Damn Ectopic

60+ days post Natale ablation.

Ectopics starting minute I woke up from procedure then pretty much stopped 8 days after ablation, assuming flecianide 100 2xdaily kicked in.

Friday the 8th i was instructed to taper meds down to full stop monday 10th. Wednesday 12th ectopic showed back up maybe 100. Now they have increased to over 1000 daily. Texas emailed and instructed to start metoprolol 25mg daily again for next few weeks. This afternnon im getting 5-7 per minute annoying. No afibb which is GREAT! Should I ride out annoying ectopics or request flecianide? Really just annoying and better then afibb maybe just looking for reassurance that ectopic are harmless or just maybe spilling my beans to people who can understand



Edited 2 time(s). Last edit at 08/20/2020 02:48AM by Driver.

They're definitely harmless and will probably pass, but don't be shy about asking to resume the flecainide or something else if the metoprolol doesn't help.

I'll send Texas an update and see what they say.

Only real fear I have of the ectopics is that it could lead to triggering afibb??

I was reading Shannons post on pacing cells that are in the line of fire and have a life span of 2.5yrs. Very interesting and also reassuring that this to shall pass in time.

Ectopics are worse in afternoon and evening any possible reasons?

Thanks!!!

Mine are worse in the afternoon too. I'm 9 months post ablation. They were horrible at times and I never thought they would taper off. Was getting runs of ten in a row or more. They have gradually diminished. Not gone, but less. I can get a bad day here and there, but mostly if I stay hydrated and don't push myself hard (physically) in the late afternoon I get hardly any. I can work out as much as I want in the morning. It's just the afternoon I have to be a little more careful. but that too is becoming less and less an issue over time. Hang in there. I had the exact same concerns early on. Now to be fair, I am still taking a tiny dose of Flecainide and Metroplol morning and night. 50 mg of Flec and 12.5 mg of Metro. It's a combination that helped me early on in the recovery and I've stuck with it. No side effects and while I'd prefer to be med free, I choose to take them. Just settles my system a little.

I have heard that cortisol and adrenaline levels can fluctuate during the day just naturally, and our bodies can react to those with ectopics. Some have higher levels in the morning and some in the afternoon. Mine may be higher in the afternoon and hence the ectopics. You may be the same. Hopefully I'm remembering that correctly



Edited 2 time(s). Last edit at 08/20/2020 12:44PM by keeferbdeefer.

Do you plan on continuing flec/met indefinitely?

When I'm active hobby farming i have alot fewer ectopics. when I go to relax in afternoon evening bam they start pumping out 5+ per minute.

I do plan to stay on them for awhile. They are small dosages. I'm just being lazy about trying to stop since I don't want to deal with a bad day or bad string of days. maybe I don't need them. but I feel great right now so I stick with this regimen. I might stop at some point in the future.

You're a little different from me. I would get more ectopcs in the afternoon if I exerted myself or had a stressful presentation or confrontation of something. You get them less during exertion. I had them more in the afternoon even when relaxed, but "stress" of any kind (even fun physical) made them worse. Just different. Not worse or better I don't think.

You may find a trigger that is really your own. Navigate it as best you can to stay sane and happy and not thinking about your heart, and then over time the trigger effect may diminish. Your afternoon thing I know has been experienced by others. I asked about it too early on. Some get more at rest, some while sleeping, some after they get up first thing, some in the afternoon, etc. It's all pretty mysterious.

And 60 days is still really recent post ablation. You are still healing.

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Driver
Do you plan on continuing flec/met indefinitely?

When I'm active hobby farming i have alot fewer ectopics. when I go to relax in afternoon evening bam they start pumping out 5+ per minute.

It's pretty common for vagal afibbers. It's at rest or while digesting (or both) you'll likely have ectopics.The problem is not really in the heart tissue, despite the burns. The problem is vagal tone.

I never have bad sensations in the morning (just a bit nauseous if I stand up too fast, due to my weak LES). After meal, in the afternoon; ectopics may appear while sitting at my desk. If I have a quiet walk or go working physically, I'm fine.

There seem to be varying degrees of ectopic beats. Sometimes it feels like a thud in my heart, and a skip, but very random happening 5 or 6 times per day. The bad ones are every minute, what feels like a pause in the beat with some light headedness. Is there a danger in either?

There are so many variables in all this, it makes me wonder what is, or isn't happening with me. An anomaly?

If it's ectopics that I have, they are WAY different than what I see discussed here and on other threads. If I am on my K, Mg and Taurine, I may have one bout a week or every other week. A bout is 2-4 seconds of what feels like afib, but stops quickly. Not repetitive, no physical impact and always just a couple of seconds. I am lucky if I can get to my pulse to check it out before it stops. As I recall, this type of irregularity was happening long before I had afib.

Before I started the supplements (a long time ago), my ectopics? occurred more frequently. So, what's going on? I have no desire to wear a monitor for weeks in the hope of catching my a 3 second event.

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hwkmn05
The bad ones are every minute, what feels like a pause in the beat with some light headedness. Is there a danger in either?

If the pauses are lasting long enough to make you lightheaded then the answer is yes. Feeling lightheaded is one step away from finding yourself face down on the floor. Got a Kardia? I'd get a recording of that and see how long the pauses actually are. If they're close to six seconds you may be headed for a pacemaker.

Rarely have them and when I do its like a skipped pulse or one second, usually last a day or so. But I will mention it to EP next week, not opposed to Kardia to get a closer look.

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Carey
. If they're close to six seconds you may be headed for a pacemaker.

I thought 3 seconds was the threshold for concern. Back in the day with my vagal AF and the metoprolol I’d see some 2.5 second pauses on my Kardia strips and those were definitely accompanied by the onset of tunnel vision. Fortunately I was almost always sitting at the time. If I were walking I’d probably have stumbled.

Say it’s not true.....I hope...

Long-term clinical outcomes of catheter ablation in patients with atrial fibrillation predisposing to tachycardia-bradycardia syndrome: a long pause predicts implantation of a permanent pacemaker
[www.ncbi.nlm.nih.gov]


Predictors of Sick Sinus Syndrome in Patients after Successful Radiofrequency Catheter Ablation of Atrial Flutter
[www.ncbi.nlm.nih.gov]



Edited 1 time(s). Last edit at 08/23/2020 03:49AM by susan.d.

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wolfpack

. If they're close to six seconds you may be headed for a pacemaker.

I thought 3 seconds was the threshold for concern.

It may be. I think it depends on what the suspected cause is and how frequent they are, but symptoms like fainting and lightheadedness would definitely increase the likelihood of doing something about it.

Maybe a stupid question. How do you tell how long the pause is on kardia?

The standard speed for an EKG tracing is 25mm/sec, represented by 25 "small squares" or 5 "big squares" on the tracing.
So, 5 big squares between 2 QRS complexes mean 1 sec. NSR at 60 bpm displays like this : 5 Big squares between each QRS.
Counting or measuring the mm between 2 QRS on the tracing gives you the length of the possible pause.

Other things may appear on the tracing, like "p" waves, during the suspected pause. How and why is a job for your cardiologist...

Hope this helps.

Yep thank you!

My ectopic show funky up an down pattern (qrs?). Do you count between both normal looking beats for the length of the pause or does the funky pattern count thats in between the normal beats?

Hope that's not confusing in my layman explanation. I'd share EKG but cant figure out how🤔

You count from one R wave to the next. The R wave is the large vertical spike.

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Driver
Hope that's not confusing in my layman explanation. I'd share EKG but cant figure out how🤔

One option is to go to [imgbox.com] upload your photo, then copy and paste the link here in the BB-Code window on the right side of the screen.

Mine are always 1.5> seconds and last a few hours. Possible cause according to sleep specialist is cpap machine does not have "senseawake" feature and keeps blasting away when I wake from sleep, lowering HR. Mind you I feel zero other symptoms other than once having light head once, but not severe of lengthy. I do like the cpap benefits but I might be looking for machine with that feature. The ramp on auto is not the same as that, but turning it off and back on might do the trick.

The threshold is 3 seconds in NSR and 6 seconds while in Afib.