Are your Paroxysmal AFib episodes preceded by PACs?

My episodes of AFib are quite often preceded by PACs that seem to build up in regularity. I have learnt that if I can stop the PACs getting worse then my AFib is less likely to occur.

I've checked they are PACs with my Alivecor (at least with my untrained eye).

My PACs often seem to be related to what I eat or the state of my digestion in some way (Vagal?), or stress. Being careful what I eat and managing my stress helps a lot.

Does any else have PACs before the start of an AFib episode?

If so, what do you do about it if anything?

Also - I carry Flecanide 50mg PIP. When the PACs get quite intense I sometimes take one but should I take it then, or should I wait until the AFib is in full swing as it were?

What do others do that carry a PIP?


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16 Replies

  • Yes, if you have noticed that the PACs are a good warning of an AF episode it is most effectove to take the "pill in the pocket" flecainide before the AF starts. The other thing that sometimes helps is to go for a walk which can suppress the PACs and the AF - probably by suppressing the vagal nerve activity.

  • My episodes of PAF were almost always preceeded by ectopics and I was told by my EP that this was quite common.

    I had an ablation 18 months ago which at 12 months was deemed to be a success as I have had no AF episodes (apart from the first 2 week post ablation period) since.

    I do still get ectopics from time to time but so far (fingers crossed) they have not resulted in any AF.

  • Fantastic!

  • My ep said to take pip fkec 50mg when pacs get troublesome as they can trip me over into af so stop it before it does. Seems a reasonable suggestion to me.

    Hope you get things under control ongoing. Be well.

  • Sorry guys what does PAC Stand for.

  • Premature Atrial Contractions (PACs) are amongst the most common forms of arrhythmias. It is due to the premature discharge of an electrical impulse in the atrium, causing a premature contraction.

  • Is this also known as ectopic beats. If so I get a run of what feels like missed beats and then four in a row. I take a deep breath try to ignore them and told by cardiologist nothing to worry about. Not every day but if I am tired I think they are worse. On flecainide x 2 bisoprolol and more so pretty lucky now that it doesn't go marching off landing up in resuscitation. Thank you for explaining. Chris

  • A random online summary Chris - not my words.......

    Ectopic heartbeats are small changes in a heartbeat that is otherwise normal. These changes lead to extra or skipped heartbeats. Often there is not a clear cause for these changes. They are mostly harmless.

    The two most common types of ectopic heartbeats are:

    Premature ventricular contractions (PVC)

    Premature atrial contractions (PAC)


    Sometimes ectopic heartbeats are seen with:

    Changes in the blood, such as a low potassium level (hypokalemia)

    Decrease in blood supply to the heart

    Heart muscle disease (cardiomyopathy)

    Ectopic beats may be caused or made worse by smoking, alcohol use, caffeine, stimulant medicines, and some street drugs.

    Ectopic heartbeats are rare in children without heart disease that was present at birth (congenital). Most extra heartbeats in children are premature atrial contractions (PACs). These are almost always harmless.

    In adults, ectopic heartbeats are common. They are most often due to PACs or PVCs. Your doctor should look into the cause, but no treatment is needed most of the time.


    Symptoms include:

    Feeling your heart beat (palpitations)

    Feeling like your heart stopped or skipped a beat

    Feeling of occasional, forceful beats

    Note: There may be no symptoms.

  • Thank you very much for this knowledge is power. Chris

  • Same experience here - I have vagal paroxysmal af and all attacks are preceded by a pick up in pacs - this past week, I had a mini episode lasting 5 minutes or so that had been preceded over several days with pacs and I was sort of waiting/expecting the next shoe to drop and sure enough........ On this particular occasion, I was about to start shaving and when it started, I splashed cold water on my face and it stopped - I don't know whether cause and effect or coincidental but I ended up out of af and with water all over the floor - a small price to pay!

  • Yes I have the same thing, I quiet often get a few days of persistent ectopics that sometimes lead into an afib episode. I try to ignore them but it's hard and occasionally they get the better of me and my anxiety level goes up. My worse afib episodes have been preceded by a day of ectopics. Eating fast or drinking more than a few glasses of wine can trigger my ectopics.

    I sometimes hang back on taking my flecainide pip, it make me feel a bit odd so I prefer not to take it straight away. I'm on the waiting list for an ablation now, hopefully this will get me sorted!

  • For me I can sometimes stop them by lying down on my bed in the dark, putting on my Bose noise cancelling headphones on and listen to this.

    Quite often after about 20 minutes my anxiety drops and my heart settles down and starts beating in sync. Might be worth a try seems to work for me sometimes.

    Can't imagine it would work when I'm in full afib at 180bpm though!

  • Everything that people suggest is worth a try why not thank you.

  • I carry metoprolol pip...... I've also learned that when I've went into afib exercise brought me back to normal rhythm. I had an ablation procedure and it has been a blessing! Have pac's and pvc's as well

  • Yes, always.x

  • Yep, same here. It almost feels like AFIB is going to start but I seem to be able to stop it if I just relax, quiet my mind, breath slowly, deep breaths. Sometimes my significant other will start talking to me while I'm trying to relax and I can immediately feel the PAC's getting worse. I've had to ask her not to talk or make undo noise when she sees me in that meditative state.

    Also, I just posted my experience with probiotics which might interest you. See the post by Swisslegend.

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