PACs/PVCs Starting Up at 3 Months Post Ablation

Hi Everyone,

Had my ablation with Dr. Natale on 5/2/13. I'm almost over my digestion problems which I posted about earlier--they lasted 5 weeks (may be a coincidence, but I was able to stop the diarrhea by switching my Warfarin dose from dinner to lunch). Anyway, I'm still not back to 100% (I'd say 95%), but am thinking it may be caused by the Warfarin and so hopefully once I get off that I'll be back to 100%.

Question for you: I really have not had much to speak of in terms of PACs/PVCs, and thank God, no Afib, in the first 3 months. All pretty quiet. Felt unbelievable. I could point to 3-4 days over the whole time where I had runs of PACs/PVCs on and off for over several hours. But after a night's sleep, I was fine the next day.

However, beginning on Friday, Aug 9th, I have been having PACs/PVCs on and off throughout the day and night--I've been woken up by them for 4 of the last 4 nights. I'm starting to get that anxiety all over again--though trying to hold of it off.

I've heard that usually you have a pretty good idea of where you're at after the 3 month mark, and that if one is having arrhythmias, they should settle down by 3 months (that is, if they are going to). I seem to be having the opposite? Triggers that I've indulged in, but not substantially--as in, maybe once to a few times a week and certainly not every day--including more sodium, sugar and chocolate--but I'm not going overboard, and have ceased on the sugar/chocolate since Friday. The only other trigger is not getting as much sleep--trying to play catch up on the last 11 years of my life...but again, I've gotten good nights rests since Friday, yet am still having the PACs/PVCs thru this morning... I have by and large still stayed away from all things gluten and continued to try and only eat organic.

Any ideas? Or, do I just need to wait until 6 months out? It was with Dr. Natale and he said I was a straightforward case, if that helps.

Thank you,

Steve

Hi Stephen,

How is your magnesium and potassium intake these days? Its also hot in many parts of the country and that puts most everyone at higher risk of dehydration too which is a big PAC/PVC stimulant.

These things are annoying but for the most part are relatively benign. I would make sure you are getting extra good quality Magnesium and also add Potassium gluconate and/or Hans' PAC tamer receipe you can find in the archives here.

As long as it is really PACs or PVCs and not short bursts of AFIB, it will die down again as quickly as it came up, but getting the extra electrolytes and making sure you are well hydrated in these dog days of summer is important to help keep things less noisy. These kind of runs, disconcerting though they can feel, are often par for the course even with an otherwise solid ablation.

If you do the ion replacement and still the ectopics continue unabated then consider getting an AliveCor Iphone monitor to confirm these really are just ectopics and not short bursts of AFIB.

Take care Shannon



Edited 1 time(s). Last edit at 08/14/2013 01:36AM by Shannon.

Steve - Often people find their heart doesn't settle down until it's closer to 6 months post ablation. As Shannon mentions.. the magnesium and potassium are crucial to stabilizing but if you are low in either or both...outside inluences such as high sodium intake or chemical additives in food such as MSG or flavor enhancers can cause problems. Sugar is known to deplete both magnesium and potassium so if you are marginally low, that can tip the balance unfavorably. Caffeine or the stimulation of that from the chocolate can be a culprit... especially if it causes stomach irritation and thus, vagus nerve irritation. Caffeine increases heart rate and increases urinary potassium within an hour of ingesting. It's also dehydrating and as Shannon mentions.. hydrating well with pure, clean water...not municipal tap water... is important because if your heart valves become dehydrated, you'll be missing beats quickly.

If you haven't read by now The Strategy, there are tips there that helped me stabilize my heart when I had begun breakthroughs four years post ablation. I'm in the process of revising that to include what I left out as very significant influences for stabilization... that which I took for granted and failed to give it proper emphasis for a continued calm heart. The first is the constant alkalizing of tissue by using the magnesium bicarbonate water as my only source of water intake and making sure that my tissue pH remains slightly alkaline which thereby ensures that I have the proper voltage to support the energy needed to maintain NSR. When voltage falls, you skip beats and shortens the refractory period which can lead to outright AF.

The second Strategy factor I failed to include as highly significant is that prior to and ever since ablation, I've used a combination fibrinolytic/proteolytic enzymes... both Nattokinase and Serrapeptase... to help control any tendency to develop an amount of cardiac fibrosis that would be a physical interference with the electrical conduction pathways. Magnesium deficiency promotes cardiac fibrosis and there are other fibrosis causes as well plus it's a naturally, ocuring part of the aging process... and no matter what your age, if living... you are aging sometimes faster than others.

If your gastric issues continue, look to both replenishing with digestive enzymes and probiotics to help reinnoculate your entire GI tract so there is a healthy population of the friendly bacteria that belong there. Often times, those become destroyed and/or unbalanced (dysbiosis) with various drugs and other influences. You might also consider Colin's recent post on his success with ginger... which is highly antiinflammatory and calming for many people.

Give it more time and don't be in a hurry to get back to old habits that might be culprits.

I wish you a calm heart .. soon.

Jackie

Jackie,

Yet another good tip: "The second Strategy factor I failed to include as highly significant is that prior to and ever since ablation, I've used a combination fibrinolytic/proteolytic enzymes... both Nattokinase and Serrapeptase... to help control any tendency to develop an amount of cardiac fibrosis that would be a physical interference with the electrical conduction pathways. Magnesium deficiency promotes cardiac fibrosis and there are other fibrosis causes as well". Any advice on what brands and how much to take?

Thanks much,
Nancy M.

IMO nothing to worry about - I'm at 10 mths now and they quietened down - Potassium is good always

Hi

Just thought i'd chip in here as a seasoned ablationer ,well 3 of them anyway I have come to the conclusion that its just something that we have to accept.
My last ablation in May 2012 lasted 6 months I though I was cured I have always used the therapy of supplements on here plus a number of others.
I can go 6 weeks of perfect NSR then back to square one with nothing helping me, not drugs or supplements.
my feelings are that some of us will never be cured.

Hi Janet,

Id be willing to bet my bottom dollar that your EP hasn't fully addressed the main trigger source(s) for you. Either that or he hasn't been able to achieve solid transmural burns, perhaps be letting off the heat a little too quickly?

In any event, SO many EPs still do not do the more complex repeat ablations correctly, even when they are busy and well known in their local areas. Its a fact Dr Natale often bemoans, and is one reason he is so focused on training as many EPs as he can in all parts of the US and in Europe through his colleages there on how to go about this the right way. Especially on repeat case.

Natale's patients vary rarely require a redo PVAI or a patch up of previously ablated areas when a follow up ablation is required. This is true too now for a growing number of his well trained protégé's as well who have learned from him the full extent that consistent good results require in the process of ablation.

Don't give up though Janet, I know you are in New Zealand and thus might have limited choices, but if there was any way you could swing it to get to the US to see Dr N, or perhaps Bordeaux if the US is out of the question, I'd bet you could get a satisfactory outcome yet.

If you have action in the Coronary Sinus or Left Atrial Appendage and your man has not ventured there at all, or if so, may have done so in a too timid fashion as is so often the case when doc spread their wings beyond the PVs, then there would be little wonder why you are still frustrated after three ablations.

It can be difficult to ferret out and clearly detect LAA triggering, especially in a first more comprehensive ablation when there are general more sources clouding the picture, and even anesthesia can suppress the more delicate tissues in the LAA and thus mute the triggering signal coming from there and that is why it is often missed on the first ablation. Especially by all those EPs who rarely or never look there to begin with and are not skilled in distinguishing LAA signals or those from the CS, even when they are more apparent and obvious to an operator who recognizes what he is seeing.

Many EPs who would never consider isolation the LAA even a year ago are now starting to do so in larger numbers as the evidence of its effectiveness in difficult cases is getting pretty overwhelming by now.

In any event, the main thing is not to feel you are a lost cause, you just need to get yourself in the hands of someone who can truly do it all and has a lot of experience in dealing with repeat cases successfully like yours. If your EP said that he gets a good number of reconnected PVs during his repeat ablations, that's a pretty good indicator that he isn't getting consistent transmural lesions from the outset, and alas, if that is the case, he or she has a lot of company in this world of EPs with so many of them still learning their way up the skills ladder.

I'm not sure what your options are from NZ, but I do hope you can find someone who can help get you over the hump!

Take care,
Shannon

Hi everyone,

Thanks for the posts. So, I had stopped taking Mg and Potassium for 3 months post-op due to my diarrhea (every day for 4 weeks, lost 15 lbs). After my initial post on this thread (23 days ago), I restarted applying Mg Oil (Ancient Minerals). That helped tremendously--I didn't want to post immediately b/c I didn't want to have to follow it up the next day with a disappointing post that I was back to square one in case I relapsed But 23 days out, I can say that I think the Mg Oil has definitely been helping me!!! It makes me crazy to think that the medical world still won't acknowledge how supplements help! This was a prime case of how Mg helped me out a ton.

One other thing I wanted to mention--along with the increased PACs/PVCs I'd been having, I had also been getting this hot, burning sensation on my chest, along with increased anxiety, stress and I'm sure higher blood pressure. This has happened to me on and off throughout the years. This time though, when I applied the Mg oil, all of those symptoms went away! I have been plagued with these symptoms for weeks at a time...and now I'm thinking those were always times of Mg deficiency...wow. After applying the Mg oil, I felt like I was floating...and about 1-1.5 hours later, the PACs/PVCs finally died down. That night stopped my 4-day streak of PACs/PVCs! Since then, I have continued to apply the Mg oil and am starting to try and add more supplements (Omega 3 fish oil from Dr. Mark Houston, for example) to ramp up to the full Strategy.

However, this week, I still had a couple of days where I had bad PACs/PVCs. Over the weekend, I wasn't applying the Mg oil as liberally and I had stopped drinking Coconut Water (2 things that helped me out and that I was doing A LOT of pre-ablation, but stopped totally post-ablation until I restarted 23 days ago). So maybe slacking on Coconut Water and Mg oil was it?

But I think it also could have been that I tried taking an oral Mg supplement - Blue Bonnet Albion processed. I had never been able to handle oral Mg supplements before the ablation (I would go into almost constant PACs/PVCs, which would then turn into Afib), including this one. Kind of crazy since Mg is supposed to be so good for the heart! I figured--it's been 4 months since my ablation, and spraying the Mg oil is kind of inconvenient, so why not give it another try? I took a dose on Sunday, and I think it's what threw me for a PAC/PVC spin again this week...and I ate a bunch of dark chocolate on Sunday...oops :/ But really, by Wednesday night, should I still be feeling the effects of 1 dose of Albion Mg and chocolate?

Getting my heart rate up helped too this week. BTW, since the ablation, I have gone on walks, but not done any strenuous exercise (never more than breaking a sweat). I didn't want to overwork my heart during the healing process. But now I'm thinking not exercising could actually be a negative for me. I hear that exercise helps balance out the parasympathetic and sympathetic nervous systems, which helps maintain NSR.

Anyway, is this normal to expect that post-ablation, even with Natale, that I could be plagued with hours of PACs/PVCs each day (my event monitor has not shown Afib, but I have had some short bursts of tachycardia--but never long enough for me to get to record them in time) if I don't stick to the Strategy? BTW, I'm totally fine sticking to the Strategy as I'm working to get my digestive system back in shape. When I spoke with Natale's nurse about my recordings, she said, "They look great! NSR w/ PACs and some PVCs!" But I was thinking, this doesn't feel great--not NEARLY as bad as Afib--but PACs/PVCs for hours on end can still where you down...

Also, I haven't had caffeine, alcohol or nicotine (and no recreational drugs ever) since I was diagnosed with Afib 11 years ago. Any caffeine I do get is through chocolate that I eat on occasion...but really may just have to give up altogether. Whatever it takes to be in NSR and PAC/PVC free...

Thanks and love to you all. I haven't posted in a while, but have continued to think about everyone on this board and keep you in my prayers.

Take care,

Stephen

Earlier in the thread "PACs/PVCs Starting Up at 3 Months Post Ablation", we talked about the difficulties a lot of us have absorbing Mg into our cells. Well, a few months ago, my naturopath recommended I try Magnesium Phos homeopathy - she said it helps with Magnesium absorption. Has anyone tried it? I use homeopathy and am a fan, but I have not tried the Mg Phos homeopathy yet. But I certainly liked the idea of the product description:

"Magnesium Phos, especially in low potency 6X, can help your body utilize magnesium in the body and from food and is completely safe (unlike 500 mg supplements that can cause bowel overload with resulting diarrhea)." See [www.elixirs.com]

I'm wondering if I take this each day if I could lower my Mg supplement dose of ~1300-1400mg daily (125mg from Concentrace + 1060mg from Magnesium Malate - Designs for Health + 150mg Elemental Magnesium from Ancient Minerals spray + smaller amounts from other supplements).

Thank you,

Stephen