Heart & Cardiology/Pvcs

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Question
I am 39 years old with a long history of SVT that has been successfully treated for the most part with metoprolol 25 ER for the past 15 years. I had one episode of AFib a year ago after trying to decrease my metoprolol dose. About 4 months ago I started have frequent PVCs everyday, all day and all night. They have been documented on a holter. My last holter, which was on a good day with fewer than I've been having showed 300 PVCs with rare couplets, done bigeminy, trigeminy, etc. I know I have had runs if 3 or 4 consecutive PVCs in the past in rare occasion when under a lot if stress. I just had an echo that showed normal heart function with mild regurgitation.y cardiologist says they are benign but has discussed putting me on flecainide strictly for my symptoms. I don't want to go on something that will cause more danger than good. I think if I could just get my mind around the fact they are benign I would be okay. Do I have reason to fear them? I've read more than 6 per minute are dangerous, but I definitely have that happen, especially at night. What will keep me from going into ventricular tachycardia or ventricular fib?

Answer
Hello Christie,

PVCs, no matter how frequent, are normal heart activity, easy to understand as normal from knowledge of the heart's electrical system and occurring in about half of us.  They don't mean you have heart disease or will in the future develop heart disease or any cardiac catastrophe.  You need not feat them.k  Vtach and vfib will not happen.

Flecainide is safe in one with a normal echo and QT, and if petty effective in reducing PVCs.  Would help prevent SVT, too.  But I agree that you don't need flecainide unless the PVCs are too frightening.  

Heart & Cardiology

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David Richardson

Expertise

Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.

Experience

Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Organizations
Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Publications
Circulation, American Heart Journal, Hypertension.

Education/Credentials
M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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