18 months post ablation and finally off meds

Had a PVC ablation 2.5 years ago, and then an afib ablation 18 months ago. I never fully got off my meds because I just felt more settled on 25 mg of Metropolol and 50 of Flecainide each day. I had tried to go lower but would start to get ectopics. They have plagued me since the second ablation.

Anyway, two weeks ago I just decided to stop it all. I had seen a slight weight gain in the last year (maybe 5-7 pounds) despite a strict calorie regimen and being active, Just could never get my cardio going when on Metropolol.

Felling pretty good off the meds, but I do get some ectopics during a workout (maybe one a minute for a couple minutes) and then they settle down for a few minutes. Might get another round here and there. I get ectopics following the workout as well, but I bet overall I don't have more than a couple hundred ectopics a day. Not bad and no afib since the procedure. I like being med free and do feel better in general with no meds in me. I get a much better workout as well and sweat much more. Hoping to drop a few pounds.

Anyway, just an update if it helps anyone with their weening off of meds. I saw another post recently with similar outcomes, although that poster was more brave than I was in terms of getting off the drugs. I should have tried it sooner.



Edited 1 time(s). Last edit at 06/11/2021 04:19PM by keeferbdeefer.

I am 2.5 years out from a successful ablation also Keef + i still have some days i get a few hundred ectopics...never even think about them unlike most non affibers who would panic over something like that but considering what we all have gone through + still are some of us if we still have not had the malady corrected.....those funny beats are small potatoes right.....personally after about 450 ARR between 2014 + late 2018 i laugh at my ectopics.
Your last line is interesting because the few people i have talked to who are still on some drugs after an ablation (other then the blood thinners for 3 months after...... i stopped the heavy duty thinners + went to natural after about 2 months......that i took before my ablation for years anyway) i always tell them to wean off the drugs and see how it goes....you can always go back on them if your heart is telling you to keep on them by it's post drug actions....its not like you can't restart them if nes.....so what's to lose.

Glad your doing so well!! Good to hear!

Completely understand the problem with beta blockers. For some people, including me, beta blockers are like anti-activity meds. Glad to hear you're getting yourself off them.

That's the way I see it too Vanlith. I can always go back. My doctor pretty much gives me full jurisdiction to self medicate with being on or off one/both the meds I'm on (or was on). I'd say I get more ectopics now, but agree again they aren't as scary as what I've had in the past. Can deal with them.

I really do think these ectopics can take a year or more to settle down. Even on meds it took many months (over six) for them to settle down and not be triggered by the slightest stressor. Now they sort of flare up in the early afternoon or after an intense workout. So I work out in the morning and just weather the afternoon weirdness. It's manageable

You are all so brave and give me hope. I've had ectopics since teens but usually 100 or so a day. First Afib in 2006, converted within a few hours. Second afib 2018, converted on it's own within 8hrs. Third afib yesterday which converted within a few hours. I take Eliquis and Metoprolol daily. Each time it converted back was after taking an Ativan to settle my nerves. I was taking Diltiazem & Flecainide for a year in 2018 but had too many contradictions so I weaned off Flec and replaced Diltiazem with Metoprolol. My question to you my friends... is there a med that will keep afib away? Is there a med out there that's the most successful on reducing ectopics which really are so worrisome to me but my cardiologist says benign. Docs say my heart is structurally sound, so what's up with afib showing up? Are they missing something? At 68 now it appears afibs starting to get more frequent.

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Muntz
My question to you my friends... is there a med that will keep afib away? Is there a med out there that's the most successful on reducing ectopics which really are so worrisome to me but my cardiologist says benign. Docs say my heart is structurally sound, so what's up with afib showing up? Are they missing something? At 68 now it appears afibs starting to get more frequent.

There are several meds that can be used to treat afib and ectopics. You've already tried two of them (flecainide and diltiazem). But like flecainide, they all come with varying degrees of side effects. The most effective of all is amiodarone, but it also comes with the most severe side effects. It's not a drug that should be taken long-term unless absolutely necessary, and then it needs close monitoring forever.

No, I doubt if they're missing anything. This forum is full of people who are in great health with perfectly normal hearts and who also have afib. That's the nature of the beast. Why do you have afib? If I knew the answer to that question I would publish and collect my Nobel Prize. In my opinion, it probably has a genetic basis but nobody has nailed that down (yet). Unfortunately, afib tends to be a progressive disease, so it's not surprising your afib is becoming more frequent. From 2002 until 2008 I experienced one or two short episodes per year, but by 2010 once or twice per year had become once or twice per week and the episodes went from 6 hours to 12 hours plus.

Is your cardiologist an electrophysiologist (EP)? If not, I highly recommend that you find one and book an appointment.

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Muntz
First Afib in 2006, converted within a few hours. I was taking Diltiazem & Flecainide for a year in 2018 but had too many contradictions so I weaned off Flec and replaced Diltiazem with Metoprolol. My question to you my friends... is there a med that will keep afib away? Is there a med out there that's the most successful on reducing ectopics which really are so worrisome to me but my cardiologist says benign. Docs say my heart is structurally sound, so what's up with afib showing up?

The Metoprolol will keep your rate from going too high, when you have an episode. It generally won't prevent afib. I assume you are on a anticoagulant, like Eliquis, too? The two risks from afib are stroke, which an anticoagulant can protect you from and cardiomyopathy from extended periods of a high (>110 BPM) heart rate (extended = days & weeks, not hours). The Metoprolol will act as a rate control med. Hence, your docs have protected you from the big afib risks. Once you take these away, then afib is generally annoying, but not life threatening.

As Carey mentioned, there is likely a genetic predisposition to afib, that can be enhanced by lifestyle or environmental factors. Afib is an electrical problem, so people with structurally sound hearts can have afib. You mention that you have contraindications to flecainide. Are any of these modifiable by lifestyle changes?

I'm 66 and had my first episode 17 years ago, in 2004. My afib progressed quickly as I started having afib every 10-14 days, and within 2 months, had and episode that lasted 2 1/2 months. It was ultimately converted with a loading dose of flecainide. My EP at the time suggested I was doing well out of rhythm, so why don't I just stay there (my afib rate was < 100 BPM)? This was during the 2 1/2 month episode. I proposed a "plan B" to the doc of detraining from my rigorous exercise training & supplementing with electrolytes and asked for a prescription of PIP flecainide for the times the other approach failed. He agreed & I've been successfully following my program since. When looked at from the perspective that my AF burden was ~57% during my first 4 months and has been > 0.1% (usually >0.02%) since, my afib has not been progressive. Studies I've seen suggest many younger afibbers become metabolically challenged as they age (as does the rest of the population). Hence I have also focussed on maintaining a very high level of metabolic fitness. Additionally, even though detraining is a key component of my plan, I remain very fit, with a carefully designed exercise program that maintains fitness, without overdoing it from my afib perspective.

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Muntz
You are all so brave and give me hope. I've had ectopics since teens but usually 100 or so a day. First Afib in 2006, converted within a few hours. Second afib 2018, converted on it's own within 8hrs. Third afib yesterday which converted within a few hours. I take Eliquis and Metoprolol daily. Each time it converted back was after taking an Ativan to settle my nerves. I was taking Diltiazem & Flecainide for a year in 2018 but had too many contradictions so I weaned off Flec and replaced Diltiazem with Metoprolol. My question to you my friends... is there a med that will keep afib away? Is there a med out there that's the most successful on reducing ectopics which really are so worrisome to me but my cardiologist says benign. Docs say my heart is structurally sound, so what's up with afib showing up? Are they missing something? At 68 now it appears afibs starting to get more frequent.

My afib was very rare, like twice a year or even less for ten years or so. Then it started to happen a lot more regularly and then got to a couple times a week leading up to ablation. Trigers were all sorts of things from exercise, to cold food, to just watching Jack Reacher on TV. Heck I think reaching above my head to change a light bulb was a trigger once. Like you, I could always self convert, but it was exhausting being in afib that much. And scared the Hell out of me. Afib tends to get more frequent over time. You may find yourself wanting to get an ablation eventually. My account above was to help put into perspective the ectopics that followed my ablation, and which I had to some extent before it. Some were ventricular and some were atrial, but they got much worse after. Took a year or more for them to settle down, and I was very skeptical they would. I was on here all the time asking "is this many normal?" and "when I do this they are worse." and "Did the ablation mess me up?". All that stuff.

I stayed on meds for a long time. I tried getting off them even 10-12 month post ablation later and would get ectopics again. So I stayed on them. Then I got off them again around 18 months and had some ectopics but just stayed the course. I'm very sensitive to them so every one gets my attention. If I'm having a bad day say once every couple weeks, I'll pop a fleccainide. But otherwise I think things are getting into state of equilibrium. May have taken my body some time to take care of itself med free. Who knows. I will say that I really think Metropolol helped my ectopics by keeping my adrenaline in check or something. Workouts and stress would trigger ectopics for me, so it makes sense Metropolol would help. But i hated the feeling of being slowed down like that.

Anyway, get the council of a good EP physician, think about your options, and continue to learn your body's routine and triggers and you can hopefully get a lot more control of things. Keep asking questions. We are all part of the same club here.



Edited 1 time(s). Last edit at 06/21/2021 05:26PM by keeferbdeefer.

Wow, that is one of the worst ablation outcomes I’ve heard of. I too have infrequent Afib which has increased in frequency and at this point I have an episode every 2-3 months. I have an occasional premature beat. In a nutshell I still have a life! I’m scheduled for an RF ablation,makes me wonder if I should cancel 😳 I’m glad you are doing better now, I don’t know how you made it through that!