Isolated PSVTs post ablation for WPW

[IPSVTs]

I was diagnosed with WPW and had an ablation done 11 years ago.  I am now 43.  My doctor told me at the time that he had difficulty with the procedure due to several pathways and that it was probable that the WPW would reoccur in the future.  He said it was only 75% sucessful and put me on a beta blocker which I did not tolerate and stopped taking.  The PSVTs never fully stopped and the number of times they occur has gradually increased over the years.  I am now at the point that I have an episode several times a week which lasts for under 10 beats and I have frequent isolated (one beat) PSVTs (over 1000) daily.  They are strong, hard beats.  I notice them and they are interfering with not only my quality of life but also my state of mind.  I am already under a great deal of stress (mostly financial) and no one needs to tell me that stress aggravates this syndrome.  It does!  I am also a smoker and have been trying to quit, repeatedly over the years, but now extremely seriously and have found that when I do (my record is now two months)  this also aggrevates the syndrome.  I get worse when I quit.  When I have even just one cigarette, the isolated PSVTs don't happen as often.  I am looking for a cardiologist/electrophys.  to consult because I moved back to my home country.  I know this is going to be difficult.  Any advise from any EP doctor would be greatly appreciated.  I had another 24 hour Holter done which showed 1432 iso-PSVTs (max. 233/hour).  What other tests should be done, what specific beta-blockers or CC blockers should I research?  What's the deal with the cigarettes?
Thank you for your assistance.

[ireneo]

By any chance do you mean PVC's when you said "frequent isolated (one beat) PSVTs daily"?  

I'm not sure what your doctor will decide. I've had 3 ablations and still have brief PSVT episodes (less than a minute). I had 2 yesterday. I also PAC's and PVC's sprinkled throughout the day. But the cardios feel this is an improvement ant the brevity of my tachys will not cause any harm. So I'm finished with procedures. My heart is also structurally normal at this point so there's no concern.

You could try medication if the symptoms bother you very much. I had to go on a CCB recently because I was going to have surgery. They wanted my heart to be as quiet as possible and anesthesia tends to stir things up. I'm still on it (not because I like it) but because it stopped my chest pain. I still have some tachys and ectopics. This will be a decision between you and your doctor.

[sueinns]

This is the community forum.  From your post, I'm not sure if you intended it for this or the doctor forum.  You could post it there as well and see what the doctor has to say.

RE: Smoking:  As you pointed out, stress aggravates arrhythmias.  Quitting smoking is very stressful so initially the palpitations could become worse.  A friend of mind (heavy smoker of 2 packs a day) quit cold turkey and didn't feel well until almost a year later.  All those toxins that you have depended on are leaving your body and there is bound to physical and psychological reactions.

11 years is a long time and the procedure has improved immensely since then.  Hopefully if you have the procedure done again, they will be able to ablade the rest of the sites.  

[IPSVTs]

Thanks to both of you for your advice, I am still trying to locate a doctor in my country.  I've also been trying to contact my previous doctor, but his website doesn't give an email address and I emailed the hospital he's affiliated with and haven't received a response from them yet, (doubt they will).  

RE: Smoking, I hadn't thought about the initial additional stress factor.  Thanks for that point of view.