had a PFA ablation almost three weeks ago. First week was ok, the odd ectopic, but now the ectopics / palpitations are happening almost constantly, worse after food and at night when lying down. Doctor tells me things should settle down soon. Doesn’t feel that way right now! I take bisoprolol and flecainide low dose daily. Also have PIP for really crazy episodes. Should I persevere without requesting further treatment or perhaps cardioversion? Should I bother my local a&e again when the ectopics are raging? Last few days even moderate exercise, usually not a problem for me, has become uncomfortable. Also I have a moderately stressful job, am I supposed to withdraw to a darkened room for 3 months until these palpitations stop?? Sorry to sound frustrated, but I am.
Two weeks after PFA ablation - British Heart Fou...
Two weeks after PFA ablation
I’m not sure what a PFA ablation is - was it for A Fib? I think you will get more replies if you post in the AF forum healthunlocked.com/afassoci...
If you are getting symptoms that worry you, maybe your GP might help explain or refer you back to cardiology. I know it can be hard to get an appointment but they should understand.
First of all I am surprised you are taking bisoprolol and flecanide. I took flecanide for many years only to find that it damaged the nerves in my feet. If you look at the side effects in the tablet leaflet you should see that that it mentions this problem. So don't take flecanide in the long term. I take bisoprolol as a replacement for flecanide.
Secondly I am waiting for an ablation having had a pacemaker fitted some months ago. I take bisoprolol as it is supposed to slow down my fast AF and then the pacemaker speeds the heart rate up. Apparently the pacemaker cannot slow down a heartbeat it can only speed it up. However, in so doing it reduces my blood pressure and it is not unusual for me to have a blood pressure of 86/45 making me feel very tired.
However, I have been told that after I have the ablation the pacemaker takes over full control and I can then stop taking the bisoprolol which should mean that my blood pressure will return to normal.
I am not sure what a PFA ablation is and whether it is the same as I am going to have. I was told that the upper chamber of the heart tells the lower pumping chamber what to do and sometimes the message link between the two gets confused and that is why fibrillation occurs. So to sort this out the ablation destroys this message link and the pacemaker takes over direct control of the heartbeat. How it does this I do not know as I thought the wires from the pacemaker are connected to the top chamber anyway. If so. I am puzzled as to how the message gets from the pacemaker to the pumping chamber? I will ask the question of my Consultant before I have the ablation
If you are still getting ectopic beats I wonder whether the message link has been properly destroyed? So if things do not settle down soon I suggest you press your Doctor for a further review.
I must admit that I am not looking forward to having this ablation and your experience shows that I am probably justified in feeling that way. I thought pacemakers were a simple takeover of the heart function but the more I learn about it the more it seems not to be.
I was on Bisoprolol and Flecainide. It’s usual to get them together, as it helps to prevent the Flecainide causing Atrial flutter.
Edited to add - it sounds like you will be getting an AV node ablation. It’s a simpler procedure, and you will then depend on the pacemaker to set your heart rate. So it should settle things down for you.
Often people are talking about left atrial ablations - to try to stop those rogue signals, but no pacemaker involved. Just the hope of getting the heart back in rhythm.
PFA is the new non thermal ablation procedure currently only used at Papworth I understand. It is much less risky than thermal ablations apparently. My cardiologist at Papworth put me onto the bisoprolol and flecanide combo, believe me I have no desire to stay on either long term. I’m sure your ablation will be fine the risks are very small. I have to wait 3 months to see if the ablation was a success, the current increase in ectopics suggest it wasn’t but let’s see. It is likely I will have ambulatory monitoring to assess the impact of the ectopics. My Doctor doesn’t seem at all worried by the ectopics, but I am, I’m less than thrilled about them becoming the norm for me going forward. I am 57 years of age with a moderately stressful busy professional life. I can’t afford to “slow down”.
I’ve just realised that you mean Pulsed Field Ablation. It takes a while after any ablation for things to settle down. The AF Association has useful fact sheets on preparing for and recovering from an ablation.
There is a three month blanking period before they decide if it has worked or not. Having said that, I understand how you feel - I’m six weeks out from a cryoablation and went back into persistent AF after two days. Feeling impatient to know what is next.
It could be worth trying to contact your EP/Cardiology department.
Good luck - hope it settles for you. It is worth posting in the AF Association forum that I mentioned earlier, as you will get a lot more answers.
Here is a link to the recovery fact sheet, which should be applicable to any type of ablation -@api.heartrhythmalliance.org...
Has anyone out there developed atrial ectopics following an ablation? 
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