spoke too soon - setback 7 months post ablation

Hey everyone,

So I posted on Sunday asking for advice on how to start an exercise regimen because things were going so well and not 3 hours later i started getting ectopic beats. Since my ablation it was like a switch was flipped. No afib and very rare, random ectopics. Now I have been getting 20+ per hour for hours at a time.
'm trying to figure out what's going on. I know that I've been bad in terms of diet and triggers and Christmas and New Years were especially bad but I just can't help but feel totally defeated like I'm back at square one.

Is it normal to suddenly develop intense pac/pvs after 7 months? It seems to me that something might be reconnecting.

Interesting to note is that I have had joint pain for the last few weeks that came out of the blue,mainly in my hip. It's actually been better over the last 5 days or so.

I started magnesium but it honesty seems to make it worse.

I have emailed Dr.Hocini but have yet to hear back.

Anyone else have a similar experience after ablation?

Monty

Could have more systemmic inflammation that is contributing, based on the pain in the hips. Did you take any Anti-inflammatories for it? or any other medications? it's possible that the meds could contribute.

Hi Montos,

If it's only ectopy, it does not signify a 'setback'. As Anti-AFIB implied it could be due to a number of proximal causes other than a return of true atrial tachycardia-style arrhythmia like AFIB or atrial flutter. Do you have an Alivecor to capture what this looks like? A 12 lead EKG is the gold standard by far, but at least you can get a good idea of what's going on with the Alivecor.

There are a number of PAC and PVC tamer formulas and recommendations in the search function of our website and in the various archives and AFIB Resources and some of which I recall you are aware of.

Just don't worry much about ectopic runs that can happen even after an ablation, unless they just get too frequent and annoying for too long a period. Often, such runs will go away as fast as they appeared after a period of time messing with your head ... so don't let them mess with you too much.

In the absence of AFIB or flutter there is generally no need for blood thinners or stroke risk concern. Some forms of PVCs that are more frequent need to be checked out if they last a good while, but most all PACs are benign.

Let's not label ectopy-only without any documented true arrhythmia a 'setback' to your ablation. That's not technically accurate.

Best wishes on these annoying critters fading away soon enough.
Shannon



Edited 1 time(s). Last edit at 01/06/2016 03:18PM by Shannon.

Shannon,

I think the reason this is messing with my head is that it happened at the seven-month point when I'm supposed to be in the clear. If it happened in the first month or two I would have been less concerned and wrote it off as a healing heart but because it happened at this point it worries me that it's something else.

As well, if I hadn't been absolutely symptom-free for six months this would seem less shocking. Prior to my ablation, I was having ectopic beats to the point that they were as symptomatic as Afib, in that they took my breath away.

I've tried the various pac tamers and none seem to work for me in the past but I will give them a shot again. Dr Hocini wants me to get a holter done and I will arrange that with my family doctor tomorrow.

I've restarted a beta blocker in the short term since that seems to help the symptoms somewhat. What's interesting is that they seem to be worse when I'm standing up they seem to be worse when I'm standing up and I can make them go away when I lay down and relax.

I've noticed my throat is quite sore for the last few days and I'm sure this is due to reflux. In the days prior to this happening I was taking 40 mg of Nexium every day and I think that may have contributed to electrolyte Issues. So now I'm taking Zantac 150 mg twice a day to try and get this under control and heal my esophagus.

Is it common for ablatees to develop late occurring ectopics after the blanking period of an ablation? I was always under the impression in worked the other way where you would get activity while the heart was healing but it would disappear with time.

Either way, after last seven months of feeling bulletproof and normal ( for the first time in six years), this feels like a huge setback even though I understand what you're saying.

Monty

Truly I believe you are still in the "blanking" period. these things happen up to 8 months and sometimes a little longer until it all settles. Talk to the doc and hang in there
Tim

Monty

After my ablation and touch up in Bordeaux 13 years ago the number of ectopics I got steadily increased. On one Holter I had almost 9,000 in 24 hours.

Prof. Haissaguerre said they were a nuisance but not a cause for concern, and that I could take bisoprolol if they were too uncomfortable.

I chose instead to experiment with magnesium, potassium and taurine and that worked for me - the ectopics still happen but I hardly feel them at all.

In one sense they are reassuring - you must be in nsr because when you are in AF you don't get ectopics!

Gill

It's not a huge setback Montos. And TSCO is right too that while the blanking period is strictly to limit acceptable apparence of arrhythmia, there is a longer period from 6 to 9 months or longer in some cases where further healing is taking place.

But for people prone to ectopic runs from time to time, these largely benign annoyances can appear at any time.

Certainly, chowing down on Nexium can do a number on your electrolyte balance and the package insert in the drug box even highlights that in a warning with respect to engendering significant magnesium depletion.

Try searching for, and experimenting with, some of the more natural anti-heartburn agents like DGL deglycerrhized licorice, mastic gum, peppermint oil, L glutamine powder 2grams to 4 grams in water, and even a quarter to half teaspoon of baking soda mixed in a modest amount of water, among a number of other natural agents that don't deplete electrolytes while helping to sooth and heal an inflamed esophagus and upper GI tract.

I fully appreciate the disconcerting feeling such runs of ectopy can bring when ever they occur, and when they include a lot of PVCs that occur frequently over a long period it is definitely worth getting checked out, but the large lion share of the time both PACS and PVCs are benign and not worth too much worry.

At this stage of the game it's certainly premature to assign these runs as a major setback in your ablation, by any means.

Best wishes Montos and chances are that this period of ectopy will subside as well.

Shannon

Thanks to everyone. They were better today but still there.

Anti-fib, the reason I mentioned the random pain was that I had this inflammation seemingly come out of the blue and my hips were sore, knees, ankles and thumbs. It was weird and I wonder if it's not some sort of inflammation. I'm stripping my diet down to a more paleo diet in the hopes that it will help.

Gill, your story is one of the reasons I went to Bordeaux. I appreciate the advice and, once the initial disappoint wore off, I came to realize that if the ablation didn't quite work I'll go back for a touch up (pretty common, really). If it did work and this is the new normal, then so be it. The ectopics aren't all that bad really. The worst part has always been the associated fear that the next one might throw me into Afib.

Monty

Monty

I remember that fear very well - but it wears off after a while, I promise you!

When I went to Bordeaux I had not found this board and though I had done lots of research I didn't know nearly as much about ablations as I do now. I didn't know that a second one is often needed, or was even possible, so when AF recurred after three days I was in despair, especially since Prof. Haissaguerre had told me that he had done everything it was possible to do.

In fact, what he meant was that he had put in all the lines that were known to work at that time, and a few hours later I was back in the lab having the second one.

One EP in London told me that the ablation lines might not stop AF from happening but should certainly prevent it from sustaining itself. I found this very comforting - if I DID get a short spell of AF I would just wait for the lines to do their job and stop it.

Gill