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.

[MeganMN]

Ablation scheduled for October 30th. My last 24 hour monitor only showed 14,000 ectopics with the natural antiinflammatories on board. Thats half of what they were! I'll keep trucking. Maybe by the time the ablation is scheduled, I won't need it. Here's hoping....