Hello everybody, hope you’re all as well as can be, 10 months post 2nd ablation and over a month ago came off of flecainide, still taking bisoprolol and apixaban. I spoke to my ep last week and said all was well was having some bumps but felt the ablation was blocking them quite well, hunky dory we both thought speak in six months. Since last Tuesday whenever I eat the ectopics are coming thick and fast. Anyone else had this trouble and do they die down? I was hoping to be off all meds and sorted by now, oh well.
Many thanks Alex.
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Achant1
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Try the slow deep breathing. Breath from diaphragm not shoulders.Pull down as far as possible and then squeeze up till your stomach touches your spine. Slow to 6 or less breaths per minute for at least five minutes. Practise regularly. It really is easy if you work at it and one can get even slower after a while. Works a treat most times. Think my best was 18 breaths in five minutes.
Thanks Bob, im waiting to hear back from the Af nurse as my heart rate was at 45 the other day normally 57. I think this may have something to do with it, as when I’m up and about my heart is absolutely fine.
I think you will find it’s a common experience but they are very uncomfortable.
Breathing techniques help, eat small meals more often, eat slowly and sip water.
They do eventually go away as long as you go slow & gradual & don’t poke the beast but could take months, about 9 months in my case but hopefully sooner for you.
Thanks for replying, this Af game really is a stinker, I try my best to be positive but it has a way of sweeping the rug from under your feet, doesn’t it?
Sorry about the ectoopics but why are you still on bisoprolol? You said the ablation was a success and you're off flec and obviously the bisoprolol isn't helping with ectopics. But even it it was, if I had a choice between having no ectopics and being on a beta blocker vs having ectopics and not being on a beta blocker, I'd choose the latter in a heart beat.
Beta blockers just don't agree with me -- and in general ectopics, within reason, are more of an annoyance than a serious medical condition. I would ask your doc to take you off bisoprolol unless he has a convincing reason to remain on it.
Ectopics for me when I had AFIB ( had an ablation 7months ago) were more troublesome than the AFIB . Also coming off beta blockers needs to be done very carefully. For many people beta blockers are very useful.
I’m trying to come off them but 7 months after my ablation I’m having difficulty doing so,
I was on flecainide first time round and came off after 8 months. This time it’s been ten months, stopped flecainide, still on beta blocker, once these beats settle down I will come off them, it’s always best to speak to your ep before doing anything.
I had a ablation2 in Nov 2020 and since then only sinus rhythm. But like you ectopics can really be a pain . My steady/ normal state is one or two per 100 beats and I have that 80-90% of the time but occasionally , and I really can’t pin a trigger or triggers I have sessions of more than an hour of really bumpy ectopics both pvc and pac that make me feel unsettled and heart obsessed.
After the last lot I paid for a consultation with my EP and he read the Kardia traces I took.
He stressed this was not likely to by dangerous but understood my anxiety.
His advice was for me to try to lose weight ( I put on 18lbs after my ablation, and to eat my last meal of the day a bit earlier ( 7.00pm rather than 8 )
Early days but 6 lbs down and smaller earlier dinners have certainly not done any harm.
I expect your oesophagus is pressed ab]gainst your heart and when you eat the direct irritation Sts of ectopic beats; either that or the act of eating brings the stomach higher to press against the diaphragm, using that onto the base koi the heart with much the same effect. Both are normal effects but when ectopics are the result, then AF can be triggered. In your case, the ablation will have stopped this response, so the ectopics will remain just that - safe palpitations. With luck!
Since my ablation for flutter in 2019 I get a lot more ectopic beats, including long bouts of them. As you say, they are not pleasant things to cope with, increasing anxiety. I hope yours die down as I expect they will.
One's heart never seems to surprise us with new tricks.
Mine has learned a new one recently.
Everytime my heartbeat drops from its normal of 60 to 43 then it feels like an invisible hand is squeezing my heart giving me a tight and somewhat painful chest with palpitations.
This time I caught it on my Kardia. Bradicardia with no P waves. This may be AV Junctional Rythm where the beats arise from the AV Node rather than the Sinus Node. This is normally the "escape beat" when the heart stops beating or beats too slow.
I suggest you check your ecg when your HB drops too low and you have This uncomfortable feeling.
Thanks for your reply, my heart has a fantastic way of never doing anything wrong when I wear a tape or use my Kardia 🤣, obviously except when I’ve had full blown Af attacks.
Hi, You have already had some helpful replies, so I will try not to repeat too much. Ectopics are indeed a real bug bearing in some ways worse than AF. I have suffered from both for many years, culminating in an ablation approx 7 years ago which has largely got my AF back under control.
Sadly the ectopics which could be bad before the ablation are arguably worse since the procedure. I can easily get 10,000 over a 48 hour period, then none for days before they return. They are almost impossible to predict and unlike AF, I have no tried and tested ways to alleviate them.
I think the fact that they are generally considered benign is ironically, our biggest problem.
Cardiologists don't really focus in on them as they do with AF, and if I went back to my first diagnosis for AF, and then later ectopics (mainly PACs) the former has changed quite a bit in terms of how the profession treats them whilst the advice I get re ectopics doesn't seem tohave changed much at all in the last 20 years.
Like many people, the ectopics make me anxious, and the anxiety makes the ectopics worse. It's a horrible vicious circle. I think any form of relaxation, meditation, deep breathing etc will definitely help, but it's getting into that calm state first of all which is the challenge.
I have had some real meltdown moments when the ectopics have been bad, and I have to work really hard to keep myself on an even keel. I would love to see more research in this area. For now, few EPs are keen to ablate for ectopics as they don't have the same level of confidence that they have with AF.
Flecainide and beta blockers can help, but have never been the solution for me. Like many I take magnesium as a supplement, and I like to think that helps in some way. I eat smaller portions and more regularly, as I find an empty stomach can be as ectopic inducing as a full one. (yes, life isn't fair!!).
The best we can do is to share notes like this, offer each other support and pass on hints and tips that might have worked for us over the years.
Some cardiologists like Sanjay Gupta up in York are very interested in ways to alleviate ectopics and post many helpful videos. I hope others will build on this to give us all the help we need with this insidious condition.
Thank you very much for you reply, ectopics are so aggravating and like you say anxiety inducing, I don’t seem to get many when I’m up and about, before my first ablation they used to be huge and take my breath away, like my heart had turned upside down. I did take magnesium and when I finally come off the beta blockers I will again, my resting heart rate is 57 but sometimes goes below 40 when I’m asleep.
Yes, I'm similar. My resting heart rate is around 57/58 but I know it goes much lower at night, and your bed can be a lonely place with ectopics kicking in. I have just fixed my umpteenth 24 hour ECG to take a look at them in action but, as I know, on the day it can be just like taking your car into the garage with a mysterious rattle. They never find it!
Of course what they do even if the burden is significant is the big question. I wouldn't entertain another ablation lightly, and would like greater reassurance that they can be eliminated or reduced before going ahead.
I don't see many examples on this forum of people who have been ablated for ectopics, and if they are out there it would be interesting to know how they got on.
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