Treatment options for PVC’s

Dear Ask The Doctor: I’m having an ongoing problem with PVC’s, currently over 20-25 a minute. It’s very uncomfortable and makes it hard to go to sleep, stay asleep, or get through the day without exhaustion. I was first diagnosed in 2002, and they pretty much went away in 2008, but have come back with a vengeance. I was diagnosed with Hashimoto's disease in January of this year, and have been on a low dose of Synthroid with no adverse effects for over two months. I had a stress echo done eight years ago to check for valve problems, and the doctors all tell me the PVC’s are “benign.” Inderal doesn’t give me any relief. Last week my PCP said they are probably stress-related, and I was given a prescription for Xanax, something I don’t want to have to take on a regular basis, besides the fact that it doesn’t seem to help anyway. Do you have any suggestions for relieving the condition, perhaps something my doctors have been reluctant to suggest or recommend? This has gone on for weeks, and is almost unbearable. I'm 5'4" and weigh 115 pounds, exercise regularly for back problems.

Dear Juliet: Provided that your thyroid function is well controlled and is not precipitating the PVC's the only options available are either medications such as beta blockers or an electrophysiology study and ablation. I would ask your family doctor to refer you to a cardiac electrophysiologist. It is sometimes possible to have an ablation for PVC’s; particularly if they are frequent and causing a lot of symptoms. The benefits and risks of this procedure can then be explained to you in detail by your cardiac electrophysiologist.