Heart Rhythm Conditions – Welcome to the group

Gloaming, Good info. I'll add mine to the mix. In 2024 I was racked by PACs - as many as 8 in a 30 sec smartwatch trace, which I calculate to be above 26% for my 60 bpm rate. The symptoms were there; I called them AF Lite. (I use AF as i've had diagnoses of both Aflutter and Afib). I was post ablation by 6 years. My AF is paroxysmal with infrequent AF occurrences however during the high PAC episode, I noted more AF sessions. I searched Dr Google which led to articles similar to those you cite although the Japanese study seems in more detail. I recall two points from the article search: 1. Frequent PACs are a precursor to Afib and 2. Best treatment is ablation. After presenting my traces to Ep he offered another ablation or a med - deflectilide, which I understand works like a chemical ablation. i was at the time experimenting with thyroid hormone levels with some success, so I deferred on his suggestions. Since, I have been successful with adjusting the levothyroxine level - the PACs and AF episodes have ceased. https://pmc.ncbi.nlm.nih.gov/articles/PMC2680813/
I'm an engineer with no medical training but here's what i would do if I were Greg, in conjuction with my EP:
1. Chase the hyperthyroid possibility. With a lot of PACs I had low TSH(hyperthyroidism); after adjusting my TSH to around 5, which is upper limit of normal range, the PACs and AF episodes stopped.
2. If thyroid isn't it then consider an ablation. THe reason I suggest that is I've read and heard from EPs that AF gets worse with age if left untreated. My ablation was cryo; I understand the pulsed field technology now available is safer and just as effective or maybe even more so as EP has less concern about damaging adjacent heart tissue or esophagus.

@pamandgreg Whoops, I don't know what I was thinking. Yes, the official report says you DO have bradycardia. I'm happy you caught that...and are paying attention more than I. (Where's that red-faced coughing emoji?) 😀

Bradycardia is officially any sustained HR measured that has a rate under 60 BPM. Many cardiologists think that number should be revised downward at least five points. This is because of the 'fitness generation' and their penchant for racket sports, running, cycling, etc where their fit hearts routinely are running below 50 BPM, often below 40...!!! And they're perfectly fine, no syncope or shortness of breath. What is not evident in the information you provided is how low, how long. And did you, during the measuring interval, feel any symptoms that could reasonably be attributed to 'bradycardia' when your monitor recorded the lowest heart rates? Does your heart respond readily to increase demand, such as rising to your feet from a seat and maybe climbing stairs to a bedroom? These are important questions that could mean your official 'bradycardia' is really of no consequence. But............if you have a history of stumbling, fainting, wheezing and feeling unwell, swollen ankles, etc...these could be signs of an HR that is simply too slow for your needs. And you have just posted that you do indeed have some minor episodes of shortness of breath. This could be ectopy or valvular function/deterioration problems.

chickenfarmer has lots of experience and learning under his/her belt, so do have a careful read, please.

I am sorry I misread your earlier statement. Sin in haste, repent at leisure.