PACs Very Annoying

[mullens41]

A little history I've had proxismal AFIB since 2016. Got a PVI ablation last November and knocked out the AFib. My problem is now I have persistent PACs. (Bigeminy). They are random but sometimes very bad. I was put on a precision monitor and showed thousands of them in a week. Flecainide Metoprolol don't help. My EP said it's only one or two bad spots doing it and he suggested another ablation. Got another ablation two weeks ago just too target the PACs. Of course for the hour and a half I was under anesthesia not one PAC! He tried adrenaline to get it to misfire, no bueno. That's the bad thing about PACs ... they have to be happening to ablate them. He said we could try again in 3 months, I know it was a simple procedure (in and out the same day) I'm not sure I want to go through that again. I'll just have to deal with it. Here reiterated that they are not dangerous in any way and I do not need to be on blood thinners. Anyone else have these annoying things?

[BobD Volunteer]

quite a lot. Try the deep breathing exercise we promote.

[mullens41 in reply to BobD]

Thanks Bob. I'm willing to try anything at this point.

[Hidden]

I have several thousand ectopics and PAC ‘s every day and they are very debilitating I really sympathise with you. I have tried many things without success but I have been reassured they will not harm me. Have you tried taking magnesium citrate that may help or look up Austin Goh on Utube he may also help. Unfortunately the more we worry about them the more prolonged they last.It may also be difficult but if you breath in for 5 seconds and then out for 5 seconds for at least 5 minutes that sometimes also stops them.

You can also look up Dr Sanjay Gupter a York cardiologist on utube who also gives a lot of advice on PAC’s, Ectopics and PVC’s

[mullens41 in reply to Hidden]

Thank you for the reply. I take 500 mg of magnesium taurate per day. What's so frustrating is these are so random. I can go two or three days with almost nothing and then I get hit with a days on and off all day. They wake me up at 5:00 a.m. almost every morning. My EP is just as frustrated as. He would love to to get rid of them for me. As I mentioned my latest ablation was really frustrating. It's like taking your car into the shop and they can't replicate the problem. And yes stressing about them does make them worse. Thank you for the advice about the breathing exercise I will certainly try it. Just knowing I am not the only sufferer is reassuring.

[Bob56 in reply to mullens41]

I have had AF for 30 plus years, but my PACs really only developed in the last 7/8 years. I had an ablation to alleviate the AF, which was largely successful, but nothing I have done has alleviated the PACs. My EP did offer the idea of a further ablation, but gave no guarantees unless the ectopics were constant and could be 'seen'. In a strange way I actually find ectopics worse than AF. Clinically we know they are considered to be benign, but unlike AF there is no proven way to help, and being benign don't rank highly on the priority list for research, intervention , new drug treatments etc.

Having said that I have, to a degree, learnt to live with them, and this in itself has had a beneficial effect as there is no doubt that stress and anxiety makes ectopics worse.

I pay a lot of attention to my diet, not so much what I eat, as when I eat and the quantities. Generally, like with AF, avoiding alcohol and caffeine is beneficial, but I also eat less at one sitting, avoid eating late at night, but also make sure I don't go long without a snack, as an empty stomach can kick off my ectopics. I tend to find that anything which upsets my digestion also tends to trigger ectopics, and I use indigestion medicine from time to time, but not every day by any means.

BobD mentioned the breathing exercises, and there is plenty of information online, including a whole book on the subject if you really wanted to go into detail.

I also take magnesium every day and as I am largely ectopic free right now, I am inclined to think it helps. Above all, I try to stay positive and whenever I do get ectopics, I usually involve myself in some activity to distract my attention. If I just sit around waiting for them to subside, they rarely do! Having said that, if they are really bad, in the thousands per day, I can't do anything, and I just have to hang in there

Understandably, AF, and issues surrounding AF, get most of the attention, and quite rightly, but ectopics are a curse and I long for the day when they attract sufficient attention from the medical fraternity to warrant serious investigation. Until then I think it's good that we compare notes and try and support each other. You are very much NOT alone!

[mullens41 in reply to Bob56]

Thanks for the reply and information. Yes they say there is a connection between the digestive system and PACs. I have tried to identify my triggers but I have been unsuccessful. These things come randomly and with no discernible pattern. I agree their benign nature puts them on the bottom of the research list. I got to the point where I'm just dealing with them as a fact of life.. A curse for sure. Sitting around is the worst thing you could do you are so right. In fact when I feel them coming on I run to the gym I do 30 on the treadmill. It makes me feel better to hit them square in the face. Thanks again.

[Sal55]

hello i just wanted to follow up, are you still having these pacs? Did you go thru another ablation?

[mullens41 in reply to Sal55]

The PACs have all but disappeared. It took 3 years and I'm also on low dose sotolol but I hardly ever get them anymore.

[Sal55]

wow 3 years! Thank u for sharing

[mullens41 in reply to Sal55]

Yea It's pretty frustrating but they do go away eventually. Even my cardiologist doesn't know why.