer. If you have follow-up questions, I would be happy to help. Just take it easy, be optimistic and good luck with the procedure.
Wish you a good health and best regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Doctor , Thank you for your answer ! When I had a follow up appointment with the Doctor who requested my Ablation , and also two other Cardiologists , they told me there was no need for another ablation with a few PVCs a day , they said the goal was to treat the focus that was throwing thousdans of PVCs a day , they also said that they almost never treat PACs atrial beats with ablation , one of them even said that going through second ablation might cause more harm than good , is that true ? I am doing everything I can to take care of my heart , I don't smoke or drink , I eat healthy Diet, I don't drink Sodas or energy drinks , I don't consume any Caffeine , However I started suffering from panic attacks and anxiety after I got diagnosed with arrhythmia but I am trying to take care of that problem too by going to the therapist two times a week .
My parents and my sister doesn't have these heart rhythm problems so I don't if this is somehow genetic . Here are my questions and I will be really happy if you can answer them for me .
How risky is second ablation and can you get it done with less than 100 PVCs a day ?
Where does the focus come from in heart ? Are you born with it ? Or do you get later in life from Viral Viruses , Hormonal chnages ? Stress ? And the last question is Can I take Magnesium supplement snd Amino acids Taurine and L-Arginine as Interner says these can stop irregular heart Beats . Thank You .
My parents and my sister doesn't have these heart rhythm problems so I don't if this is somehow genetic . Here are my questions and I will be really happy if you can answer them for me .
How risky is second ablation and can you get it done with less than 100 PVCs a day ?
Where does the focus come from in heart ? Are you born with it ? Or do you get later in life from Viral Viruses , Hormonal chnages ? Stress ? And the last question is Can I take Magnesium supplement snd Amino acids Taurine and L-Arginine as Interner says these can stop irregular heart Beats . Thank You .
Brief Answer:
Welcome back
Detailed Answer:
Hello again, XXXX! I am glad I was helpful in the first part.
I will try hard to address your questions, personalized to you. These problems are probably born, and sometimes there is not necessary to have other people in your family with your problem, because it is highly probable that a genetic mutation caused this. This is the case, especially in arrhythmic foci in the outflow tract in the right ventricular. As I am not the doctor who followed you up during treatment, understand my position that I can speak only theoretically. All the above factors, as physical activity and psychological stress, can cause extrasystoles even in healthy individuals. What about the second ablation? It is known that it is more risky than the first time, but if the arrhythmia is affecting your quality of life, as I can understand it does, then careful weighing between benefits and risks should be done, and if the expected benefit is higher, it is reasonable to undertake risks also. It is almost common that after ablation there are some foci, "hidden" ones, that are not subjected to ablation. PACs are totally harmless, while PVCs over 10.000 a day are considered abnormal and pathological. Indeed, magnezium helps stabilize the electrical changes and disturbances in the heart cell membrane, and it is widely used for this reason, and also to prevent malignant arrhythmias and to abate these phenomena. So, my opinion is that magnezium supplements can be used in your case.
I hope I was helpful and answered your questions. Should you have more questions, I would be happy to help. If you do not have further clarifications, close the discussion and rate the answer. Good luck and take care.
My regards,
Dr. Meriton
Welcome back
Detailed Answer:
Hello again, XXXX! I am glad I was helpful in the first part.
I will try hard to address your questions, personalized to you. These problems are probably born, and sometimes there is not necessary to have other people in your family with your problem, because it is highly probable that a genetic mutation caused this. This is the case, especially in arrhythmic foci in the outflow tract in the right ventricular. As I am not the doctor who followed you up during treatment, understand my position that I can speak only theoretically. All the above factors, as physical activity and psychological stress, can cause extrasystoles even in healthy individuals. What about the second ablation? It is known that it is more risky than the first time, but if the arrhythmia is affecting your quality of life, as I can understand it does, then careful weighing between benefits and risks should be done, and if the expected benefit is higher, it is reasonable to undertake risks also. It is almost common that after ablation there are some foci, "hidden" ones, that are not subjected to ablation. PACs are totally harmless, while PVCs over 10.000 a day are considered abnormal and pathological. Indeed, magnezium helps stabilize the electrical changes and disturbances in the heart cell membrane, and it is widely used for this reason, and also to prevent malignant arrhythmias and to abate these phenomena. So, my opinion is that magnezium supplements can be used in your case.
I hope I was helpful and answered your questions. Should you have more questions, I would be happy to help. If you do not have further clarifications, close the discussion and rate the answer. Good luck and take care.
My regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks again Doctor , Just want to ask one more question PLEASE ,I read online that chronic accurance of Ectopic foci can cause ventricular fibrillation ? Is that a risk for me ? Thanks
Brief Answer:
May be
Detailed Answer:
Hello again, XXXX!
There is always a possibility, however low, that the presence of abnormal numbers of PVCs can trigger malignant ventricular arrhythmias. The reason why is ablation carried out, followed with careful medical treatment, is particularly to prevent these arrhythmias from happening. I hope everything goes alright, and you will live a long and healthy life.
Good luck and kind regards,
Dr. Meriton
May be
Detailed Answer:
Hello again, XXXX!
There is always a possibility, however low, that the presence of abnormal numbers of PVCs can trigger malignant ventricular arrhythmias. The reason why is ablation carried out, followed with careful medical treatment, is particularly to prevent these arrhythmias from happening. I hope everything goes alright, and you will live a long and healthy life.
Good luck and kind regards,
Dr. Meriton
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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