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Young afibber, almost 1 year post ablation

Posted by Dolomites 
Young afibber, almost 1 year post ablation
March 08, 2019 05:38AM
Hi everyone, my name is Markus from Italy.

I am almost 32 years old an am an afibber since almost five years now.
I am around 190cm and weigh around 85kg

My history:
I always had ectopic heartbeats, I can remember them for all my life. especially after sport or stress (for example exams) I had plenty of them and on a daily basis. They became more frequent in my twenties. After sports while relaxing or lying in bed I got every 3rd to 5th heartbeat a PAC. With 27 I went the first time in tachycardia. Since then I had 6 rather intense episodes and decided to get an ablation, because no matter what, I wasn't able to control the ectopics and the anxiety was taking it's toll. Ectopics could be triggered through eating, wind, fullmoon, sport activity, etc. It was at some point completely nerve wrecking. Quality of life was not existent as I am a guy that loves to snowboard, hike, MTB and do everything sport related.

The ablation was performed in 2018 on March 27th by Prof. Kottkamp in Zurich Hirslanden clinic. Kottkamp is specialized in treating afib and does a lot of research.

I was only in need of a PVI. There were no significant fibrosis or other triggers found in the atria. No other work had to be done. The recovery time was mentally and physically tough, though. In July my grandfather died due to heart failure. In August my father died due to skin cancer. I was very close to both of them. As you can imagine, sleepless nights in the hospital and the panic attacks due to so much loss didn't help.
During the last year, the ectopics became less and less. Infact they are a non-problem now. I'd say I am around 5-10 PACs or PVCs. This is the quietest my heart has been in forever.

The reason I post here is the following though:
During the blanking period I had two short runs of what I believe was flutter. The episodes lasted only for about ten seconds. Since then my heart was very quiet for about 4 months with only ectopics. But since then, I get more and more of these "runs". They last at maximum for 15 seconds and are fortunately very unstable. Therhythm is mostly frequent. I was not able to catch them with my Kardia yet. The plan is to do a 7day Holter ECG to get these rumblings on tape, but to me it seems that I will need another ablation due to reconnection. Do you have some advice for me? What is the consenus regarding these non sustained ATs?

Thanks in advance,
Cheers Markus
Re: Young afibber, almost 1 year post ablation
March 08, 2019 09:45AM
I would not mind another ablation without knowing what are those runs of AT. They've to be recorded.
I don't know why you're thinking about a PV reconnection, since you don't say you've been back in afib since your ablation.
Re: Young afibber, almost 1 year post ablation
March 08, 2019 06:56PM
They last at maximum for 15 seconds

And for that reason I doubt that any EP would recommend or even be willing to perform another ablation. Episodes lasting less than 30 seconds are considered sustained and generally aren't treated. I would expect at most you may be offered a beta blocker. But wearing the Holter monitor is a good idea so at least you'll know what it is. My bet would be flutter.
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