Heart Rhythm Conditions – Welcome to the group

@carly14 It's baloney...my uneducated and untrained opinion. It 'helps' if you happen to be in AF at the time of an ablation, and yes, they can induce AF most of the time using adenosine, caffeine, isoproterenol, and other chemicals, but if you are an early patient, just diagnosed, NOT IN full-time AF, then most likely all the EP has to do is to isolate the pulmonary veins, and that does not require you to be in AF. In fact, since your atrium is not beating chaotically, his/her placement of the energy tip is more predictable and controllable. So, in a sense it's actually better if you're in NSR at the time.

For a second ablation, in my case it was that he had missed one small gap around my 'third' pulmonary vein, which he was hell-bent on re-doing... a full PVI. When he zapped that one tiny gap, my heart immediately went into happy NSR and has remained there, coming up to 3.5 years now. In your case, your disorder may have found a new path, and it WOULD indeed by handy to have that actively firing at the time he begins to map your rogue circuit(s) and zap them.
I hope you see that it's a nuanced question and response...it depends on what we're looking for, your history with AF and with corrective measures, including a previous (successful, or did it fail inside of a year?) ablation. And, to be completely reasonable and fair, his particular training might have made it clear, and predictably reliable, that it's best to have your heart in active AF at the time because it makes stopping it so cut 'n dried. One zap, and your heart resumes steady, unbroken, NSR. He would challenge your heart with isoproterenol, and your heart stays in NSR? Great, he's just found and isolated the problem circuit...which is what all of us want for you.

So, I call baloney, but....I'm not your EP, I don't know all about your history, and you aren't gonna pay me anyway. Take it for what it's worth. And I would go back and ask him for three more minutes to 'splain why. I would think it a great use of my time, and you may just end up getting the procedure you need. Right?

Hello, My name is Reggie. I am 58 year old recently diagnosed with SVT and captured on ekg. After 2 hours of rapid heart rate and fluttering I sent to the ed and as rhey were about to cardiovert I recovered.

I have Sarcoidosis and had a bout if Covid 2 years ago where I established a rapid heart rate. Standing is impossible without symptoms and near collapse. Exercise i tolerance, extreme fatigue. I have been on immunotherapy for the sarcoid in my lungs and seems to have been in remission.

I was seen by cardiology and have been on bisoprolol during this episode. They increased my dose and after a few days I couldnt eat feom nausea so the stopped it. Then I was switched to caedizam and that made thinga worse and was seen back to ed. I am now at 180 extended release with 4 changes to get to this dose. Still having rapid heart rate and when on the short acting had another episode that last 1.5 until all measure were unsuccessful at home, I took Verapamil...30 min later normal rhythm.

The electrophysiologiest will not do a ablation till he can stimulate it again. How do you know if you can and when does that seem reproducable?

My rheumatologist requested a cardiac cat scan and I am pending a second echo and the results of a 15 ekg. Prior cat scans, stress tests only determined tachycardia, bo abnormalities A physical therapist did a modified table test and assumed pots but I was on the blocker bisoprolol already so not too conclusive. I had ortho hypostatic BP, and rapid heart rate and advised to treat as if pots.

I have now occasional fluttering and rapid heart rate of 145 when doing light activity before sob, and tremors, fatgue and near collapse or crash set in. If I do to much I am out for days with extreme exhaustion.

@reggie68
This article may help you to situate your case and what the EP has told you about being able to stimulate the SVT prior to applying energy to tissue:
https://onlinelibrary.wiley.com/doi/10.1111/jce.16496

Hello thank you so much my name is Kathy and I am on metopralol for a history of afib. I just turned 60 years old. I have had a bad flare of IBS for the last week with little eating or drinking, My heart rate went as low as 44 today that has never happened before. I came here to see if I could find any information at all. Searching the internet has only created panic.

Kathy

@kathigg When a person's heart is behaving and beating normally, in sinus rhythm, metoprolol at a even a low or a moderate dose might cause the rate to drop low, but also still cause the beats' contractions, themselves, to be weak and to lower blood pressure. Between the slow beats and the weak contractions, you might be headed for a .....header. A fall. Fainting. You want to avoid that like the plague. So, please contact your primary care provider in the morning and let that person know what you have learned about your heart rate. They should know you're on metoprolol. Let your cardiologist know as well. Between those two, one of them should help you to avoid trouble with low blood pressure.

I'm Jerry (@favoritepitch), 76 next month, early 2024 I ended up in the hospital 3 times for heart-related. No previous heart conditions though advised to start a low-dose statin at least a decade ago; didn't start but made some dietary changes; exercise was already way above average. Been feeling strange sensations in clavicle areas bilaterally, but attributed it to changes in exercise regiment. Jan 2024 at a wellness visit with PCP, after hearing of my reported (clavicle-area sensations and lightheadedness a couple days prior), hooked me to an EKG, reported that my usually around 50bpm HR was at 117 while sitting and displayed atril flutter; he rushed me to the nearest, best heart hospital. Treated for a-flutter in ER via medications, transferred to a unit and next day medication-induced stress test; cardiologist later reported scans looked "pretty good, no significant blockages." Prior to stress test, the physiologist specializing in cardiology took diet and exercise history. He said my history of serious endurance training (at least 50 years; soccer (college), mile runner and x-country in 9-12th grades, and high-volume cardio training for road-racing at 10Km to marathons, indicated research from the previous 15 years indicated I fall squarely in the category of long-term, endurance athletes who end up with cardiac arrhythmia(s) - in my case both a-flutter & then a-Fib. Discharged with various meds to continue. Four weeks later rushed to hospital with an MI; angioplasty and stent (thank you doc!). Four weeks after the MI my cardiologist was with me for a scheduled electro-cardioversion at "heart" hospital where I'd been rushed two months earlier. Cardioversion removed a-flutter and a-fib; 5 minutes from being discharged from hospital that same day, I was overcome with a feeling of something bad is happening to me. Shouted for help that I was "going down" and immediately flat-lined, was brought back, flat-lined again, brought back and rushed to emergency surgery for temporary pacemaker (thank you doc! - my cardiologist, for a second time within 8 weeks). Cardiac electro-physiologist (EP) came to me and said there were options, but her diagnosis was I had sick sinus syndrome (severe underlying conduction problem) that had been masked by my a-flutter and the cardioversion's removal of the a-flutter and a-fib enabled the SSS to "take over" causing the flatlining to happen (about two hours post-cardioversion). The EP strongly recommended I not leave the hospital without a permanent pacemaker. Got the pacemaker around 8-9pm that day. Between the pacemaker and the meds (especially metoprolol), my exercise has been cut back immensely though - not exceeding 70-75% max HR since then - March 2024. But thankful to be alive and able to exercise even at this level. I want to learn as much as I can about SSS: how is it diagnosed with certainty? what are the metrics, methods, and tests underpinning the diagnostics? I understand it is not curable. Will exercise actually accelerate further deterioration of the sino-atrial node and therefore SSS? And other related questions to SSS including could electro-cardioversion have caused damage to my sino-atrial node or other parts of my heart causing the "severe underlying conduction problem?" Grateful to be a part of this community at Mayo, to learn and share. 9/15/2026

@kathigg my protocol was Metropol ER 25 mg 1X day and 100 mg of flecainide 2X day every day for intermittent a fib. I get several episodes a year and sometimes they go on 24 hours and I really need the Metropole when I'm having an episode to get my heart rate down to about 110 from 160. When I was taking Metropol daily, I was using Metropol extended release and my blood pressure was dipping way too low like 90/45 and I was advised to just take the Metropol as needed when I get an AF episode. My protocol now is I am still on flecainide twice a day, and I take a Metropol TARTRATE 25 mg, the fast acting Metropol, and brings my heart rate down a lot sooner than the extended release did. I don't know if it's helpful, but metoprolol extended release on a daily basis dropped my blood pressure way too low so I take it only when I get AF now, and the tartrate version is extremely helpful lowering heart rate during an AF episode.

@hikemtpark2 This does help thank you so much. I did get to see the cardiologist yesterday and she said that I could go down to just 12.5 metoprol tartrate a day and then hopefully wean off. I do have the pocket pill if I were to go into AF. But even without the metoprol my heart rate has been staying in the 50s and 60s, Exactly what I've been praying for.

@gloaming Thank you so much they did tell me yesterday to cut it to 12.5 a day and then eventually wean off because my heart rate is staying in the 50s and 60s I appreciate it!

I was diagnosed with ARVC in June 2020. An ICD defibrillator was implanted. I started Flecainide a few years ago which helped as I had had 2 episodes of tachy which were treated by an ICD discharge.
I had an ablation (inside and outside of heart) in May 2026 which had complications. 2 punctures to my R ventricle and followed by several weeks of terrible Afib possibly due to the inflammation post ablation.

I am recently told that I have a severely leaky tri cuspid valve which is currently being evaluated. Possibly due to ICD leads?

I’m a 64 yo female with care here at Mayo Rochester.

I value this support, which I have not sought until now.