PACs and PVCs

Hi all, I've mostly been a lurker and have really appreciated all of the information I have found here. Diagnosed with afib December 2016, probably had it for years and wrote off the episodes I had as stress/anxiety. I would be awakened anywhere between 2-4 am with heart racing to 150 bpm and in afib. Always corrected on it's own within 2-4 hours. I'd have an episode once every 18-24 months.

December 2016, I had an episode that didn't stop, went in to see primary care doc and diagnosed. Went to ER, it finally corrected on its own and they discharged me within a couple of hours. Referred to cardiologist and EP, had several other episodes (approx. one per month after diagnosis). Last episode came while hiking in the middle of Yosemite this past summer, so I decided to have an ablation (July 24). I'm 51, fit and active, run sprint triathlons a couple times a year, lift, hike and am in good physical shape, with no other health problems.

Since the ablation, all has been good. I had a couple of brief episodes the first couple of weeks afterwards, all normal of course, and have been afib free since August 11.

Now to the question - I hear people describing having PACs and PVCs often on this forum. How do you know what is what? Occasionally, I have what feels like a skipped beat. I get them periodically, it's fleeting, then goes away. I get them when I lie down to sleep at night, not regularly, just once in awhile, and it's enough of a little jump that I get nervous that I'm about to slide into afib.

Are these skips PACs or PVCs? Or something else? And are these indicators that the afib will return?

For me -- and it's probably quite person-specific -- the PACs feel like a butterfly "flutter" whereas the PVCs feel harder and a little painful like a "heart squeeze." If you don't already, you should get a Kardia monitor (they are easy and work with your phone). You can "see" what your heart is doing when you're feeling this stuff. Sounds like you're doing great, post-ablation.

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kantler
Are these skips PACs or PVCs? Or something else? And are these indicators that the afib will return?

They're almost certainly PACs. Nobody can be 100% sure without an ECG, of course, but that's what PACs and PVCs feel like, and given that you have afib they're more likely to be PACs than PVCs.

They are not indicators that the afib will return. PACs can trigger afib, but since they haven't so far it means your ablation is doing its job.

For me, a PAC is just a "skipped beat". A PVC (which for me are VERY rare) feels like a small thermonuclear device was detonated in my chest. Kardia will tell you for sure. PAC is just an extra QRS complex stuck in between normal ones. A PVC will have a pronounced negative deflection and look really different from a normal QRS complex.

No, they don't mean afib will return.

Thank you - sounds like PACs. They are infrequent and would be difficult to catch on the Kardia (I do have one) as they come and go so quickly.

I am a hair over 2 months out from my Natale ablation which was my 4th, 1st by him. I am off the Multaq now for like 2.5 weeks and in rhythm and have been since the procedure. I do get occassional PVC and/or PAC's as well. Have caught them on my Kardia. They are getting less, but I would just accept they may always be there or not and as long as you are not in afib, carry on happily. My heart has not been able to maintain it's own rhythm with or without drugs in years so I am very hopeful at moment. If a few PVC's and PAC's hit me once in a while so be it. I lost three years of my life to AFIB.

All that said, I totally understand how every PAC/PAC can make your mind think here we go again. I have to fight that mental battle, I hope it goes away over time.



Edited 2 time(s). Last edit at 12/02/2017 05:37PM by Fibrillator.