Is Catheter Ablation for Mild PVCs Worth It? Risks and Benefits

Mild premature ventricular contractions treated with radiofrequency ablation?

If someone experiences premature beats (PVCs) only 2-3 times a week, is it advisable to proceed with catheter ablation? I want to eliminate the symptoms of premature beats entirely, and I'm wondering if this procedure can ensure that I won't experience them in the future.
Previously, I had 500-1000 PVCs a day, but now I manage them with medication, and the frequency has decreased to about once every two weeks.
Recently, however, I've been having 2-3 episodes per week.
Does this indicate a worsening of my condition? What can I do to completely eliminate premature beats? I'm concerned that these premature beats might progress into more serious arrhythmias, such as atrial fibrillation (AF).
Additionally, is mitral valve prolapse considered a structural heart disease? Is mitral valve prolapse classified as a heart condition? I would appreciate your help, as I simply want to avoid the sensation of premature beats and am considering surgery.
Thank you.

Mr. Gao, 20~29 year old female. Ask Date: 2022/05/27

Dr. He Dongjin reply Cardiology

Hello, is mitral valve prolapse considered a structural heart disease? Broadly speaking, yes, but it is generally not regarded as a condition that significantly increases the risk of severe arrhythmias from premature beats.
There's no need to worry too much; having 2-3 premature beats a week is considered mild and not indicative of deterioration.
If you want to eliminate premature beats and are considering catheter ablation, keep in mind that there are risks of surgical complications and recurrence, which may not make it worthwhile.
It would be advisable to consult with a surgeon in person for a discussion about whether to proceed with the ablation.
Peace of mind from Changhua Hospital cares for you.

Reply Date: 2022/05/27

More Info

Catheter ablation is a procedure that can be considered for patients experiencing premature ventricular contractions (PVCs), even if they are mild and infrequent. However, the decision to proceed with this intervention should be made after a thorough evaluation of the patient's symptoms, frequency of PVCs, and overall heart health.
In your case, experiencing PVCs 2-3 times a week is certainly less frequent than the previous episodes of 500-1000 per day, which indicates an improvement in your condition, likely due to medication. However, the concern about the potential for these PVCs to evolve into more serious arrhythmias, such as atrial fibrillation (AF), is valid. While PVCs are often benign, they can sometimes be associated with underlying heart conditions, and in certain cases, they may lead to more significant arrhythmias.

The risks and benefits of catheter ablation need to be carefully weighed. The benefits include a potential reduction or complete elimination of PVCs, which can significantly improve quality of life for those who are symptomatic. However, the procedure is not without risks. These can include bleeding, infection, damage to the heart or surrounding structures, and the possibility of developing new arrhythmias.
It's important to note that while catheter ablation can be effective, it does not guarantee that PVCs will never occur again. Some patients may experience recurrence of PVCs after the procedure, although many find significant relief. Therefore, it is crucial to have realistic expectations and to discuss these with your cardiologist.

Regarding your question about mitral valve prolapse (MVP), it is indeed classified as a structural heart disease. MVP occurs when the mitral valve does not close properly, which can lead to regurgitation and other complications. While many individuals with MVP do not experience significant symptoms or complications, it can be associated with arrhythmias, including PVCs. Therefore, it is essential to monitor this condition, especially if you are experiencing symptoms.

In summary, if you are considering catheter ablation for your PVCs, it is essential to have a detailed discussion with your cardiologist. They can provide insights based on your specific situation, including the frequency and severity of your PVCs, the effectiveness of your current medication, and any underlying heart conditions. They may also recommend further diagnostic tests, such as an echocardiogram or Holter monitor, to assess your heart's structure and function more comprehensively. Ultimately, the goal is to ensure that you receive the most appropriate and effective treatment for your condition while minimizing risks.

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