Decisions, decisions.....

Still fighting with the PACs after my May 10th ablation for SVT. I finally got a Wellue 24 hour ECG recorder and the PAC burden is pretty impressive. I did two different 24 hour recordings and the first one was 44,677 PACs in a 24 hour period with 1,154 short runs of atrial tachycardia. The second recording was 31,533 PACs (bigeminy, trigeminy, singles, couplets) and 877 short runs of atrial tachycardia.

It is such a high burden (26%). On both recordings, my daytime burden (8am-8pm) was about 16% and the night burden (8pm-8am) was around 36%. The burden from 9pm-5am was about 48%. It just seems so high.

I know from the last EP Study/ablation that the PACs are in the left atrium and he suspects near the PV. He may have to do a PVI if he goes back in for another ablation.

It is just so difficult. I have had an unsuccessful ablation attempt in May of 2023, another unsuccessful attempt in December 2023 with subsequent pericarditis, a successful ablation for SVT in May 2024, then vasculitis from Verapamil in July 2024. Now I am looking at another ablation and am also on Ivabradine from Inappropriate Sinus Tachycardia after the ablation.

It just feels a bit defeating. Interventions are not without risk, but there is also plenty of risk with such a high burden of ectopy, and I won't try any more meds... I'll have to decide, but I don't like any of the choices....

I wish you had better options going forward. Maybe look for another EP? I agree with the medication if nothing you have tried so far works there probably it probably won't change. I understand how a burden that high affects you (mine was about 35-40% when I went to the hospital in June) it's not something you just get used to. For myself, I would probably just go with the ablation. There are risks involved any way you decide to go. Good luck and keep fighting the good fight!

I’m sorry the options aren’t better. I don’t have the knowledge or experience to offer any advice, but I’m hoping for the best for you!

Thanks all. I am going to try a few more supplements as a last ditch, and then will schedule another ablation.... 30-40,000 a day is just too many. My EP agrees, its no good.

There’s a lot of evidence about Taurine preventing and resolving arrhythmias, especially in Japanese studies. If this was my situation I would see no problems with taking 10-15 grams per day to see if it resolves your issues. The worst case scenario is you’d get diarrhea if you’re body was having too much of taurine and definitely no harm otherwise as I have consumed up to 20 grams and never had any issues. If you do decide to try I’d recommend the brand called NOW as they’ve been around and definitely produce high quality supplements. Other than Taurine, I’d suggest high dosages of thiamine, b-12, and possibly copper to help with arrhythmias.

Wish you the best,

Johnny

Thanks, Johnny. My doctor has had me on Taurine for quite some time in addition to some other things. She has added some anti-inflammatories as well- Quercitin and Curcumin, etc. The interesting thing is that all the antiinflammatories actually stopped the PACs for about four days and then they came back with a vengeance. I am going to try to add in Arginine/Citrilline before setting up another ablation. Thanks for the suggestions!

Have you considered a Mini Maze intervention? Just came back from the StopAFIB conference and Dr. Wolf gave his presentation on how his procedure addresses this problem. He has helped folks even in persistent AFIB back to sinus rythmn. It may be worth a consult to see what he thinks based on your history.

I have had AFIB for 25 years. Had two ablations, the last of which mercifully held me in sinus rhythm for seven years until I then again began experiencing AFIB events. These events worked their way up from an occasional arrhythmia to about once per week over a time frame of about a year. I then began experimenting with taurine dosages. I also had been taking citrulline as it has the effect of increasing arginine in the blood stream better than taking arginine as arginine doesn't effectively pass through the digestive system and citrulline is a precursor of arginine and it does make it into the circulatory system intact. I adjusted my dosages of both of these to three grams each twice per day and have had an 18-month run now of virtually zero AFIB events. To me it has been a total success story, and I feel terrific! I also take magnesium, both taurate and biglycinate, coq10, vitamin D with K2, also fish oil.

thanks for the update on dosages! My ablation worked, but I am still wanting to prevent further issues!