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Ablation of ectopic beats

Since ectopic beats do not shorten life, the treatment of them, therefore, does not prolong life. Therefore in people who do not feel them, there is seldom the need to treat them. Usually the only reason to treat these extra beats is when they make the person feel poorly enough that they can not do their activities of daily living including work, exercise, sex, etc. The only exception to this is in patients who have many (usually more than 20,000 in a day) PVCs who develop a dilated cardiomyopathy. This is a very rare occurrence.

Options for therapy include trying to live with the ectopic beats and do all the activities of a full life, take antiarrhythmic drugs to prevent them, have a pacemaker implanted to increase the pulse rate and suppress the extra beats, or have an ablation to map out the site of origin of the beats and destroy it by burning (RF) or freezing (cryoablation). Ablation is usually only an option for persons with a single focus rather than multiple foci. Usually, effective therapy (either medications or ablation) will reduce the number of ectopic beats by a factor of about 100 (e.g. 5000 per day would be reduced down to 50 per day). The effectiveness of ablation is on average about 90% for PACs or PVCs. Any junctional ectopic beats that arise close to the AV node should be approached only with cryoablation, in my opinion.