AF or PVCS ablation

[Kittyca]

I have had a high burden of palpitations since my covid booster in September 2022. In February had 48 and 7 days Holter which both showed 11% PVCs plus bigemeny and trigemeny. My Apple Watch showed only SVT not PVCs.

I had nhs appointment with EP and he advised ablation and promised to do AF and PVCS in one go. He also said that all my ectopics were SVTS ( ‘ectopics had a broad complex but sharp onset so they may be ventricular in origin but could potentially be atrial ectopics with bundle-branch aberrancy’). So he is going to do In first line AF ablation.

I decided to go for the second opinion and had a private appointment with different EP. He told that my ectopics were monomorphic ventricular ectopics and an ablation was needed for PVC ectopics only. He also said that it was not a good idea to do both ablations in one go as it may be dangerous.

Now I am in limbo: don’t understand what ectopics I have and what ablation is needed. As far as I understand they are different, success rate is different and blank period is different too. What’s more I have not had AF episodes for about a year.

Could you please advise! I am really very stressed by the situation…….

[SeanJax]

the only question you need answers from both ep is how many ablations they did a year in the past five years for Afib or PVC . If below 50 ablation a year run away from both of them. Get an opinion from an expert ep who did hundreds a year and go with this expert. He or she will tell you if both can be done in one shot or not. Medically speaking do Afib first and try to control PVC medically. If it fails then go for the second ablation in my opinion . It is not a question of ablating both or not but the success of the ablation itself. Ask the right question.

[Kittyca in reply to SeanJax]

Thank you very much for your answer, I am very very grateful to you!!!!!!!!!

I asked the private EP about the number of PVCs ablations a year he has done and he answered 30. So it’s not enough or AF ablations must be added as well?

Success rate (according to his words) 90% for PVCs and 70% for AF.

[dmack4646 in reply to SeanJax]

There are no many EPs that have done hundreds a year