PAC/PVC Ablation

Had a pulmonary vein ablation in October 2002 and no AFIB since (thank God!) but have always been plagued by varying amounts of PACs and PVCs. Am on Flecainide (100mg X 2), Nadalol (80mg X 2) and Accupril (10mg). The palpitations over the past 10+ years have ranged from about 100-200 per day up to 15,000 or so. Sadly the low number is rare and, on average, I probably have around 1,000/day. Have learned, for the most part, to ignore them. About 6 or 7 years ago I went through a several month period when they were very high and quite disconcerting and have apparently just entered another similar phase...definitely not AFIB but the palpitations occur anywhere from every two or three beats to every 20 or so beats. The heart is steady and slow in-between.

So my question, which I seem to ask every few years, is...has there been any progress in the success rate and safety of an ablation to address PACs/PVCs? Is a PAC/PVC ablation feasible for someone like me? Can a PVC/PAC ablation unintentionally promote AFIB?

I Remain, at 58, very active...workout 1-2 hours per day, have obtained my black belt in Taekwondo and also attend, 2-3 nights per week, a high intensity fit class (interval training). Literally, am in the best shape of my life. And just got back Sunday from several days of rigorous skiing in Colorado (had very low amount of palpitations in Colorado...it just got worse yesterday). Most times I feel my workout regiment has kept palpitations somewhat at bay while other times I feel it may have irritated the situation. Had my annual physical several months ago and everything was excellent.

Am not anxious to go under the knife again but, after 10+ years of this, am getting very wary of this ordeal and just wanted to know realistically if I had any ablation options. Or any other options for that matter. Just wanted to see if anyone was aware of any developments as it relates to PAC/PVC ablations. Thanks!

Wade

Wade

Since my successful ablation in 2003 I too have had many ectopic beats - up to almost 9000 was the highest on a 24 hour Holter. Professor Haissaguerre, who did the ablation, told me not to worry about them but they were very uncomfortable, like being kicked hard in the chest every few seconds. He also said they they didn't do ablations for ectopic beats, but I could take bisoprolol, which he said was "like a shield for the heart".

I started taking magnesium, then added taurine, and finally magnesium and thought that they had stopped, but a subsequent Holter showed that they were still happening, I just don't notice them any more. The supplements seem to soften them so that I hardly feel them.

Very occasionally, about once a year, they become very uncomfortable again and I take 1.25mg of bisoprolol which seems to stop them.

Gill

Gill, did you have them before the ablation?

For many years before the ablation I had paroxysmal AF and episodes were preceded by lots of ectopics. Immediately after an episode my heart would be very calm, then there would be an occasional ectopic, then a few, then lots, and finally another dose of AF. It was as though something was building up and then discharging itself.

The episodes increased in duration and frequency until they all joined up and I had persistent AF for 18 months until the ablation. I think ectopics don't happen when you are in AF so I didn't have them immediately before the ablation. Afterwards it seemed to me that an occasional ectopic beat was not a bad thing because it meant that I was in normal rhythm. But over time they increased each year until they became a problem, though my EP in London says they are a 'nuisance',

I wish EPs could experience ectopics and AF for themselves - they might then stop calling it 'a nuisance' and telling patients to 'learn to live with it'.

Gill

Gill,

My AFIB sounded much like yours and so have my post-ablation etopics. Just for clarification...you mentioned in your first post that you began magnesium, then taurine then magnesium(again)...did you mean to say some other supplement?

Thanks for your response!

Wade

Wade

Oops! Should have read magnesium, then taurine then potassium.

Gill