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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have PAC's With No Flutter. Have Fatigue. Taking Zyrtec. Had Cardiac Ablation For Atrial Flutters. Reason?

I am 2 years out from a successful cardiac ablation as treatment for atrial flutters. I am now 57 year old female in good health with an active fitness regimen and a healthy diet . For the last year, I have experienced PAC s which have not triggered flutters, which I m told is a good thing. However, the PAC s make me so fatigued, that I rest if I can or just try to push through the fatigue, if I can t stop. They occur randomly and appear to have no correlation with any activity, emotional upset, food or drink. Living in west Texas where there are many allergens in our environment, I take Zyrtec on a pretty regular basis, as needed. I have noticed that when these PAC s occur, it is often when I am stiffing due to allergy attacks, before I think to take the Zyrtec. That seems strange to me.
Sat, 30 Mar 2013
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Cardiologist 's  Response
(PACs) are one type of premature heartbeat, irregular heart beat, or benign arrhythmia. These ectopic beats occur in the upper two chambers of the heart, called the atria,usually require no medical care. Individuals with this condition usually report feeling that their heart "stops" or misses a beat.
List of some of the possible causes :

Alcohol
Smoking
Drugs such as cocaine;
Caffeine
Tricyclic antidepressants
Magnesium and potassium deficiency
Calcium excess;
Thyroid problems;
Chemical (electrolyte) problems in the blood
Heart attack
Adrenaline excess;[
Lack of sleep/exhaustion
Stress
Certain medicines such as digoxin, which increases heart contraction[
Myocarditis;[
Cardiomyopathy, hypertrophic or dilated;
Myocardial contusion;
Hypoxia;
Hypercapnia (CO2 poisoning);
Mitral valve prolapse

DIRECT ALLERGY CAN NOT PRECIPITATE PAC, POSSIBLY OF STRESS DURING ALLERGY LEADING TO PAC. DISCUSS WITH YOUR CARDIOLOGIST IN DETAIL
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

The most likely reason is recurrence of the original problem - well documented in many.
The best option will be to go for EPS (Electro Physiological Study) again / a second ablation can cure most such cases

Take care
Wishing speedy recovery
God bless
Good luck
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Have PAC's With No Flutter. Have Fatigue. Taking Zyrtec. Had Cardiac Ablation For Atrial Flutters. Reason?

(PACs) are one type of premature heartbeat, irregular heart beat, or benign arrhythmia. These ectopic beats occur in the upper two chambers of the heart, called the atria,usually require no medical care. Individuals with this condition usually report feeling that their heart stops or misses a beat. List of some of the possible causes : Alcohol Smoking Drugs such as cocaine; Caffeine Tricyclic antidepressants Magnesium and potassium deficiency Calcium excess; Thyroid problems; Chemical (electrolyte) problems in the blood Heart attack Adrenaline excess;[ Lack of sleep/exhaustion Stress Certain medicines such as digoxin, which increases heart contraction[ Myocarditis;[ Cardiomyopathy, hypertrophic or dilated; Myocardial contusion; Hypoxia; Hypercapnia (CO2 poisoning); Mitral valve prolapse DIRECT ALLERGY CAN NOT PRECIPITATE PAC, POSSIBLY OF STRESS DURING ALLERGY LEADING TO PAC. DISCUSS WITH YOUR CARDIOLOGIST IN DETAIL