Heart & Cardiology/PVC Question


I have a history of PVCs and I understand that they are common and benign.  I think the most I've ever had is about 10K in a 24 hour period.  I've tried several antiarrhythmic drugs (flecanide, amiodarone, rhythmol) before deciding to go another route after my cardiologist explained the risks to me (I was in my mid-40s at the time).  Aside from the risks, the drugs never worked for very long - my body adjusted to them very quickly.  I've had 2 unsuccessful ablation attempts in which the doctor wasn't able to locate the source of the issues.  After the last one several years ago, I decided to learn to live with them.  

Three years ago I was hospitalized for a suspected stroke and at the time, they discovered by my heart rate was very low.  In doing the workup at that time, I had every test you could possibly think of on my heart and they found that it was structurally sound.  Fast forward to today.  I went to see my primary about a month ago and she was concerned because she heard a pause and my heart rate was log again so she decided to do an EKG. As usual the PVCs showed but and she wanted me to see my regular cardiologist.  To be honest, I forgot to make the appointment.  I know that I have PVCs and that they are benign so I work really hard to ignore them, and when I can't, to grit my teeth and get through them.

Anyway, after a particularly bad dizzy spell, I remembered that I was supposed to see the doctor.  My cardiologist did the standard holter monitor.  I went back today for the results and was surprised to hear that I am having bigeminies, trigeminies, quadrigeminies, v-tacks (sp.?) and episodes of repeated PVCs.  My doctor said that they recorded 14K incidents which is more than what I had the last time I did the holter monitor a few of years ago.

Since I try so to hard to ignore these and my cardiologist told me I was sound, I was a bit unnerved that she is sending me back to the arrhythmia doctor and suggesting that I may have to try the meds again.  She told me something has moved to a moderate category now.  

I'm 51 years old, 5'3 and 165 lbs.  Although I have rheumatoid arthritis, high blood pressure and fibromyalgia, I think I'm pretty healthy.  I watch what I eat, exercise regularly (even through my dizzy spells).  I rarely eat red meat (maybe a few times a year), don't drink and I strictly monitor my sugar intake.  I had bariatric surgery almost 4 years ago, lost 85 lay s. and have kept the weight off.  I have one cup of coffee (1/2 caffeine) most weekdays - that is the maximum caffeine intake.  

I'm on 3 blood pressure meds:  carvadilol, losartan and amlodipine.  Otherwise, I take thyroid medication (stage 1 papillary cancer 5 years ago, cured today).  Multivitamins and calcium daily.

If PVCs are always benign, why do I need to do anything about them?  What is a v-tack?  How do PVCs relate to my dizziness?  She specifically said that my dizzy incidents are most likely related to the PVCs.  Is there anything I can do myself to make this better?

I'm sorry this is such a long note and I thank you for taking time to respond to me.

Hi Rhonda,
If your dizzy spells are related to the PVCs they are not benign and should be treated, which is why you need to return to your EP cardiologist for further evaluation. I cannot judge what is needed from her, unfortunately.
Hope this helps,
Dr T

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