Insanely High PAC Burden

[MeganMN]

Still fighting with the PACs after my May 10th ablation for SVT. I finally got a Wellue 24 hour ECG recorder and the PAC burden is pretty impressive. I did two different 24 hour recordings and the first one was 44,677 PACs in a 24 hour period with 1,154 short runs of atrial tachycardia. The second recording was 31,533 PACs (bigeminy, trigeminy, singles, couplets) and 877 short runs of atrial tachycardia.

It is such a high burden (26%). On both recordings, my daytime burden (8am-8pm) was about 16% and the night burden (8pm-8am) was around 36%. The burden from 9pm-5am was about 48%. It just seems so high.

I know from the last EP Study/ablation that the PACs are in the left atrium and he suspects near the PV. He may have to do a PVI if he goes back in for another ablation.

It is just so difficult. I have had an unsuccessful ablation attempt in May of 2023, another unsuccessful attempt in December 2023 with subsequent pericarditis, a successful ablation for SVT in May 2024, then vasculitis from Verapamil in July 2024. Now I am looking at another ablation and am also on Ivabradine from Inappropriate Sinus Tachycardia after the ablation.

It just feels a bit defeating. Interventions are not without risk, but there is also plenty of risk with such a high burden of ectopy, and I won't try any more meds... I'll have to decide, but I don't like any of the choices....

[CDreamer]

Very difficult choices.

[Ppiman]

I feel for you and, although my ectopic burden varies a great deal, it is rarely as high as you describe. I think another ablation is what I would be going for.

Steve

[OzJames]

I used to get ectopics that would last 6 or 7 days and felt like pretty constant. I’d read about Vit D3 helping others and have now been on 2000iu a day and now get them few and far between. Is it that… I don’t know but sticking with it along with my low dose Flec and beta blocker. I feel for you and hope it’s sorted soon

[jolian]

Research supplements like potassium (gluconate), taurine and of course magnesium and vitamin D. The ratio of sodium and potassium is important as well. Another thing is the duration of supplements - perhaps months to show a useful benefit. Check on en.wikipedia.org/wiki/Roemh.... If its related you might check on a major simplification of your foods.

[MeganMN in reply to jolian]

Thank you. I am also working with an Integrative Medicine doctor and have been trying supplements of all kinds. I have regularly been taking Taurine, various anti- inflammatories, magnesium, etc. Am about to start Arginie/Citrilline as well. We will see. I suspect another ablation will be in order, but would love it if any of these supplements worked. Have been taking them for quite some time now.