@vaughandodd Aw, shucks. I really feel badly when I see stories like this. Why, you ask? Because it's my story. Very briefly, I was sliding into nastier AF just weeks before my first ablation. Had it, and in six days I was in the local ER flat on my back with leads all over my chest and legs. AF had returned, but this time it was reeeallllly pissed off. I had to go on amiodarone for seven weeks. Told to stop it over a two week taper, which I did, but the AF came back. ER attendant said let's do another two weeks and then another taper. This was at 400 mg per day, 200 BID, and then a taper on 200 per day, or only the one tablet. This time, it actually worked. Then about a month later, I was walking holding my toddler grandson's hand in Calgary, visiting, which is at 3500 feet ASL I felt my heart go, used my Samsung Galaxy watch to take an ECG, and it reported, 'AF detected. See your cardiologist.' I got the results of my earlier Holter when I returned home two days later, and the nurse said, 'You have a LOT of PACs, but no AF.' She emphasised the word 'LOT'' and I heard it.

With that little personal story, I have since done some reading (I always try to learn more about each experience). It turns out that if one has AF in the blanking period, but only in the first three/four weeks, even out to Week 6, and then it stops, and the Holter shows no AF, that's a very positive sign. On the other hand, if you seem clear of AF until much later in the blanking period, if your Holter assessment near Week 12 shows either AF or many PACs, that's usually not a great prognosis for the weeks and months ahead. Later onset of ectopy and AF usually means you're headed for a touch-up ablation in the not-too-distant future. My frequent ectopy in the Holter suggested that my ablation had not succeeded, and a month later came the proof while holding my wee grandson's little hand.*

I don't like saying negative things. They can be hurtful, and they can cause a lot of anxiety. But ethically, with what I 'think' I understand about these things, I can't blow smoke on you. I think you should make sure your EP knows exactly what your ECG shows, and that the two of you should have a discussion about it. I think he/she should/might/would very much like to...offer you a redo. If nothing has changed about your heart's physiology, no knew information about the state of deposition in your cardiac arteries, no niggling worries about your mitral vale....then I don't see why you can't agree to try again. That, too, is my history. Second ablation has worked like a charm. In two weeks, today, I am three years free of AF.

* Just a caution about what I have posted. First, I have no medical training. I don't know you. We are two individuals who have widely different backgrounds and genetics. This is important because I have read posts by people claiming they had serious ectopy or AF for weeks after an index ablation, but here they are five years later and haven't experienced a single blip for the past four years. That means that eventually their heart settled down after....AFTER...their blanking period and all has been good. So, I may be flat out wrong about what I said about late onset ectopy....in your case. Time will tell. Please keep that in mind.