3 1/2 months post ablation update…and question

[Moose09]

I had my 3rd ablation on Nov 3rd. First was for atrial flutter which I consider successful, second was PVI cryoablation, and this third was to check the PVI and to go after afib in the right atrium. I must say that immediately after the ablation I felt much worse, far more afib than prior to the procedure. I had a stretch of 4 days non-stop where I was afraid I had entered persistent afib.

But then one day it just stopped! Gone. I had no symptoms. I haven’t had a completely symptom free stretch like that for 2 years so I wasn’t sure what to make of it, I was sure symptoms would return. And they did - but only ectopics. I have PAC’s and some PVC’s. According to my Wellue (thank you to this group, I wasn’t previously aware of this tool!) I have about 20,000 PAC’s a day and about 300 PVC’s a day. But so far (I’ve only recorded 3x) no afib. But I don’t think I’m feeling afib symptoms either. So good news!

While it’s great news that I’m not experiencing afib, I’ve read that a high burden of PAC’s is of concern, causing cardiomyopathy. This is while taking 200 mg flecainide, which I would dearly like to stop. My PAC burden is over 20% while on flecainide.

Prior to my EP follow up in March, I plan to consult with the Bordeaux Hospital in France regarding their ablation, and also with Dr Ohtsuka in Tokyo regarding his modified Wolf mini-maze procedure. My question is whether anyone has seen a guidance document on how to choose between an ablation and a mini-maze. It just seems to me that EP’s naturally recommend ablations, but does there come a point where it makes sense to attack the problem from the outside? My EP said to me prior to my last procedure that he might not be able to get to the problem tissue because it might be too deep (which makes me think the mini-maze makes sense).

Does anyone have thoughts? Thank you!!!

[BobD Volunteer]

Purely regarding the ectopics, please try the slow deep breathing exercise. Use stomach not shoulders and slow breathing to six or less breaths per minute for at least five minutes. Works a treat for stopping them.

[Moose09 in reply to BobD]

Thank you Bob. I was fortunate to participate in a cardiac rehab program and we learned deep breathing (they called it belly breathing since you use your belly or stomach). I found it quite helpful for my afib episodes which would most frequently happen in the evening. If not for deep breathing and meditation I don’t know how I would have slept! But the ectopics are happening anywhere from 12-18 hrs a day or more. Sometimes they start at 6 pm and last until noon, sometimes I get lucky and they don’t start until 10 pm, and they stop at 10 am. I still do deep breathing several times a day, perhaps that’s why I’m not seeing the afib? But it’s not helping the ectopics.

I’m not bothered too much by the ectopics, perhaps because I’ve had afib every day for 2 years and it seems it may be gone. 🤞🏻 But I’m still concerned about the high burden and what to do about it. I’d like to be as informed as possible when I go to my EP follow up appointment.

Thanks again!