Decisions and high PAC burden

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....