After several years of symptomatic and worsening Paroxysmal Atrial Fibrillation and Premature Atrial Contractions, I had a cardiac ablation in January 2021 that was very, very succesful - I would heartily recommend an ablation (sorry for that pun!).
I have had the odd, rare episode of Premature Ventricular Contractions since the ablation. I am very aware of them and find them quite horrible. I know that they are PVC's as they are easily recognisable on my Kardia, and by the cardiologist who saw the printout.
However as of the last month or so I am getting increasing periods lasting several hours where I am getting up to five per minute. I find it unnerving and impossible to sleep or relax when they are in full-swing. I had a similar period of them about a year ago (about 9 months after the ablation) and I was advised to go back on Flecainide (50mg, twice a day). They eventually settled and I have had none for about a year until recently. I am not taking any other prescribed medication.
I have been discharged from the cardiologist. At what point should I consult my GP? I had a bit of a battle with my GP who would not refer me with my AF - I ended up paying for a private cardiologist consultation, who was very good and suggested an ablation through the NHS.
I know my flecainide dose is faily low, bit I get the feeling my GP will simply suggest increasing the dosage. I am aware if the pro-arrythmic properties and feel a bit hesitant.
Are PVCs really as harmless as many advocate? Am I in any danger? I'd be grateful for anyone's advice or similar experiences.
Cheers all!
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Harmful NO. Anoying Yes. Have you tried the slow deep breathing exercise? Diaphragmic breathing down to six or less breaths a minute for at least five minutes. Works a treat when you do it correctly,
Hi BobD, and thanks for the reply. I do slow deep breathing from time-to-time (I also meditate frequently) but the PVCs no longer seem to respond to any calming measures I try... maybe I need to look again at my breathing technique. Thanks for the suggestion.
I just discussed this very issue with my cardiologist last week and we’re currently thinking of another ablation for the PVCs as they are too frequent and leave me exhausted sometimes. The AF ablation seems to have worked but these are just as draining. I seem to read a lot of people experience PVCs after an AF ablation, wonder why that is? Anyone know? Im told they’re harmless but more of a nuisance which can still impact quality of life but I’ve been told to focus on my mental health more also as that exacerbates them. Hope they settle for you.
@Bailey2004 Thanks. I've just had a really great week away with my family - lovely time spent with them, playing boardgames, walking, spending time with nature... all things I hoped would lead to some reduction in my PVCs but they have actually worsened over the past week. Thankfully I was still able to enjoy my time away, but I did find it frustrating that things were getting worse. I sympathise with you - they really are exhausting, both physically and mentally. I would happily go through another ablation if it looked like it would help. I'm keeping my fingers crossed that things will settle down soon. Good luck with your own!
I have no experience of PVCs but in your position I would bypass your GP and go back to your cardiologist of the last private appointment. Then discuss all the options. Clearly some change is required and increasing Flecainide may or may not work.
Since reading James Nestor's book 'Breathe' and listening to both him and Patrick McKeown on YouTube I have improved my breathing during the day and whilst asleep. I have also recently on my daily x2 walks started taking a deep breath and humming 'Ommmmmmmmm' - sounds weird I know but is known by Yoga followers etc and I understand the science is it improves the level of Nitric Oxide. In turn that seems to reduce my anxiety a tad and enable me afterwards to slow my breathing down to under 6 per minute. Good luck.
I had a cryoablation 18 months ago for persistent AF. Worked well, but suffered from constant regular ectopic beats ever since. 2 months ago, suddenly went back into persistent AF, and having another ablation. My consultant suspects that ectopics are due to reconnection of one of my pulmonary veins, eventually leading to AF again. 75% chance of fixing it this time!
P.s. AF actually less noticeable /more comfortable in chest than ectopics!
I have just the same. This past few weeks, they have gone away somewhat for some reason, thankfully. I get them daily still but the runs of them that you describe aren't happening for some reason (my fingers are crossed as I write this). I think that this cyclical aspect is in the nature of these things. I have digestive and diverticular issues and I could say the same about those.
I have been told that ectopic beats are almost always "benign" so you shouldn't fear them as they aren't weakening the heart or its valves as AF can do sometimes. The cardiologist I see now and then seems only concerned by AF. I feel similar whether in AF or when having the runs of ectopic beats and rely on the Kardia and my Apple Watch to guide me. I take only a bisoprolol when needed. I do think myself that they reduce the heart's output somewhat, as AF does, and this is what leads to feeling so fatigued and anxious when they occur so often and for an extended time.
I've had PVCs a lot years ago, and have always been told by doctors they don't need to be treated, and, yes they can be quite annoying. I'd suggest the breathing techniques that Bob posted.
I am not recommending one or the other idea, only recounting my experience.
AF started in one swoop for me in 2010. Lived with it when it was 4-8 hours 1/month, then increased to per week, then 1/ week and the episodes were 12-24 hours. Finally, I had 4 ablations in 2014, the last was successful until I had spine surgery and it was necessary post-op to take COX2 inhibitors. ARGH ... everything I'd avoided for years but for the surgery to be successful I took them. 6 months later the AF returned. Last ablation #5 was in 12/2021
Ablation 5 reduced what had become episodes of 1-2/ week, 24-35hours in duration and 160-220bpm... to half of those numbers - except bpm which stays the same.
On to the Flecainide... I tried daily and it was awful @50 then 100mg, hence the EP said I could do PIP. My EP and I believed after a year of Fleca that it had become pro-arrhythmic. Oddly after my last ablation, with the ongoing AF if I don't take the Flecainide the AF duration is 15-20 hours, if I do take it, 4-8 hours, and a lower bpm.
So hard to know, and in the end I just go with my instincts. Trying a last ditch effort here working with a Dr who has "cured" AF, a diet and medications - anti parasite and antifungals as well as NO Gluten, Sugar, Dairy or Alcohol. He believes these issues lead to an inflamed terrain.
Needless to say I am a bit grumpy these days and it is only Week 2!
The meds react so differently on everyone, at present I take Fleca PIP @150mg at the outset of an episode. Doesn't stop it but slows it down.
At the end of this diet, if it doesn't help, I am back in for another ablation. The last one was very complicated and he said he'd seen areas light up that he'd never seen before, even asked most of cardiologists in the hospital to come look! He said he felt he'd been in my heart too long and pushed too much adenosine to keep ablating and was aware I might need a retouch.
So, voilà... one AFibber/AFlutter's experience. I hope this one person's good and difficult experience with Flecainide can help you decide!
Thanks iris1205! It sounds like you have a plan of action and wish you luck. I am, thankfully, one of the lucky people who don't seen to experience any issues with Flecaininde. I used to use it PIP prior to my ablation (larger doses than my now twice daily 50mg) and, other han a little tiredness, did not get any issues other than it shortening my 'episodes'. Thanks for your reply, and good luck!
Hi busybody_yah. I'm a huge Magnesium fan and have been supplementing with it for many years - I think it was largely thanks to this that I 'lasted' so long as a 'paroxysmal AFibber'; beating the cardiologist's expectations by several years. I really do credit it with delaying the 'progress' of my AF. I cut back from 600mg to 400mg/day since my ablation 20 months ago (that's total actual elemental Magnesium) in a divided dose.
I didn't get any PVCs until several months after my ablation. Prior to my ablation I used to get Premature ATRIAL Contractions that would sometimes increase in frequency, clustering until they fkicked off a full AFib episode. So, for me at least, PACs were definitely harbingers of AFib, but the PVCs seem to be a whole different thing!
My first AFib episode was in 2011, when I ended up at A&E. "New onset AF with Hast ventricular response" was the diagnosis. Apart from the irregularity the rate was sometimes up in the 180bpm. After about 7 hours and no response to drugs, they were about 30 minutes from taking me down to start a cardioversion when a switch flipped and I was back in NSR... a heavenly feeling!
At a follow up with the cardiologist I was told that within 5 years or so I would probably be in full-time AFib but was given Flecainide to use as PIP. Needless to say, the research started and I managed to stave off 'full' AFib - only ever getting to the stage that I felt something other than PIP was needed in 2019. Apart from the Magnesium and some other supplement changes, I quit coffee and alcohol as these seemed to be triggers.
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