Recent ablation for 20% PAC

I can only relate to my own case, which was for AF in the left atrium. I had a failure the first time, but the second ablation, same physician, seven months later has me in NSR for almost twenty two months now.

The literature I took home warned that even successful ablations will quite possibly have a few short runs of AF in the next few weeks. This is normal, and one should not be dismayed or alarmed. Instead, one should be concerned only if one is FREE FROM the treated phenomenon for several weeks AND THEN develops runs of the same problem. IOW, if the phenomenon crops up later in the 10 week 'blanking period' where the lesions are expected to continue to both close up against each other and to heal, that is not usually a good sign. On the other hand, the literature I have seen (about 18 months ago now) suggested that early runs of the unwanted arrhythmia are nothing to be alarmed about. It's the later ones, after week 8, say, that indicated a probable failure to close off the focus or re-entrant of the spurious signal.

Best thing is to be calm, strive for normalcy in all that you wish to undertake, including exercise (but always follow your prescriptions and advices given in handouts or verbally when you were discharged), and report back if you know intuitively that the surgery has not succeeded in ridding you of the arrhythmia.

One other consideration, and it presents a real dilemma for a lot of patients: consider changing electrophysiologists. You want the best you can avail yourself of, whether locally or with some willingness and resources to travel. This takes research. Your heart is the only one you have, and you want really experienced and skilled hands fooling around with it. Get copies of all notes/records/data about your case so that, if the time comes and you elect to seek someone else's help, you will have what he/she needs to assess your case and to decide for herself if she wants to try to help you...and can.

If I understand your question correctly you describe having an ablation for PACs and not Afib. PAC ablations are less common than Afib due to the high degree of difficultly in accessing the nodes. My EP does not do ablations strictly for PACs as he claims he literally has to be in the spot the are originating from and seeing them fire while he is performing the surgery. So comparing it to Afib is apples and oranges. But that said I recently had my 2nd Afib ablation (1st ablation May/2019) by the same doc and he suggested that during the procedure for Afib he was able to access areas for PVCs and PACs but he was unsure if what if any relief I would see. In other words no promises. He suggested it would take some time to know the results for PACs and PVCs both of which I have at times had intermittent burdens fo 25%.
That said this link https://pubmed.ncbi.nlm.nih.gov/33533993/ suggests that new mapping strategies give good results for PAC ablations. "Mapping strategies and ablation of premature atrial complexes"