PVCs, PACs and SVT risks


Submitted by Dr T on February 22, 2013 – 10:22am

Hi Dr. T. I am a 45 year old woman with a history of PVC’s. I have had PVC’s since I was 17. Within the last month my symptoms have gotten worse-increasing palpitations, dizziness, shortness of breath. During one episode of sinus tachycardia I was taken via paramedics to the ER. I was placed on toprol 25 mg daily which did not help. I was placed on a 48 hour holter monitor and it showed PVC’s, PAC’s and 3 episodes of SVT. I have also had episodes of sinus tachycardia with my heart rate around 170’s. I attempted to complete a stress echo but could not finish due to an episode of sinus tachycardia. I have been started on diltiazem 180 mg day. I have always taken very good care of myself with low fat high fiber diet, exercise, no caffeine, no nicotine, no alcohol. Is diltiazem the best medication for my arrythmias? Is walking the best exercise to stay healthy? Will the arrythmias shorten my life expectancy?  What about ablation for my symptoms?

PVCs, PACs and SVT are all arrhythmias for which drugs like beta blockers and diltiazem are often used to reduce their  frequence and incidence.

If your heart has been proven to be healthy otherwise, any further treatment such as an ablation requires consultation with an EP specialized cardiologist.   An EP test will confirm whether there is an “extra nerve” as occurs in most patients with SVT. Whether you would benefit from an ablation depends on the findings, your symptoms and risks involving the arrhythmias, vs. the risks of treatment. 

Just remember this:

  • PVCs and PACs are usually benign
  • Most patients with SVT usually have a benign clinical course.  In other words, SVTs as a rule do not usually cause fatality.  However, in some patients when heart rate reach very high level (above 250 bpm) serious consequences can occur, including fainting spells and Sudden Death. In some cases, heart failure can result from chronic uncontrolled rapid SVT
  • Just because ablation CAN be done, it doesn’t mean it SHOULD be done. 

Heart healthy exercise usually requires more than walking. Of course this depends on how physically active you are otherwise.

Hope this helps,

Comments 2

  1. Post

    I had a failed attempted ablation 1 year ago now and my episodes just seem to get worse. I was referred to a specialist and they say that i am having constant pvcs ans well as pacs. But because i have only shown 2 episodes of svt that they wont attempt another ablation. The thing that they dont understand is that i have had to change my lifestyle, i can no longer jog like i used to everyday, ive been forced to quit my very physical job, and i cant even go to theme parks nor walked down a flight of stairs. It is very frustrating.

  2. Post

    I have svt also and heart arrythmia and pvcs my heart flip flops all the time i have an svt about 1 in 4 months i notice thats it gets worse during my period im assuming its hormones i get excercise..my heart doctor wants to do the ablation..all though it is tempting..the thought of being put into one untill they find the problem is very scary for me..i have always got the svt to stop by breathing exercises and holding my breath on and off it is very annoying my heart speeds and slows down for split seconds all throuvhout the day..its makes me very depressed..but then some days its like my heart is normal

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