Heart arrhythmias, most especially when we're acutely aware of them, are indeed anxiety inducing. I am an atrial fibrillation patient, although after the second of two catheter ablations, I am free of AF, now going on 32 months. But I was a long distance runner who became highly attuned to my body, and as soon as I would start fibrillating I would feel the anxiety and the thumping in my chest. It was awful. People told me I was looking distinctly grey in complexion. That's all in the past, at least for now (ablations for AF tend to last only a few years and then a second or third is needed, or the patient just has to accept living with it).

I don't know a great deal about PVCs, although I had a lot of PACs between ablations. I do understand that it's an electric disorder, and I believe certain electrophysiologists who specialize in complex cases of arrhythmia can deal with PVCs via catheter ablation. In the very worst cases, no matter what the arrhythmia is, they can nuke the AV node and implant a pacemaker. That's usually the last option, but it's not like there aren't one million Americans living with pacemakers today...and quite happily, thanks very much.

You should consult an EP at your earliest opportunity. The key is the anxiety, or generally the lack of quality of life. Often the specialists want to improve how you live if they can't formally address the defect or disorder and stop it dead in its tracks. AF, what I have, is a progressive disorder. I wouldn't be surprised to learn that PVCs are at least part of a progression toward a disordered heart (without having bothered to look it up, but you can). My point is to take concrete steps to stem the PVCs while you can, while your disorder is early in its stages, and that is what you would want to discuss with the EP. Your goal might be simply to stop the premature contractions, but ideally it's to help you to live more carefree, peacefully, and to sleep better, to live more happily, without the doom and gloom. Tell your cardiologist that you would rather deal with this problem aggressively to stop them from happening since they make your life so miserable. If he/she won't offer to refer you, seek out an EP on your own behalf. Then, visit yet a second EP and get that all-important second opinion. If they both jive, then you're probably on the right track in terms of what can/should be done.

Troponin is a protein indicating disrupted myocyte tissue. If it's above a threshold, it means the heart muscle is damage here, there, wherever and it needing to repair itself. My own troponin levels were elevated after spending a few hours in AF, but they weren't scary levels, only mild indications of some minor repair going on. I would suspect that aged hearts see higher and higher levels of troponin the more issues they have, but that's where I'm way below my level of expertise...which is near zero as a layman.

Last comment: you live in your own skin. If it is no longer pleasant, advocate on your own behalf to get crackerjack experts, even if you have to travel to the best ones, to intervene for you. Happened to me and to literally 10M other Americans (I'm Canadian) in the past five years, some of whom only need minor medications or lifestyle changes, some who need pacemakers, some who can have day surgery, an ablation, and be done with it for the next 5-10 years...or longer.