What are you still taking post ablation?

I had my afib ablation almost three months ago. No breakthrough episodes but I do get PACs from time to time. My EP has had me on Flecainide the entire time (100 mg two times a day), and we started Metropolol 12.5 mg once a day about a month ago. This all keeps me pretty settled, although my heart rate is very low (about 55 bpm) on this regimen. I think if I went off of these, my PACs wold be a lot worse.

While not optimal, I'm OK with this. I've heard people say that the ablation wasn't successful unless you can go off the meds. Have the majority of you been able to drop all meds? Or do you take things to keep PACs and such at bay?

my last ablation was 4 yrs ago. I also have a lot of PACs and I’m very bothered by them.
I was also in Flec and Metoporol. Occasionally I would take a xanax during times of stress
anyway i started noticing heart pauses. My heart rate was dropping to 40s low 50s.
Thought for sure I needed a pacemaker. Anyway doc took me off everything.
Getting off Flec changed my life for the good just as getting on it at one time did.
My heart rate went to normal, pauses went away, I can breath better under physical stress.
YES I still have pacs but for whatever reason they aren’t as strong.
When they are bothersome I have prescription slow release potassium I take and it
helps.

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tsco
my last ablation was 4 yrs ago. I also have a lot of PACs and I’m very bothered by them.
I was also in Flec and Metoporol. Occasionally I would take a xanax during times of stress
anyway i started noticing heart pauses. My heart rate was dropping to 40s low 50s.
Thought for sure I needed a pacemaker. Anyway doc took me off everything.
Getting off Flec changed my life for the good just as getting on it at one time did.
My heart rate went to normal, pauses went away, I can breath better under physical stress.
YES I still have pacs but for whatever reason they aren’t as strong.
When they are bothersome I have prescription slow release potassium I take and it
helps.

Thanks for that feedback. Interesting. I see my EP in a few weeks and will ask him about getting off the two meds over time. Appreciate you telling me how yours evolved. I've treated Flecainide like a crutch that I'm afraid to get rid of. Hopefully by getting away from it my heart rate elevates a little and things stay settled.

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keeferbdeefer
While not optimal, I'm OK with this. I've heard people say that the ablation wasn't successful unless you can go off the meds. Have the majority of you been able to drop all meds? Or do you take things to keep PACs and such at bay?

If you never come off the antiarrhythmics then you'll never know if your ablation was successful or not. If you stop the drug for a lengthy period of time and have no recurrences of sustained afib, then it was a success. Frequent PACs don't make it a failure and taking an AAD to calm the PACs is simply your choice.

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Carey
If you never come off the antiarrhythmics then you'll never know if your ablation was successful or not.

You’ll know it was a success if you had AF weekly or monthly before the ablation and no AF for a year or more after the ablation whether or not the AAD was/is continued.

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mwcf
You’ll know it was a success if you had AF weekly or monthly before the ablation and no AF for a year or more after the ablation whether or not the AAD was/is continued.

If the AADs were ineffective before the procedure and effective afterward, that's certainly an improvement, but the standard used by EPs is that success = freedom from all atrial tachy-arrhythmias without AADs one year post-ablation. As long as you're still taking an AAD, you can't know if it was fully successful and you can't be added to the success column in a study.

This exact issue is one of the major criticisms of some of the FIRM research papers. They counted ablations as successful even if the patients needed AADs to remain in NSR. That was a very scientifically deceptive thing to do.

After my 2nd Ablation, I left Austin taking ZERO AAD,s. I was on Sotalol but Dr. Natale just kept me on 25 mg Metoprolol ER 1x a day. I could not take Multaq because in 2016 optima RX would not pay for Multaq and my Local Cardiologist did not like Flecainide at all.
Anyway, Currently doing well