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3 months after Pulsed field ablation--peak heart rate issues
I'm three months after my second pulsed field ablation. This one covered the back wall as well, and seems to have stunned either the sinus node or some nerves. My heart rate runs 10-20 bpm below where it used to and when I try to exercise, e.g. run, it's hard for me to get the heart rate anywhere near it was before the ablation. The doctor says what I have is called chronotropic incompetence and he hasn't seen this with pulsed field ablations this long after the procedure. Choice is to get a pacemaker or give it more time.
Has anyone had a similar experience? Did it get better over time? Were there things that you did that helped? I'm not on any drugs that depress heart rate.
thx
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I don't have an answer for you, sorry (I'm a recovering AF patient who had two ablations with RF, not PFA), but you might want to inquire of a local cardio rehab clinic to see if they get the odd patient with your chronotropic incompetence syndrome and how/if they deal with them successfully. It's worth a shot....mebbe...?
worth a shot--thanks for the suggestion.
I had my PFA about 7 months ago, and found low heart rate issues as well. I regularly swim laps and found my HR would start increasing towards the 140-150 range, but it would then drop into the low 80's and stay there no matter how hard I exerted myself while continuing to swim.
I was able to get off the Amiodarone after a little over a month, but that didn't seem to change my HR much. About 4 months after the PFA, I finally got off the Eliquis, changing to baby aspirin, and, in talking with my cardiologist, she confirmed that may have been keeping the HR low. In my past 3 months off the Eliquis, I no longer experience this artificially-low HR.
Your note doesn't mention what medications you are on, post-ablation, but this might be something for you to consider.
Helpful, thanks!
I'm not on any rate affecting medication--was on flecainide briefly but nothing else. Am on Eliquis, but a low dose--will talk with my doctor tomorrow for the 3 months check up and suggest I drop it.
How long after you went off Eliquis did you start to see a response? And was it immediate and substantial or gradual?
One other point: My heart rate variability had dropped post the ablation by 1/3--from an average of 75 to 50. Over the past 10 days it has sprung back to normal range. My resting heart rate has been back to normal for a while but the HRV move was sudden over the course of a couple days.
Were you monitoring your HRV? Did you see any change? How did it correlate (or not) to the improvement of your peak HR?
thx
S.
@shg I monitor my HRV daily. Mine is fairly steady and confined with a narrow range, 35-55 ms. My HR varies more from day-to-day, anywhere from 32-62. This in a heart with two recent RF ablations and that used to run 44 BPM at rest.
Personally, while I monitor my HRV, it is so reliable that I spend more time pondering my HR. I believe it responds to hydration, serum and myocyte electrolyte balance (both potassium and magnesium [most of us get enough calcium that we can safely forget about that one]), sleep duration and quality, system inflammation, blood glucose levels and control, and stress.
My Eliquis dosage was only 5mg per day. While my low HR wasn't always present while swimming laps, the last time it happened was 12 days after stopping the Eliquis.
As for the HRV, this also wasn't consistent, but while on the Eliquis my Garmin watch fairly often showed an 'unbalanced' HRV. This has not happened since stopping the Eliquis.
It took a multiple attempts to finally get the okay to drop the Eliquis, but it certainly looks like it was messing with my HR. Good luck with your doctor.