Palpitations

Hello everyone. I haven’t posted here in awhile so let me tell you my story (I’ll try and make it brief)

When I was in my 40s, about once a year I was having long episodes of atrial fibrillation. Flash forward to 2019 and I’m 54 years old- the episodes are more frequent and more debilitating. August 2019 I have my first ablation. Didn’t take. November 2020 I have second ablation at Cleveland Clinic. Thought it worked but since that time I’ve had three episodes of a-fib, my last one was 22 hours! In addition to all this, BEFORE I had any of these surgeries the only thing I experienced was a-fib. Now after all the surgeries I get the occasional “hiccup” in my heart…not completely a-fib…but my heart just stops and skips a beat. My GOD, it makes me shudder and my anxiety goes through the roof. It’s normally when I’m at rest, never when I’m exercising or running around. So what the heck happened? I NEVER had these palpitations before the surgery. Now they are a regular occurrence I’m regretting having these surgeries as I believe more damage was done. I don’t want another ablation and would rather be prescribed some sort of medication to control the arrhythmias.

Has anyone experienced this drama? I want my life back.

Here is what I recall, don't have a reference and my memory could be faulty. Sometimes PVC's (premature ventricular contractions) can feel like a pause with big beat after. I think this is because there can be little to no ventricular ejection of blood during the PVC beat. That is why it feels like a pause. Then the ventricles have a normal amount of blood filling them during the next beat, before contraction. Hence the ventricles "overfill" and when they contract, it feels like a "hard" or "big" beat after.

Does this describe what you are feeling. A continuous monitor would likely confirm this on the ECG. There is a home ECG monitor that will monitor for 24 hours that one user has been using. If interested, I could look up his posts.

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tallguy31
Hello everyone. I haven’t posted here in awhile so let me tell you my story (I’ll try and make it brief)

When I was in my 40s, about once a year I was having long episodes of atrial fibrillation. Flash forward to 2019 and I’m 54 years old- the episodes are more frequent and more debilitating. August 2019 I have my first ablation. Didn’t take. November 2020 I have second ablation at Cleveland Clinic. Thought it worked but since that time I’ve had three episodes of a-fib, my last one was 22 hours! In addition to all this, BEFORE I had any of these surgeries the only thing I experienced was a-fib. Now after all the surgeries I get the occasional “hiccup” in my heart…not completely a-fib…but my heart just stops and skips a beat. My GOD, it makes me shudder and my anxiety goes through the roof. It’s normally when I’m at rest, never when I’m exercising or running around. So what the heck happened? I NEVER had these palpitations before the surgery. Now they are a regular occurrence I’m regretting having these surgeries as I believe more damage was done. I don’t want another ablation and would rather be prescribed some sort of medication to control the arrhythmias.

Has anyone experienced this drama? I want my life back.

As George suggested, monitoring would help being sure those are PVCs or PACs.
I totally agree those palpitations are awful when you feel them. Particularly in the case of PVCs.
My opinion is those premature beats can be the price to pay to be afib free. There's no "cure" to afib. Just meds or ablation. Ablation is now considered a "first line" treatment, since it's statistically more efficient for relatively young and healthy people, but I disagree with that. I think it's better trying some meds, seeing how they work (or not) before going for ablation. There's one main reason for that: when burns in the heart chambers are done, they're done. Our heart will never be the same. If a drug don't work, one may always switch to another one or choose ablation.

What you're feeling are probably PACs, and the first thing you need to know about them is they're harmless. They may feel distressing, but they are not dangerous and pose no threat to you. They could be PVCs, but having had afib and an ablation, PACs are more likely. Either way, they don't represent any sort of damage to your heart. And although it may not seem this way now, they're a lot better than afib. I would suggest a consultation with the Cleveland Clinic doc who did your ablation. Don't rule out another ablation. Trust me, you don't want to spend the rest of your life on antiarrhythmic drugs and a second "touch up" ablation is often the solution.

Not sure If everyone read my post in-depth but I never had these symptoms before the surgeries. My heart DOES skip a beat as I’m checking my pulse while this is happening. it beats about 6 or 7 times then just pauses (skips a beat) when I’m having these episodes. The next beat is delayed and it’s quite strong. It sends a shudder down my spine and it feels like someone unplugged me and “rebooted” my heart. Let me repeat: I never had these episodes before my surgeries, and now they seem all too often. My a-fib has actually gotten WORSE and more frequent after my second surgery (it’s been over a year) and It’s really making me think twice about having the surgery. My a-fib was less frequent and I never had these daily heartbeat issues. Again—I wish I could turn back time and have treated this minor issue with something different. I truly believed ablation was going to at least solve or lessen my episodes—and it has not.

We answered your questions. Havic "skipped beats" after ablation is frequently reported here.
Monitor your heart. You'll know for sure wether they are PACs or PVCs.
But don't believe your afib has gotten worse because of the ablations. It's likely it would have gotten worse without ablations too. Afib is like that.
I think your ablations have not succeed freeing you from afib. It happens. Statistics tell there's a percentage of success vs failure.
Some people here fall in the bad side of said statistics. I'm one of them.

EP says they are PACs and has me on flecanide now. We will see how this turns out, I’m hoping it at least can stop the PACs as they are incredibly disturbing—even though I’m always told they’re nothing to worry about. I wish my body felt that way!!

Tell us how it goes with flecainide!

I've been on Flec 50mg 2xday AND Metoprolol 25mg once a day for about 6mos for palps mostly PVCs. The first few weeks, PVCs were few & far between. Some days none! Then last couple weeks the skipping beats, mostly PVCs have returned enough to be disturbing but not enough of a burden for a PVC ablation. It appears as if the Flecainide stopped helping. My cardiologist increased Metoprolol from 25mg to 37.5mg to see if helps but after two weeks it's still disturbing. Even tonight after I fell asleep for about an hour they returned so often that it woke me up! Now that I'm awake...none. I HATE THEM! I take Eliquis since my last Afib episode 3yr ago. According to my docs, my condition doesn't warrant any procedure types.

Well, it’s been about a month since my EP started me on Flecanide. I have to admit, the PACs have decreased significantly but I also want to let everyone know I’ve started a regimen of acupuncture as well. Since Western medicine has somewhat failed me I’m looking to the East. Now, whether or not it’s the acupuncture or the Flecanide..I don’t know. But I am feeling more comfortable and the PACs are quite rare now. They used to last an hour or so, now it’s only a few minutes maybe once a day.

What’s sad about my entire story is that before any ablations, I had no problems with PACs or skipped heartbeats. I only had a-fib maybe twice a year, which begs the question should I have tried the “pill in the pocket” flecanide for those a-fib episodes that occurred a few times a year? I guess I’ll never know.

From 2002 until 2008 I would experience 1-2 episodes per year, each one lasting almost exactly 6 hours. And then 1-2 per year evolved into 4-5 per year, then monthly, then weekly, and by 2010 it was multiple episodes per week lasting 12+ hours each. That's what afib does; it's a progressive disease. If I had done nothing in 2010 I expect it would have become persistent afib within the year.

So don't kick yourself for the ablation. It's very likely that sooner or later. your afib would have done what mine did. As for the PACs, it's very easy to find out if it's the flec or the acupuncture. Just stop the flec for a few days. My money is on the flec.

Interestingly enough, I’m still on the Flecanide but backed off on the acupuncture a few weeks ago…and guess what, I’m having the PACs again. I immediately scheduled my next acupuncture appointment on Friday. I’m hoping the combination of both will relieve this nuisance.

tallguy.... it's been a couple of months since you started back on acupuncture, so how is that doing?? I'm thinking of trying the same to hopefully reduce my PVCs which happen enough to reduce my quality of life but not enough to have an ablation. I've got an EP appt in two weeks and I'm going to question being on Flec for PVCs that is not helping in my opinion. Maybe he'll let me keep Flec as a PIP in case of an afib episode. Since this grandma is over 65, they're expecting my afib will return more & more over time. It's been 3yr since my last one. I, too, wish I didn't have any cardiac issues but we're all learning to live with the cards we're dealt. I HATE IT SO BAD IT MAKES ME CRY SOMETIMES! But in the wise words of my dear deceased mother whenever I complained, she'd say..."it could be worse"!
I so love this forum and reading all the posts from wonderful people about their journey. It really makes me feel not alone.

The acupuncture (as far as I could tell) did help, however it was $100 a session and I was having it once a week. I had to stop going for awhile and wish I didn’t, just recently my PACs have returned so I’m scheduling an appointment next week immediately! I’m so tired of this. I even gave up alcohol for a month and it didn’t make a difference (even though docs insisted it was contributing to the issue!). I’m at my wits end, I want my life back with JUST the occasionally a-fib and no PACs!!

I haven’t posted in awhile and wanted to give everyone an update. So, the Flecanide failed. Anytime I’d get a bit tired or overheated from working, my heart would go back into its state of palpitations. I literally would have to stop what I was doing, sit down, and just wait until it would go away. I finally thought to myself, IM TIRED OF THIS! I can’t live this way the rest of my life. I’m not an old man! I exercise regularly, I eat right, etc, this can’t be happening. I started to do a LOT of research, I mean a TON of research. This led me to wean myself off of EVERY medication I was taking: Flecanide, Metoprolol and Lipitor. It’s now been 2 1/2 months and the results have been INCREDIBLE. In the past decade or so, I’d been having trouble sleeping. I figured it was just because I was getting older. I’d tried sleeping pills, gummies, Xanax to help me fall asleep and stay asleep. No longer. I’m back to sleeping like a teenager! I fall asleep, and I STAY asleep. My energy levels have rebounded. My muscle aches have disappeared. And most importantly? MY HEART PALPITATIONS ARE LITERALLY NON-EXISTENT. My belief is the STATIN was the main culprit as it robs your body of COQ-10. Both my parents had a-fib and palpitations….and they both took a statin. I remember when my afib episodes began 14 years ago, almost the EXACT same time I started taking a statin,

I’m not a doctor, but all I know is that my heart is back to almost 99% normal. Two operations, tons of anti-arrthymia medications didn’t do a damn thing. Wish I had known this years ago. That’s my story.

Very glad to hear this, tallguy!

Your post is buried on page 5, so don't expect a lot of responses, but I'm glad to hear you've done so well by simply stopping a bunch of meds.