Daily PACs about 2 and a half months post ablation

[Golf1515]

Hey folks. Just wanted to see if anyone else had an uptick in the number of PACs ? I had my first ablation for Paroxysmal AFibb on May 9th. Technically I’m still in the “blanking period “ I guess. Had some bumps in the road along the way up to now but the worst of it are the number of PACs I’m having. It’s almost as bad as the Afib. Anyone ever taken a low dose Flecainide daily to help? It’s miserable and I’m thinking that might help

2nd question- is it possible for things to settle down even after the 3 months. I know that time frame is the widely accepted time frame to judge a successful procedure. I’ve had no Afib but as I said the extra beats are awful.

Sorry for the lengthy post but man I need some feedback from the helpful folks like this community.

Thank you!

[HiloHairy]

My ablation was on April 20th.

After a month of nearly permanent afib I had only one afib event which was eight days after the ablation. Since then, I've had what I think of as ectopic beats at least three times a week. I think they're slowing down now even though my cardiologist has taken me off metoprolol, deltaism and the blood thinner Pradaxa leaving me only on Multaq.

What's concerning me mostly is that while my heart rate at rest previously had been in the low 50s it's now in the mid-70s and while my aerobic exercise heart rate used to be at 110 it's now in the upper '80s.

I'm still hopeful this will all work out in time.

[CDreamer]

Yes it is common to have Ectopics after ablation. Mine went on for about 9 months but did settle eventually. Yes, they made me feel even worse than the AF on bad days. I found exercise or over exertion (even though I thought I was taking it slow) the main antagonist but stress and stressing over having the Ectopics is up there.

Try the LSD method of breathing - that’s Long, Slow, Deep breaths - reduce your breathing rate to 6-7/min. Practice every morning and evening and make it automatic that’s your go to protocol when Ectopics start up. Try Mindfulness Practice - anything to calm the Monkey Brain as a relaxed brain and body = much fewer, less symptomatic Ectopics.

HR tends to stay high after ablation I’m afraid. Mine rarely goes less than 75 whereas pre ablation = 60-65 resting and 120 exercising.

Take care, still very early days and remember that Ectopics mean that although your heart may be wanting to go rogue, it isn’t and that over time they will reduce and eventually disappear.

[Ppiman]

I think doctors allow twelve weeks for healing and 'maturing' of the scar tissue, but a large study I read showed that much longer seemed the case. In that study, by two years most patients were still free of arrhythmias.

My own experience is that the number and frequency of ectopics have increased following my ablation (in June 2019), although variably. My doctor calls them 'benign ectopics'. I imagine we are all different and it will depend upon the root cause of these beats. For me they are disturbing and uncomfortable and occasionally progress into AF, which feels little different. If I get a racing heart with them (100-130bpm), I take 1.25 mg bisoprolol, which helps all round.

Here's a small part of a recent Kardia trace showing a typical run of them:

Steve

Kardia ECG trace showing ectopy

[JoseT]

I had also PACs after my ablation this May and turned out i was low in Potassium. I am taking every day electrolytes and having now <1 % PACs according to the holter.

yes, fleicainide usually stops PACs but make sure your electrolytes are on balance.

[Coco51]

Can't add much to the above but yes I had them and still have days when they come back. Hope yours improve.

[Sal55 in reply to Coco51]

how long ago was your ablation?

[Coco51 in reply to Sal55]

I had them in May 2016 and September 2017. But my symptoms honestly don't bother me much any more. Maybe I have got used to them, but I feel them less.

[Sal55 in reply to Coco51]

how long would you say it took you till it didnt bother you anymore?

[Coco51 in reply to Sal55]

Hmm...now you've made me think. It's been complicated. I had a very rough recovery period lasting 4 months and thinking the 2nd ablation had failed. So I went back on Flecainide and after that had a good year with hardly any trouble. So much so that I came off Flecainide. But my heart went a haywire, so went back on Flecainide again. Unfortunately I was still having PACs and AF again though not so often or intensely as before the 2nd ablation. Then I really worked on my stress levels and saw a psychotherapist who taught me self hypnosis. That was 2018. Since then I have been less troubled. Something seemed to change in my attitude and the way I thought about it. So now, when the PACs return (often stress is a trigger, and once a wasp sting) I use the breathing and self hypnosis techniques if I need to. But usually try to ignore them So I guess the short answer is it took about 16 months to get into my current frame of mind. Sorry - is that too much information?!

[Coco51 in reply to Coco51]

I should add that I had persistent AF i.e. non stop for 5 months before the first ablation and that is notoriously harder to treat.

[Sal55 in reply to Coco51]

oh wow! Thanks for sharing and no, its not too much info. I am praying day and night for these PACs to go away. I do stress a bit more than the regular person too

[Coco51 in reply to Sal55]

I think we all stress a lot! It's easy to get into the frame of mind where you're waiting and worrying for the next wonky heartbeat. Even so Flecainide does help definitely. And I also take Magnesium Taurate - 1 per day - and 500mg of vitamin c. I really think they help too. Magnesium drip is one of the A&E treatments for AF and vit c is anti inflammatory. But the psychological help has been the best, and giving it time to settle. Good luck.❤

[Sal55 in reply to Coco51]

flecainide made me feel terrible. Like i was doing heavy doses of dope. Are you still on it? And how long it took you to adjust?

[Coco51 in reply to Sal55]

Took a while - a good few months. I know what you mean. The combination with the Bisoprolol at times makes me feel sluggish. I had a bad stomach with it initially too. But on a second try it worked so well on controlling the heart that I persevered. Before I had the ablations it didn't have such a good effect. Mind you, I think the Bisoprolol is worse. Yes I am still on both of them but feel my quality of life is good. I am 71 and walk a lot. Trying to work at fitness a bit more.