I had an ablation Nov 2020 which cured my persistent AFib. Was in 100% sinus rhythm until June 2022 when I caught Covid, and had a long run of Premature Ventricular Contractions (PVC's). Spells of arrythmia have continued, 2 out of 3 days my Kardia reports SVE's (Ventricular Ectopics), otherwise normal sinus, other than a very occasional PVC report. I've no idea from the Kardia what the ectopic burden actually is.
Have chatted to my GP who (as I am essentially asymptomatic) doesn't seem much concerned but is playing a wait and see strategy before a possible cardiology referral.
Question: do ectopics signal the possible return of the dreaded AFib ? Should I step up the pressure on my GP for a cardiology referral ?
Resting BP and heart rate are in the normal range typically 127/77 and around 65.
All the best
Colin
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Yachtsman
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I’m surprised your GP hasn’t referred you for a 24h ECG. I have paroxysmal AF. I haven’t had an ablation. However I experienced increasing ectopics before my first episode of AF. I know there are people who will relentlessly state that ectopics are ‘benign’ and strictly speaking, they aren’t dangerous in themselves, but I believe they are a symptom of something not being quite right. I have also experienced an increase in ectopics with viral infections too. So I think it’s something you need to keep an eye on. The worry is that you might be experiencing short episodes of AF without realising.
In my experience, ectopics are very difficult to control. I know people will say “do some breathing exercises” and don’t eat this, don’t eat that, but none of that has ever helped me. There may be nothing wrong with those suggestions but if that was all it took I wouldn’t be having thousands of them every day. Sometimes they settle down for no reason and then they rev up again after a prolonged period of calm. I would request a 24h ECG and then you’d have a better idea of your ectopic burden and find out if there are any undetected episodes of AF.
Iv tried everything over the years to calm my ectopics and nothing worked for me unfortunately.!! They start when THEY want and stop when THEY want.!! Iv even tried a yoga position where you balance on your head upside down against a wall. it was going well until airport security asked me what I was doing.!!!!!
Ice cold water helps in fact my first episode in af the ambulance people gave me an ice cube to suck. Have used cold water for ectopics too and has worked.
I agree totally that ectopics are very difficult to control. The problem is that no one seems to know why we have them or why some people feel them and others don't. From what I read here AFIB ablation patients almost always get ectopics after a while. I get quite irritated when I hear people talking about breathing exercises and dieting. What they seem to forget is that most of us who have ectopics did not always have them. So what changed? That's what we need to find out.I can remember the exact moment I experienced ectopics for the first time. More research needs to be done in this area. I propose that a global 'Ectopics Research Institute' be setup where research goes on 24/7 to find answers and develop novel treatments. Now who's with me?
I've been having a great deal of SVEs since my 4th ablation 2 years ago. In the main they didn't bother me. However in recent month or so they have become almost disabling and are pretty much all day everyday although I have had a few days remission .
I contacted my surgery last week who have agreed to cardiac referral. I also requested a beta blocker other than Bisoprolol and was given Carvedilol. This has proved worse than useless 😕 .....
I believe that they can be a prelude to AF .I've noticed random Possible AF readings show up on my Kardia and certainly alot of the SVE readings show absence of P waves.
If you're really asymptomatic I don't think you'll find that much is done .
I have been long diagnosed as having Sinus rhythm bradycardia with ectopics. Although I have since had a stroke and Afib has been detected I have always been told the ectopics are common and benign. The explanation is that the heart can't function normally with just one controlling nerve impulse generator, it needs repeats across the heart muscles to speed up the localised muscle response. These are the source of the ectopics as explained to me. As such they are in the most part functional in a positive way. But it does depend on frequency and whether sinus rhythm is disturbed. Have you shown your Kardia printout to your GP. Mine recommended Kardia purchase and when I showed him the print out he commented it was clearer and more precise than the surgery ECG equipment!My Afib was detected following me having a LINQ implanted ECG device (about the size of an AA battery). This was important because it meant my meds changed from antiplatelet to anticoagulant.
Of course if I had this 7 years ago when first sent for checks and not sent away with a don't worry, I may have escaped a stroke.
That is the nature of health care advance, availability of treatment etc. Thank goodness it is advancing but we can't always expect GP's to know the latest research and even guidance. As patients with known conditions we are fortunate these days to be able to research to cutting edge international treatments etc. We are not practitioners and probably don't have a full skill set to make judgements but it does enable to talk to our GP with more insight. I think my GP appreciates that I understand, try to understand and above all am doing everything I can to improve the health I have at an individual level. It's a partnership.
Hi , out of interest , what part of your brain did the stroke effect . My husband jd a stroke 7 weeks ago due to AF he had an ablation in 2017 , wasn’t followed up with blood thinners . We re it sure how long his AF had returned for as he jad stopped wearing his Apple Watch ages ago. It has effected the language part of his brain . He can’t read or write but his communication is slowly improving and speech .
Hi, sorry to hear that. The clot lodged in the mid cerebral artery feeding many areas including speech and retrieval of words and speech. So for a while I could hear and understand everything with some right side loss but couldn't reply to questions. I had the answers but couldn't get them out. Gradually speech came back but was very muddled and I think I may have been prattling on! With thrombolysis near normal.service was resumed. But I am aware now that I can't find words or sometimes come out with the wrong word. I sort of say it knowing it is wrong but can't stop myself. I then have to correct myself and search for the right word which sometimes comes sometimes not. I know it's a stroke issue but some might think I have age related forgetfulness!!!.I have been reading. Early on engaged a lot with health unlocked on the running support forums which I think helped my brain and language get back to near normal.
Hope this helps and good luck. My stroke was March last year and I think it took about six months to feel less stressed about the consequences. But I am very lucky to be in this position. In my home area at the time average priority wait times to get an ambulance for a stroke was an hour with long waits in a and e. Had I not been thrombolysed the outcome would be very different hence my almost obsessive focus now on exercise and being as fit as possible.
Thanks for replying , as my husbands happened in his sleep they wernt sure of the safe window to use the clot busting drug so Jist had to have thinners to disperse the clot . He can’t read or write at the moment so I’m having to one on here on his behalf . Given me hope these he will improve . Thank you
Very interesting explanation of ectopics, thank you. Agree 100% that our healthcare works best when we are active participants. It’s very much a partnership. Sorry to read of your stroke. I hope you stay well. .
Hi Colin. Iv recently had a two week run of them and got an appointment with GP. I asked for a 24 monitor and he was having none of it even though he noticed them when taking my pulse.!!!!
Instead I was sent for a ECG and bloods 2 days later, and my heart behaved perfectly.!! I did ask him to send the results to the cardiologist who sorted my ablations though and he agreed.👍
Iv had them decades Colin so try not to worry too much ( easier said than done)? They can be a total pain in the doo dar sometimes I know.? My EP and cardiologist have told me in the past that they nothing to worry about. You’ll be ok mate.👍
Just a small point Colin; SVE stands for Supraventricular ectopics, meaning NOT originating in the ventricles, but rather in the top of the heart. This is good news though, as anything originating in the ventricles tends to be regarded as more serious.
I don't think they do, and a cardiologist would likely be unconcerned if he was like mine. I was told that, even when in multiple runs as mine often are, they are considered benign and essentially, normal. Did you have them before you discovered you had AF and a Kardia? I've had them since my mid-twenties. Since my ablation for atrial flutter in 2019, I have many more though (as well as some AF, sadly).
PACs are said to be able to occasionally precipitate, but the connection between the two events is not understood so far as I can read.
That’s a shame for you as they can be a very uncomfortable and worrying symptom. My daughter in law’s brother had mild Covid but still ended up with some lung scarring. My brother is a kind of Covid denier and anti-vaxxer but the illness is far from the kind of “flu” he would have people believe.
I've started having PVCs this year on average 100 per hour.A cardiologist described them as significant.
The complication arises when coupled with a pacemaker which I have for complete heart block and have been trouble free for 18 years until January this year.
Normally the pacemaker maintains a minimum rate of 70 BPM, but during PVCs this can drop to less than 40 BPM leading to dizziness and falls.
Not only is it a worry, but clearly the pacemaker cannot cope with these extra beats.
Nearly 8 months on, I'm no further foward
The GPs have been supportive but are limited in what they can do and they struggle to get a response from the cardiologists.
So far, treatment has been to swap Atenolol for Bisoprolol which the cardiologists have raised from 1.25 mg to the maximum of 10 mg daily, all to no effect. The GPs and another cardiologist do not understand this beta blocker strategy describing it as not making sense. The ectopics are causing a slow erratic heartbeat via the pacemaker so why use Bisoprolol?
The real problem is the way in which the pacemaker interprets the PVCs.
I gather that the strategy is to locate the source of the ectopics.
Most noticeable episodes occur when I relaxed and if I wake during the night, I can have a BP of less than 100/50 and BPM of 30. Simply standing up from sitting can be hazardous
So sometimes ectopics can be insignificantand sometimes not so.
I also had COVID in June last year. I experienced horrendous ectopics afterwards. Eventually had a 24h holter but by then they'd started to diminish. I also had very high BP and was getting sudden drops when it would go very low. It was really bad. My cardiologist wasn't concerned about the ectopics but was concerned about the BP, quite rightly, as it led to a blocked retinal vein which caused some sight loss and I now have to have an injection in that eye every 4 weeks to stop the sight loss worsening. The ectopics have gone and now I just get occasional very brief runs of fast but regular heart rate, only last a couple of seconds. Do you think your ectopics may be lessening as time goes on?
About a year ago I started to take a 375mg Magnesium Supplement daily. I haven't noticed any improvement personally, but I don't think the supplement can do any harm, as almost everyone in the UK does not get sufficient magnesium in their diet.
I take magnesium taurate 125 mg (divided in two doses 12 hours apart) which for me, eliminates 99% of my ectopics. It’s made an amazing difference in how I feel because my ectopics were frequent. I also have PAF less than 1% burden.
It definitely sounds worth asking for a 24 hour tape.
I'm one of the people that dietary changes seem to have helped. After a successful cardioversion in Jan 2020, I noticed ectopics after I ate bacon or sausages or ham, so cut out all processed meat, and stopped noticing any.
Last year, after slowly reducing my bisoprolol from 10mg to 5mg under my cardiologist's supervision, I had a 24 hour tape during which I was aware of a lot of ectopics. My dose was put back up to 6.5mg. I was following a low carb diet and ate some fatty lamb before and during the test. I stopped eating that, and stopped being aware of ectopics.
For my next 24 hour tape this summer, I ate only fish (which is anti-inflammatory) for my protein during the test - wasn't aware of any ectopics and my pulse felt very regular. I don't get the result of that tape till mid September, so it will be interesting to see what it shows.
I've been taking magnesium taurate daily for some time now as well.
You should get the ectopics properly assessed as a high burden can cause problems long term. It’s so frustrating that the general opinion is they are benign and won’t cause any problem, they can be a serious problem as after years of suffering with them I’m now finding out !
Just remember, there is not a cure. It’s a Band-Aid for a fib at Cetera. Some people are very lucky and it holds for a long time but unfortunately a fib and flutter tend to worsen. I don’t mean to make you sad. My first only lasted six months then I had it back and the next one lasted a year. About 2 1/2 years since diagnosed, I got my pace and ablate in February. I have no regrets. I wish I could’ve done it sooner. We are all different, but I would’ve thought you would’ve already talked to the doctor, knowing how long it takes to see one. If it feels lousy more than once get a checked out if you’re not still on meds, you may end up on one that will put things back in check.
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