Do frequent or runs of PACs lead to Afib?

[oceanminded]

I had around 15,000 PACs during my last 24/hr holter monitor along with some atrial tachycardia and/or runs of PACs. I'm now taking 25-50mg of metroproprolol 2x day. Cardio Dr said to try this and come back in a couple of months. He did worry me by saying this could turn into afib one day since it's probably coming from the left ventricle. My question is will I know if I'm in afib vs tons of Pacs? Also, does an ablation seem reasonable down the road if my frequency of PACs stay the same or would it be better to wait and see if this thing turns into Afib before I consider an ablation.

Thanks!

[david2951]

   Catheter ablation is always an option whenever an arrhythmia is present. However, if you are not experiencing palpitations, or if you are but they aren't that bothersome for you, then I wouldn't worry as much about the numbers of your Holter study as much as how you feel. The Holter study would have shown if you already have A-fib, so it sounds like you don't as of right now. At this point I would just try to take preventative measures to see that this doesn't become A-fib. Keeping a close eye on it is key. If it ever does become A-fib, then maybe an ablation would be a good idea. However, if it doesn't, you have to consider if the procedure is really worth the risks (although they are very, very low risks), because PACs and PVCs by themselves (especially PACs) are benign arrhythmias. If you can live with them I would just live with them, but it's up to you to make that call with your doctor. Also, I would just make sure that your PACs are not the benign result of something more insidious. I would maybe ask to get an echo and/or a stress test done just to make sure that your heart is structurally fine and that this is just an arrhythmia problem, not any kind of cardiomyopothy or anything. If an echo showed that you had that kind of issue or a low EF% for any reason, it would make having PACs a little more risky since people with low EF's are more susceptible to having their arrhythmia become something more dangerous. It really doesn't sound like it would be though. Hope everything works out for you!

[Jerry_NJ]

All of us become more likely to develop atrial fibrillation as we grow older.  I'd take your doctor at his work/knowledge.

As for knowing, not sure, but I'd think it worth while to take at least a low does aspirin a day, with your doctor's concurrence.  AFib, even short runs, increase the risk of blood clot formation, which can lead to stroke.  The aspirin, may need a full dose, will reduce that risk.

Have you ever had your heart physical measurements taken, e.g., with an echocardiogram?  That would tell the approximate size of your left atrium (and other chambers as well).  If the left atrium is over a normal limit, the likely hood of AFib is increased.  The echo will also check your valves.  All of this should be known, I think before any serious discussion of ablation.