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Atrial fibrillation, low BP. Did ablation for SVT. History of premature atrial contractions. Can these trigger atrial fibrillation?

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Cardiologist, Interventional
Practicing since : 1998
Answered : 410 Questions
Can Ectopic heartbeats trigger A-fib if you haven't had A-fib before? :

Hello, I’m a 41 year old female. Around 2 and a half years ago, I started having SVT, PVC’s, PAC’s, and an increase in sinus tach – which started when I was in college. I’ve had lots of testing and have been told that I have a structurally normal heart, no heart disease, etc. My ejection fraction is 70%, my blood pressure tends to run a bit low, and my cholesterol is optimal. I exercise everyday and try to eat healthy food. I do not take any medication.
Almost 2 years ago I had an ablation which was successful in treating the SVT. I haven’t had any episodes since then.

I still have PAC’s, PVC’s and sinus tach. Previous testing shows that I have around 150 of each a day. Some days I don’t notice any, but when I’m stressed out, I notice more – sometimes up to 20. (This just happened over the holidays.) I’ve been told that they are benign. I still get a little nervous when I have the ectopic heartbeats. This is based on reading some contradictory things. I’ve read that they can trigger A-fib, and this frightens me.

My question are:
1. Could PAC’s and PVC’s trigger A-fib in me? (I’ve never had A-fib before, and I’ve been having them for 2 years and the ablation didn’t trigger A-fib.)
2. If they can trigger A-fib – what is the likelihood of this?
3. My new eletrophysiologist does not think that I need to have any more testing. He says I’m too young to need another stress test or echo. Do you agree? (I’ve read that frequent sinus tach can lead to heart failure.)

Thank you for your help!
Posted Wed, 18 Apr 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Prabhakar C Koregol 11 hours later
Thanks for posting your query.
I understand your concern.
Yes, Atrial fibrillation(AF) can be triggered by premature atrial contractions (PACs) but only in patients where there is substrate for AF such as Left ventricular hypertrophy, Hypertension or valve disease. So in your case, the likelihood is near to zero or that of general public which would come to 1%.
Yes, if you have been tested once and found to be normal, there is no need for retesting.

I hope I have answered your query. Please accept my answer if you have no further queries.

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