A cardiologist says that if you have thousands of PVCs but a normal echo, you should get an EP test for a possible arrhythmia.

If you have PVCs (premature ventricular contractions), you may have developed an understanding along the way that these “skipped heartbeats” are benign as long as your echocardiogram is normal.

“Just because the echo is normal, that doesn’t mean that the person does not have bad coronary artery disease or a PVC focus that is causing all the PVCs,” says Dr. Sameer Sayeed, MD, a cardiologist at ColumbiaDoctors of Somers, NY.

Coronary artery disease can cause these “skipped heartbeats,” and an echocardiogram cannot detect or evaluate plaque buildup in arteries.

Other tests can evaluate for the existence of heart disease or assess heart disease risk: coronary calcium scoring, and the CT angiogram.

“If there are many thousands of PVCs, the patient’s coronary arteries should also be evaluated,” says Dr. Sayeed.

“If they are normal, then EP testing should be performed to determine if there is a PVC focus and if it should be ablated.”

An EP test is an electrophysiological exam of the heart to see if there is a rhythm disorder. It takes about three hours.

“When there are excessive PVCs, the heart is at risk for an arrhythmia or weakening of the muscle [cardiomyopathy] due to the excessive stimulation by the excess PVCs.”

Dr. Sayeed performs echocardiograms and stress tests at the Midtown Manhattan and Westchester offices at Columbia Doctors. He is also trained in cardiac CT imaging.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  



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