← Return to Heart Rate after Ablation

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Heart Rate after Ablation

Heart Rhythm Conditions | Last Active: Mar 7 6:41pm | Replies (48)

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@flyboy51

In my 70s and resting heart rate has always been mid-50s. Have taken Bisoprolol-HCTZ and Amlodipine for 20 years or so. Afib detected Oct. 2019 during yearly physical. Had 4 cardioversions between Oct. 2019 and May 2024. Each duration became shorter. Cardiologist recommended it was time for a catheter ablation. Had it done in June 2024. Went well except for the following incidents.

6/23/2024 @ 11:30 AM - Afib starts. BPM 108.
6/27/2024 @ 6:30 PM - Afib stops. BPM 85 and remains close to that until 7/17/2024.
7/17/2024 - Afib (aflutter?) episode at @ 9:15 PM. BPM 127. Subsided at 9:45 pm. BPM is now 66 and remains so.
Pulse eventually dropped back to mid-50s and remained there until 12/10/2024.
12/10/2024 @ 12:30 PM - Pulse began racing while laying in bed. Checked using Kardia Mobile device. BPM 81 and displayed ‘Normal Sinus Rhythm’. Checked again at 4:30 AM and 8:00 AM. BPM remains low 80s and displays ‘Normal Sinus Rhythm.
12/31/2024 - Pulse has remained between 88 - 91 with Normal Sinus Rhythm indicated. Cardiologist recommends monitoring it for now and saw no issues with Kardia EKG. Felt it was okay as long as below 100 and no Afib indicated.

My questions are:
Why would this have happened 6 months after the procedure?
Will it eventually revert back?
Does it indicate another issue?

Thanks for any information, theories, etc.

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Replies to "In my 70s and resting heart rate has always been mid-50s. Have taken Bisoprolol-HCTZ and Amlodipine..."

I don't believe that anyone, not even an expert, could/would/should answer your second question...when will it stop? You are quite apparently still paroxysmal, meaning your arrhythmia stops on its own before 7 days have passed while in continuous arrhythmia. That's a good place to be if you must have an arrhythmia. I'm speaking mostly about atrial fibrillation (AF) and I claim no enhanced knowledge or understanding of other arrhythmias (I believe there are 15).

Your devices show normal sinus rhythm, so you have what is called a 'tachyarrhythmia'. Still technically an arrhythmia because its an abnormal rhythm, but it's still sinus. Your heart has multiple quickly repeating beats on what we call a 'run'. Quite often tachycardia and premature atrial contractions (PACs, which fall under the general rubric of 'supra-ventricular tachycardias'). https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/ectopic-supraventricular-arrhythmias), arise from catheter ablations. Even flutter happens to some patients treated for atrial fibrillation, and it's usually easily treated....comparatively.
https://my.clevelandclinic.org/health/diseases/22152-svt-supraventricular-tachycardia+/8*752
Catheter ablations have, across the average of electrophysiologists practicing everywhere, about a 75% chance of succeeding, meaning you go a full year with no treated arrythmia. If you have the same arrhythmia as before, and it is just now three months after the 'blanking' period, you are quite possibly an ablation failure, but your EP should be the one to say yay or nay. He/she will be the person analyzing your ECG, not me.

Lastly, the heart is continually looking to establish new focal points, or re-entrants, for the extra cells that are causing the dysrhythmia. So, maybe further catheterization is in your future...again, your EP will be the one to tell you.

If it's another issue, that has to be established via tests, formal ones. If it's the return of the same type of arrythmia, then I would think it's just a new growth of 'node cell's that are substantial enough to want to begin to send out their own clarion call for the hear to beat to their tune. Except that their tune is out of synch with the SA node and AV node.

This is disappointing, quite obviously. Happened to me with my first ablation...I was in hospital six days later with a runaway heart. I had to go on amiodarone for almost ten weeks, but a second ablation six months later did the trick for me. Second ablations have a somewhat higher probability of succeeding in nipping the extra voltage, about 85% across al EPs. The very best EPs do a bit better.

I hope that helps. Please do contact your care givers and experts and let them know what's going on. Also, HOW YOU FEEL is going to let them know you need relief...and soon, please.

I'm 71. (F) Brady when resting in the 40's and as low as 35 overnight.

Your EP can have you wear a Holter monitor 24 hrs/day for a week or two to see what's going on.

My ablation was July 18, 2024. On 25 mg Metroprolol 2x/day and Amiodarone 200 mg 1x. (and Eliquis, Hydralazine 50 mg 2x, and amlodipine 1x for HTN from hypercortisol).

I had an AFIB occurance with racing heartbeat 2 weeks later for 2 hours then it converted on it's own. I still had intermittent HR spikes when doing normal tasks.

My EP failed to tell me using my arms would cause racing spikes and my Internist was like "STOP peeling carrots" "STOP mopping the floor" "Stop reaching, Stop lifting" "AFIB beegets AFIB!" ! And they mostly stopped (for the whole blanking period.)

THEN I got Covid for the first time 3 weeks post ablation and my BP stayed slightly higher ever since but no AFIB.

Nothing happened then, until January 2025 when I had an allergic reaction to a Holter monitor adhesive. Got massive hives AND a big lesion on my nose overnight! Biopsied, it was a SHINGLE! So it's all related.

Then a couple days after the hives, had another AFB with only a few 150 HR spikes for two hours and it converted. I blame the hives/histamine.

Co-Morbidity: Mild sleep apnea I just found out and ongoing Cushings Syndrome with hypercortisol so that doesn't help at all. (from the Covid vax)

My holder monitor 5 days was ok, everything in acceptable ranges.... but I've noticed some spikes lately like, three times in two weeks of 118 and 130. But my hives are not resolved yet. So we'll see if something is brewing. Those spikes sorta freak me out but the EP's PA is casual about it.

Regardless, the EP said get off the Ami and Metoprolol - in progress. Since I'm still Brady. But used to be called TACHY-BRADY but the tachy disappeared...for now. I plan on very limited activity to not produce heavy spikes while the Metoprolol is fighting me tooth and nail to wean. It does that!

Anyway, get the Holter monitor and make sure they give you the report after discussing the results. I notice they tend to gloss over stuff.