I'm in no way an expert and my symptoms are 1/8 of what you are experiencing, thus my "story" may not help. However, I too was diagnosed with PVC's (about 9,000). On top of that, I had serious sinus problems & finally had sinus surgery which cured much of my sleep problems. Sounds odd, but you might check into that because after my sinus surgery, MANY of my previous health issues vanished (I had major sinus issues; bacterial/fungal infection/polups, etc.).
Back to the heart issue. I am 44 yr old, 180 lb. and "used" to exercise a lot, but haven't done much at all in the past 15 yr. I don't smoke, drink a few beers now/then and 4 cups of coffee/d. I am overly cautious about any meds, so much that it took me many discussions with my Heart doc, a few more with a cousin who is a "brain" at Duke (heart doc) to finally try metotoprolol after diagnosed with PVC's. The 1st night of taking 25 mg pill (this is after my sinus surgery), I slept better than I have in 20 years. It was life-changing. However, you want to make sure that your blood pressure doesn't drop too low; mine never did (min. of 110/60 or so). I am not taking toporol sporadically and only 1/2 pill at a time. Was told that I could take it like tylenol; just when needed vs. every day.
Hope something in my story helps you out. I've been extremely lucky over the past 3 yr "side-stepping" malignant melanoma, getting my sinuses cleaned out, and no issues with PVCs other than discomfort at times. Travis.