Irregular heartbeat three months after ablation

Hi,

I am really hoping someone has an answer to this that is reassuring. I had my ablation at Southlake Hospital in Ontario, Canada with Dr. Pantano on June 30th. Around the second week of August I noticed my heartbeat was irregular - it would go maybe 20 beats in a regular pattern then go about ten quicker and then back to regular for another 15 or 30 and then back to faster for about ten or twelve beats. At times it would beat along nicely for over 60 beats before quickening up for several beats, other times it would only hold the regular pattern for 10 or 15 beats before switching.

I phoned my cardio but he said I should follow up with the hospital. The hospital told me to wait until the results from the follow-up Holter monitor which I started on Sept. 16th.

I have just finished that. The monitor connected to my phone, so I could see the ECG patterns. There I could see that sometimes even what I felt were regular beats still varied in length. I am now waiting for them to contact me. In the meantime, I am feeling more and more drained of energy. I am used to walking at least four kilometers every day but yesterday I had to rest half-way, and when I got home I had to lie down and rest.

I am taking Multaq. I worry that this is a very slow afib. I know that Multaq caused death to people with permanent afib. Does anyone have any insight into what this can be? I assumed after three months that any irregularities would have settled down.

Thanks in advance,

Marg

Most likely what you're feeling are pre-atrial contractions (PACs) but without being able to see a recording no one can say for sure. PACs are annoying but harmless, and deaths from Multaq really aren't something to worry about. It's a very safe drug.

Can you copy an example of these episodes from your Holter monitor? If not, you might want to consider buying a Kardia device. That will allow you to see what's going on and it will tell you if it's afib or not. Either of the two models they have are okay, and you don't need to pay for the subscription service.

[like] to Carey's post. PACs are common, regrettably, after an ablation for AF. So is flutter. We can be reasonably assured it's not flutter at play here because a heart in flutter tends to stay in flutter...it' doesn't go in 'runs' as you are experiencing. I had many PACs after my index ablation in Victoria's Royal Jubilee Hospital under Dr. Paul Novak. A second ablation (25% of all index ablations fail across the practice of catheter ablation) worked well for me, and that 'may be' in your future. The Holter results will tell the tale.

I hope you were not still taking the Multaq while being assessed by the Holter...? If so, your heart is being manipulated in a way to confound the veridical assessment you would want from the Holter. It's like removing a spark plug from one cylinder in an engine, hooking up the running engine to a computer to assess its state of running, and then remarking that one cylinder seems to not be firing. Taking an anti-arrhythmic drug while being assessed at the end of the blanking period can't be the right way to do it. My opinion...I'm not a physician of any description.

Thanks for your replies. Gloaming, it seems strange to me as well, but I remember after my first ablation, still taking propafenone when Dr Khaykin ordered a 48 hour Holter. It was after that that he told me to wean off it.

That is very strange to me. Imagine feeling ill with a fever and some aches, you take a 200mg ASA (aspirin), but go to your family doctor for help, he takes your temperature and asks you how you feel, and you say I feel pretty good actually. No pain or aches, and my fever is gone. Oh, great, well....I guess see you in a few months for your annual? You return to your home and within six hours you need another aspirin....or two...or they don't work any longer and your symptoms return with a vengeance.

Very strange.

How else are you going to find out if the propafenone is still needed?

By stopping it before the Holter monitor assessment. If the AF returns, it must have been the propafenone and not a successful ablation...which I believe the intent of the Holter to be.