had a PFA ablation almost three weeks ago. First week was ok, the odd ectopic, but now the ectopics / palpitations are happening almost constantly, worse after food and at night when lying down. Doctor tells me things should settle down soon. Doesn’t feel that way right now! I take bisoprolol and flecainide low dose daily. Also have PIP for really crazy episodes. Should I persevere without requesting further treatment or perhaps cardioversion? Should I bother my local a&e again when the ectopics are raging? Last few days even moderate exercise, usually not a problem for me, has become uncomfortable. Also I have a moderately stressful job, am I supposed to withdraw to a darkened room for 3 months until these palpitations stop?? Sorry to sound frustrated, but I am.
2 weeks after ablation - ectopics goi... - Atrial Fibrillati...
2 weeks after ablation - ectopics going a bit crazy!
Maybe not 3 months but it sounds very much as though you are doing too much too soon. Keep reading the fact sheet on recovery and doing the slow deep breathing exercises. Start worrying in six months if things are not better by then.
What’s too much? My Doctor didn’t tell me to take 3 months off, or stop my gentle daily exercise. I’m trying hard to take it easy, not let any stress in, working part time and not travelling with work at all since last October; however Im not yet financially independent and cannot divorce myself totally from work and life itself…or maybe I should for 3 months at least?
I’ve had 6 months of ectopics since my ablation for AF last April and had unsuccessful ablation for ectopics 11 days ago. I too have stressful job so I’ve finally made decision to take a couple of months away from work to see if they finally settle as it is draining. Doc told me to really try focus on my mental health as he believes that will have major impact. Hope yours do settle quicker than mine have.
Sorry to hear yours have not settled yet. I’m pretty sure there is a connection with anxiety and also the gut. You have to laugh though, how can you NOT get anxious when you know your heart is not beating as it should? I hope you get some relief soon, all the best to you.
Hi there, I'm sorry to hear that your ablation for ectopics failed. I'm interested to know why. May I ask were they PACs or PVCs and why did the ablation fail?
both PACs and PVCs several thousand a day but for some reason they couldn’t be triggered during mapping and instead the high does of adrenaline induced my AF so needed cardioversion. He believes now that even if he did manage to ablate they would just pop up elsewhere so would be case of chasing them forever to try and ablate. Took me off bisoprolol to increase heart rate to see if Flecainide worked better on its own when heart rate was faster. So far looking promising as not capturing as many these last couple of days but I’m also working really hard with anxiety doing yoga and meditation. BP still a bit up at 145/76 but hoping that will come down soon.
OK, were they multifocal or unifocal PVCs? They say multifocal PVCs are harder to ablate.
yep multifocal, agreed not to put me through another ablation attempt any time soon and see if can get it controlled with change in meds and looking after mental health.
Ah, I thought so. That does not necessarily have to be the end though. You can pursue this further if you want to. Ablation technologies have advanced to the state where MF PVCs can be successfully ablated in some cases. The problem is that not all EPs have had the training and don't have the expertise to do it successfully. You see, there are EPs and there are EPs! Some of them are at the very cutting edge of their profession. If you can find one of those your chances of successful ablation and long term relief from symptoms are considerably improved. Just my opinion. I wish you well.
Hi Mike where are the good EPs I have had 2 ablations for ectopics not sure whether they have made them worse but now I get massive pain across my chest sometimes when I get ectopics, I feel its like heart attack pain, it stops me breathing ,not all the time but on a daily basis, the EP has basically washed his hands and just told me not to do anything when I get the pain! Also I have become very breathless since going on Flecinide and Nebivolol I had a CT scan of the heart 1 month ago and all seemed normal, where do I go from here? Does anyone experience severe pain with ectopics?
I'm really sorry for your pains Greg35. May I ask what type of ablations you had and did you have PACS or PVCs?
I think it was RF ablations as the EP said he burned away for 6 hours! Didn't tell me what he burned but I think I have both PAC and PVCs really has ruined my quality of life although the meds have helped to a certain degree just wish there was something other than ablation as the EP did say ablations don't work well for ectopics! So meds it is!
OK, can you please confirm that you did not have these pains before the ablations? Are you absolutely sure?
Yes Mike I did have pain very occasionally when stressed or very tired but only once maybe every 6 months now its daily or when I have a virus not sure whether it was due to the ablation the meds or maybe my heart was just deteriorating but it has really limited my life, I don't think I have heard of anyone with this spoken to 4 cardiologists and they have never heard of this either, can't believe I am the only one that has this, anyone has any experience of this I would love to hear from them, thanks
Hello greg35, you might want to have a test done to see if your pain is "chostochondritis". I have had it for 50 year's and at times it feels like I'm having a heart attack but I'm not' After many, many visits to the ERs and amassing all the information I can from Drs. that when it flares up it's painful to inhale or exhale but as long it hurts when you press on the area where it hurts and it is painful it is not a heart attack it's the inflammation of the cartilage, which is around the sternum and rib cage, very painful at times and no telling when it will. One good thing though it is not life threatening just painful. Hope this helps. GOD Bless!
Thank you for replying kocoach, but I really don't think it's chostochondritis as I only get the pain with an ectopic beat its a huge pain but only lasts a second when the ectopic beat hits me, it is very frightening and EPs have no idea why I am having this and I never know when I am going to take it sometimes it happens when I am sitting down, no rhyme or reason! but until I know what it is I have no way of trying to research it. Many thanks Ingrid
Bob please can you share the links for the factsheets, many thanks !
Bob, where can i find the deep breathing exercises please. 3 months post ablation having a bad bout of arrhythmia, but also have a chest infection and taking antibiotics and steroids, so not sure what is causing what, but tried some deep breathing last night - it didn't work so not sure I did it correctly. Many tks
Lay on your back in a comfortable place with arms at your side. Breath in slowly using your diaphragm not your shoulders , pulling your stomach down as far as you can. Hold for count of two . Push your diaphragm up as far as it will go to exhale. pulling your stomach as tight to your spine as you can. Slow your breathing down to no more than six breaths per minute (my bests is 4 ) and do this for at least five minutes , longer if you can. Simples.
A similar exercise is used by US Navy pilots to get to sleep on aircraft carriers I'm told.
Many tks, not my technique last night -will give it ago
sorry to hear of this
What can I say
I myself have done four ablations none have worked now I am going for other solutions to become AFIB free fortunately there are many mini maze procedures with good results search and find out but please if 1 or 2 ablations haven’t worked then go for something else do some searching good luck
Seriously you are doing moderate exercise within 3 weeks?? This might be contributing to the ectopics plus the work stress. I don't know why they don't tell us to book 3 weeks off work at the outset. Go for walks by all means but don't 'exercise' or take your HR up unduly - your body is healing and needs time to do that. It really is 12 weeks and then some. After 8 weeks last time I was gardening, mowing after 12. Amxiety and stress do not help us so do what your can to minimise those. Perhaps some slow breathing techniques would be a good idea? It can be months before you really notice the difference. Please be patient- you'll get a better outcome if you allow yourself that time.
Sorry to hear you're struggling Robert. This forum sure is a good stop! I think these days we have huge pressure on us to recover fast - partly the wonders of modern medicine, partly pressures within the health system, and partly our own (and employers) expectations. Following severe flu my husband pushed himself back to work and has suffered ME ever since. Sometimes it's false economy not to put ourselves first and it sounds like you've got a lot going on. Take a breather, a blanket day, a sick week, and focus on what your body needs to recover.
great advice and see my post below!
Hi totally agree re the 3 weeks off advice, I was told only to avoid “strenuous exercise and heavy lifting” for 2 weeks and no advice about work at all…my exercise is limited to 20-30 minutes brisk-ish walking. Maybe I’m underplaying how serious an ablation is, and the recovery time required…I work in Sales and pressure is part of the game and as my boss said to me last year “this company is no country for old men”. Nice eh. I am 57 years of age the cheeky bugger. A few years to go for me yet before I can retire.
I got a very basic discharge after ablation last May .Nobody came to see me for a chat after about resting etc.Very poor of hospitals I think.I followed the fact sheet on this forum to the letter and all OK but my friends husband was walking and doing Xmas shopping 3 days later I was agast.Please try to take it easy re exercise.
Your boss needs a good talking to!
Haha it was only when he came to see me in hospital after my emergency afib admission ( and my first cardioversion ) that he realised the stupidity of his attitude. Hes Been fine since, however I do feel already I’m being sidelined a bit work wise.
Hi - I also had a Pulsed Field Ablation (PFA) - in the UK (Liverpool Heart and Chest Hospital) last September (not sure where you are based-although you mention A&E rather than ED-so assume UK). There are only two UK centres presently offering them I believe - unless that has changed recently. I spent most of my time with the Consultant discussing the procedure (including the reported advantages of PFA) rather than the recovery and the discharge information was basic, with no apparent update to reflect any (if indeed there are any) differences for this relatively new procedure, so the AFA guidance was my 'go to' for further detail.
From what you say I assume you are still in normal sinus rhythm (NSR), or at least not back in AF, but I do understand how unpleasant significant palpitations can be. I am now 5 months post PFA and as far as I can tell (I avoid Kardia or similar devices as I don't want to end up obsessing about it) remain in sinus rhythm and I am doing well. However, I have also had spells of palpitations (although much milder than yours by the sound of it - which is fortunate because my medication options are limited for other heart related reasons) and it was hard not to become anxious, especially in the first few weeks after the PFA, that these were going to send me back into AF.
I am now getting fewer palpitations, although early in the new year I had a spell of not feeling great, which I put down to Christmas/New Year excesses! Since my ablation I am trying hard to improve my lifestyle, particularly my diet, as I want to give the procedure the best chance I can to remain successful for as long as possible. My original paroxysmal AF was always brought on by exercise (but was fortunately very infrequent - 3 episodes in 17 years) whereas since I had an NSTEMI last April and subsequent PFA (the heart attack seemed to be a catalyst to send me into persistent AF) the palpitations I get now seem to be more related to diet and stress as well as position (although I did have a spell of palpitations - a 7 day Holter showed mainly a modest PAC and PVC burden - a few months before the NSTEMI).
So, as others have said, do your best, within your own circumstances, to optimise your lifestyle (easier for me as I am now retired). With regard to exercise, if this is an important part of your life (it is for me - both in terms of my physical and mental health) then you may be frustrated by the post procedure guidance, which I found particularly vague. So I erred on the side of caution and built back up very gradually (not helped by having two nasty spells of lurgy - not Covid - in the Autumn and just before Christmas). Since the new year I have been back doing 5km Parkruns (reduced the time from nearly 36 minutes to under 29 minutes) and regular reasonably strenuous bike rides. I have felt some very occasional palpitations during exercise, but otherwise felt fine and I am pleased with my progress this month.
I wish you all the best with your recovery.
they will settle down hopefully soon. Try taking things easy. I go through bouts of ectopics and they can last a week and more which can be very unnerving sometimes.!!
They are a total pain in the posterior to be quite honest. Then they just disappear as fast as they come.! Weird
same here. X
Well, a week later and remarkably the ectopics have reduced significantly, I would say I’m in 95% sinus rhythm. I realise there is a long way to go yet and like all of us I’m just waiting for the AF and ectopics to return but for now I’m just glad those horrible constant ectopic runs haveceased!
Up date - Four months after pulsed field ablation at Papworth - AF still at bay, stopped taking daily Flecainide on the advice of my EP, still on daily Edoxaban and 2.5 mg Bisoprolol. Feel much better, cycling gently again, occasional brief palpitations but nothing more. Made my first work trip into Europe since October last year. So far so good.
great news, very interested to follow you PAF journey. Keep doing well
Ectopics after Covid 
Ectopics post 3rd ablation
Post ablation ectopics
Ectopics after 16 hours of PAF
