Ventricular Premature Contractions: Surgical Options and Concerns - Cardiology

More Info

---

Ventricular premature contractions (VPCs) are a common type of arrhythmia characterized by early heartbeats originating from the ventricles. While many patients with VPCs may remain asymptomatic, others may experience palpitations, dizziness, or even more severe symptoms depending on the frequency and underlying heart condition. In your case, it seems that you have undergone catheter ablation (often referred to as "electric burn") to manage your VPCs, but you are still experiencing some breakthrough episodes.
The presence of ectopic foci, or abnormal electrical discharge points, in the epicardial (outer) layer of the heart can complicate treatment. It is important to understand that while catheter ablation is often the first-line treatment for VPCs, especially when they are symptomatic or frequent, there are instances where surgical intervention may be considered. Surgical options typically involve more invasive procedures, such as epicardial ablation, which may be indicated in cases where catheter-based approaches have failed or when the ectopic foci are located in areas that are difficult to reach via traditional catheterization.

The risks associated with surgical intervention for VPCs can be significant. These may include complications such as bleeding, infection, damage to surrounding structures, and the potential for new arrhythmias to develop. Therefore, surgical options are generally reserved for specific situations, such as:
1. Severe Symptoms: If VPCs are causing significant symptoms that impair quality of life and are unresponsive to medication or catheter ablation.

2. Underlying Heart Disease: In patients with structural heart disease, surgical intervention may be necessary to address both the arrhythmia and the underlying condition.

3. Failure of Other Treatments: If catheter ablation has been attempted and has not provided adequate relief, surgical options may be explored.

It is also worth noting that the rarity of surgical interventions for VPCs may reflect the effectiveness of catheter ablation in most cases. Many patients respond well to this less invasive approach, and the need for surgical options is relatively uncommon.
Your current treatment plan involving medications such as Dronedarone (臟得樂) and Bisoprolol (心康樂) is a standard approach to managing VPCs, especially when they are not causing significant symptoms. The 24-hour Holter monitor you are scheduled for will provide valuable information regarding the frequency and pattern of your VPCs, which can help guide further treatment decisions.

Feeling discouraged after experiencing breakthrough VPCs post-ablation is understandable. It is important to remember that treatment for arrhythmias can be a process of trial and error, and it may take time to find the most effective management strategy for your specific situation. Regular follow-up with your cardiologist is crucial, as they can provide ongoing assessment and adjust your treatment plan as needed.

In conclusion, while surgical options exist for treating VPCs, they are typically considered only in specific circumstances. Your current management plan with medication and monitoring is appropriate, and it is essential to maintain open communication with your healthcare team to address any concerns and adjust your treatment as necessary. If you have further questions or feel uncertain about your treatment options, discussing these directly with your cardiologist can provide clarity and reassurance.