Tachycardia following Ablation

Posted by beebo @beebo, Feb 10, 2024

My ablation (2nd) was performed in November and immediately after that I experienced an increase in my resting heart rate from 65-70 BPM to low/mid 90’s BPM.
I’m back in sinus rhythm but this week I had my 90 day follow up that included a EKG. My EP says that tachycardia, which I now have is not unusual after an ablation. So the fix now is to have a cardioversion and if that doesn’t correct it then another ablation will be done. Anyone here have a similar experience? Thanks

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crazykbl | @crazykbl | Feb 13, 2024

Seems like you have a good doctor. So the best of luck and prayers. 😇😇

bethfrompa | @bethfrompa | Jan 30 9:56pm

In reply to @gloaming "Yes, it is exceedingly common to have both tachycardia and even short runs of AF during..." + (show)

@gloaming

Yes, it is exceedingly common to have both tachycardia and even short runs of AF during the blanking period. In fact, the latest science suggests that if one has some short runs of AF early in the blanking period, it is a much better sign than being AF-free for several weeks and then to start having some AF show up late in the blanking period. Bottom line, though, is that each heart gets to say how it feels about what was done to it. Each heart starts an ablation with a different history and a different condition, not to mention valve condition, enlargement of the atrium, state of heart failure if that is part of the history, and so on. We're all unique when we lie back on the gurney. Similarly, unless the ablation has missed something, we'll all experience something unique during our recovery. Some people report that they had elevated HR for many months, but over time it began to slow and now they're normally at 70 BPM.

The heart has been roughly handled. It will be cranky. It might have been cranky for some time if you had been having a lot of PACs or AF in the weeks prior to the surgery.

One other common fact is that people who have otherwise successful ablations will break into flutter. Their AF will go away, which is great, but suddenly their heart rate soars to 180 plus. This will be flutter, and it can sometimes, not often, be corrected by a cardioversion at the ER, or the EP will want to go in again and correct what he knows to be missing from the first effort at ablation. Flutter is often easier to fix than the initial AF that started the whole ball of wax.

Finally, don't be too dismayed if your first ablation doesn't work. The failure rate across the global medical community is about 25%. It's a tricky procedure, and remember that each heart has its own history and unique expression of AF, which the EP has to figure out while he/she's in there poking around. The great news is that a second ablation enjoys a predicted 80% success rate, which, when added to the 75% success rate of the first effort, makes for a pretty salutary outcome for anyone who finds that their first ablation didn't quite work.

Jump to this post

I actually joined this website so I could post a reply saying Thank you so much for this great response, one that all EPs should give to their ablation patients.

In three days I'll be four months past my ablation. I'm grateful that I only had intermittent AFib and flutter, so I'm supposed to be able to expect a good outcome. I just tonight, for the first time, had a short run of tachy, and only at 105. I think it went on for just about 15 minutes then back down to 74, though my usual resting is 60. I Googled this, and lo and behold, no one ever told me that tachycardia post ablation is common. I swear I've found 90 percent of my info online instead of from my doctors, very discouraging. Thank goodness for all the good people online, posting what they post.

I haven't felt anything I would consider as AF -- when I feel something kind of fluttery, as though the AF monster is trying to crash the party again, it goes away in just a minute or two, not enough time to get my Kardia out and do a scan. These little flutters are evenly spaced and mostly come at night. I'm eager to get my next Holter (not until April) to see what it shows. I just weaned off Metoprolol and really really really don't want to have to go back on it, because it caused really bad nightmares and just plain poor sleep.

Anyway, I don't have a question or anything, I just felt comfortable ranting here! 🙂 I don't have anyone to talk to about this -- I'm single, and my daughter and son-in-law have their hands more than full with a toddler and now an infant, too, and I'm new to the area and haven't made any friends close enough that I'd expect them to listen to me about my heart condition. Thanks, all of you who I haven't met, for providing a community, and best wishes to all of us and our cranky hearts!

gloaming | @gloaming | Jan 31 1:23am

In reply to @bethfrompa "I actually joined this website so I could post a reply saying Thank you so much..." + (show)

Hi, Beth. I'm so pleased that you found some relief and affirmation in my post so long ago...it seems long ago. I called my EP's office on Valentine's Day last year and spoke to his clerk, Crystal. I said hi when she picked up, told her who it was, and added that today was my first anniversary free of AF. She laughed. I had only caused her to laugh once before, and that was to tell her she was the busiest lady on Vancouver Island...and she is! I'll be calling again in two weeks. Gotta give thanks where it is due. 😀

About the odd twinges and suspicion that you've had a few ectopic beats. It can be PACs, which everyone has (premature atrial contractions (some say 'complexes'). It can also be, believe it or not, bowel gas. The transverse colon crosses from your right to your left inner abdominal wall and bends sharply downward toward the lower bowel. That sharp bend is close to a full kink, and it can trap stuff there, so much so that when it let's go, so to speak, a bunch of backed up gas will surge across, right under your diaphragm and heart, and you'll feel rippling, and hear noises...or not...but the sensation can fool you into thinking you have a run of ectopy going on.

You are under some stress, obviously. You have taken a big step and moved, you're out of synch with people you wish you knew...but don't..., you're a bit lonely, and you're trying to find a routine that is comfortable. If all you get under that load is a few blips, or moving bowel gas, you're in good shape!

teacher2001 | @teacher2001 | 5 days ago

In reply to @bethfrompa "I actually joined this website so I could post a reply saying Thank you so much..." + (show)

Wow - lots of info from you - and very informative for me who is waiting for my first ablation March 4th. I’ve been waiting two years due to lack of funding in the Canadian health system. I’m praying no second ablation as I have to travel to Toronto for it and find the whole scenario very stressful - which causes palpitations. I too don’t have all the answers to my questions and hearing from you has helped. Hope you can continue to get advice from this site. Stay strong - you aren’t alone. Take care. xo

bethfrompa | @bethfrompa | 5 days ago

In reply to @teacher2001 "Wow - lots of info from you - and very informative for me who is waiting..." + (show)

Thanks, teacher,

I want to add that the ablation procedure itself was easy-peasy, pain free (except the sore throat the following day from being intubated). I'm the biggest chicken ever when it comes to invasive procedures -- I work in the legal field and only ever hear about the things that go wrong, not all the ones that go right -- but for this, I went in in the morning, was put thoroughly to sleep, woke up under a warm blanket three hours later, and have not had an AFib episode since. I had no pain in the chest or at the groin site; I wasn't even especially tired or groggy or anything at all. If you're feeling anxious, it's completely understandable, but hopefully you'll remember that this scaredy cat near Seattle got through it with no problems, so you will, too. 🙂

teacher2001 | @teacher2001 | 5 days ago

In reply to @bethfrompa "Thanks, teacher, I want to add that the ablation procedure itself was easy-peasy, pain free (except..." + (show)

Thank you Beth! I’m a scaredy-cat too! Your positive thoughts have made me feel a lot better. Hugs!

doclarrea | @doclarrea | 5 days ago

In reply to @teacher2001 "Wow - lots of info from you - and very informative for me who is waiting..." + (show)

Hello. I ha a Dx of PSVT. On propafenone and bisoprolol max doses. I’ve been having palpitations lately getting worse, which causes a great deal of discomfort. My cardiologist referred me for an evaluation to see if I could have an ablation. But I know the chances of it being effective are about 80% and I am ambivalent about having it done because of the inherent risks involved during the procedure and the chances of having the ablation repeated , no to mention it might not work. Frankly it scares me. I’m 68. Anyone going through the same thing outhere?

teacher2001 | @teacher2001 | 4 days ago

In reply to @doclarrea "Hello. I ha a Dx of PSVT. On propafenone and bisoprolol max doses. I’ve been having..." + (show)

Hi! I’m 78 and have been told I have an 85% chance of the ablation being effective so after many years of palpitations and not being able to travel, etc. I feel it’s worth getting it done. And yes, I’m nervous but feel everything will work out - a lot of people say it’s an easy procedure. Deep breath, be brave and just do it. I’ll let you know how it went after March 4th. xo

gloaming | @gloaming | 4 days ago

In reply to @doclarrea "Hello. I ha a Dx of PSVT. On propafenone and bisoprolol max doses. I’ve been having..." + (show)

The risks of damage or death, across the entire practicing EP field, is about 1.4% for an ablation. This is very low. People buy lottery tickets where they think they have a chance of winning when it's 0.00000005%. Yes, the loss of a coupla bucks is pretty small by comparison, but they spring for the bucks when their chances of winning are 10M times less!! And only one or two people will run down the street waving their huge check out of the 10M ticket purchasers.

Something else to consider; where is your headroom now that you're on the max doses? What's left for you...amiodarone? A pacemaker? Wouldn't you rather submit to an ablation, with that hefty 80% probability of success, than to have your AV node nuked and then leads wired to your heart?

I understand your fear. I had some misgivings about an ablation. But, when I weighed the relative risks of continuing to lose ground with drugs that lose ground, and to figure that mitral valve prolapse or atrial enlargement might lead to heart failure....AND then to add how terrible my AF made me feel, just with the anxiety? I practically begged to be placed in a line-up for an ablation. My first ablation failed. Bad luck. But, because of the low risk, I was otherwise fine. Just PO'd. Seven months later, another ablation, and in 13 days I will have two years free of AF or anything except the very odd triplet of PACs....which we all have anyway, healthy heart or no.

beebo | @beebo | 4 days ago

In reply to @teacher2001 "Hi! I’m 78 and have been told I have an 85% chance of the ablation being..." + (show)

If you have never had an ablation it’s natural to be apprehensive about the upcoming procedure. It really is a non event in terms of any discomfort or pain. You check in, spend some time waiting till they’re ready for you and the next thing is you’re waking up and waiting to be released. It does take up a good part of a day so bring your phone or a book. Best wishes and let us know how it turns out.

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