frequent pacs after ablation

When I had my first ablation in July of 2022, I was getting more and more AF, and my rising dose of metolprolol had my heart rate while in NSR in the 32-35 BPM range. I felt prickles on the back of my neck and felt light-headed. Fortunately, the PVI came at the right time and I was good for about a week. Then came full-blown AF and I had to go on amiodarone. I stopped amiodarone at the eight week mark and went off everything until my Holter assessment two weeks later. That assessment said I had, in the words of the outreach nurse who offered to relay the results to me, '...a LOT of PACS.' She emphasized the words 'lot of'. I have since learned that, while many EPs and cardiologists seem to be indifferent to PACS, they are in early indication that things are not going to be peachy for long...and that's exactly how it went for me. Inside of five weeks I was again in AF, it settled down, and then hit me again and I was scheduled for a second ablation.
That was a somewhat long, and maybe uninteresting, personal anecdote, but it is relevant to what I fear might be happening in your case. I actually have done a ton of reading and watched videos by qualified EPs, and while many/most patients should expect some ectopy in the first three/four weeks after an ablation, it should settle down if the ablation has been done correctly...and has fully isolated ALL foci and re-entrants. On the other hand, if a typical ablatee finds towards the time they are to get the Holter assessment that they suddenly begin to experience ectopy, it's not good. Not absolutely not good, but generally it indicates that there are problems that will probably get worse before very long. So, that's my message: ectopy after about 6 weeks or so is generally not good. The heart is supposed to stabilize, the lesions are supposed to meld together and from one contiguous set of 'dams' around the foci and re-entrant(s), and that should mean the heart gets quieter and stays in NSR by the time the Holter monitor is assigned to the patient.
I don't know how well-read you are about all things AF/PACs, but there are several places where they can be generated. They include the left atrial appendage (LAA), the coronary sinus, and even the Vein of Marshall sometimes needs an alcohol ablation (they run very cold alcohol through it to freeze the electrical generators if they have found any there). I don't know what mapping you have had, where all your lesions have been placed....and it may mean that your case is sufficiently complicated that you'll need an AV node ablation and a pacemaker. That's pretty drastic, but it's by no means a rare thing...it happens with lots of AF patients. I also don't want to alarm you since you are surely wound up already...sorry...but I 'm just trying to offer you what I think I understand about what comes next.

@gloaming
I always find your posts interesting, helpful, informative and reliable as you do your research. Keep them coming! 😊

I'll do my best. I have to keep reminding myself that I'm not an expert, and to remind those reading that what I post is just what I think I understand. It's always best, if what I say raises doubts or more questions, to run them past the real experts....please. Maybe that's what my mission should be; make people think of more questions and to encourage them to place those questions before their expert caregivers.