Post surgery tachycardia - options?

Hello. First, and not to be argumentative, technically tachycardia IS an arrhythmia. Secondly, it may be (I have no medical expertise or training) what is known as POTS (postural orthostatic tachycardia syndrome), a well-known phenomenon with exactly your circumstances described in the literature....standing and then bam,...the heart begins to race. You should consult a cardiologist about this. You do not want to fall or to suffer a stroke.

Seven years ago, my left knee was totally replaced. I felt very anxious a bout the whole procedure, and a month or so following surgery, I developed tachycardia, which seems under control, although I've developed a-fib, which is not controlled after several successful meds and cardioversions. I've also developed dizziness--more than just the postural variety. I've just learned to live with it, but I've gone from being a very active 80s-year-old to a hobbled old lady. A second cardiologist I consulted asked me if my regular cardiologist had recommended an ablation in the early days of my condition. No, he hadn't, and I asked cardio #1 why not. He said the procedure wasn't commonly done in 2017-18. I skeptically accepted his answer. What more could I do? I'm 87, had a cardiac arrest during a hip replacement--so I guess there will be no more major medical interventions for me. Any thoughts out there? --Ruz

Wow. I'm pushing my primary physician about the tachycardia because he seems to think it'll just resolve, but it isn't; and may be getting worse. Pre-op, I tried to keep active; but now I'm afraid to go work out (in the pool). Thank you for the ablation info - maybe it's more common now? If so, I'll push for it since I'm still in early days. So far, no a-fib or anything like that; just my heart revs up too much.

Thank you about the arrhythmia info. My primary did an EKG in the office and said basically, there is no arrhythmia, no unexpected changes in the readout - just my heart is reving up. My primary wanted to see if it would resolve itself, but it seems to be getting worse, so I pushed for an appointment and hopefully will get the referral to a cardiologist - I absolutely do not want to fall or have a stroke! I'll have to look up POTS and learn more.

@ruz39 Ablations, but only rarely by extremely capable and skilled cardiac surgeons, have been undertaken for over 20 years. They have gotten better over time with both training and with more knowledge, but the tech also keeps improving.

I have had two ablations. Depending on the skill and experience of the electrophysiologist performing the ablation, there is roughly a 25 % failure rate. This isn't a great statistic, but it also means that 75% of them do work. Also, and because of that high failure rate, many patients need a redo, either in a few months to get the AF nipped, or in several years when they need a touchup (the disorder is progressive in nature and many/most patients need a redo in a few years....very common).

It's day surgery. Worst part, at least for me personally, was having to lie flat on my back for three hours after regaining consciousness so that the incision can close up and begin healing. It will be on the upper thigh, more inside than in the top middle as you look at your thigh when recumbent.

Ablations are now considered to be the gold standard of care....that's how good we've gotten with them. You want the fibrillation absent as much as possible because it is when the heart fibrillates for hours and hours that it begins to 'remodel' itself (you can google, 'what is remodeling during atrial fibrillation)'. Ablations do not 'cure your heart...remember I said that it's a progressive disorder....but it can stop the fibrillation cold...which is what you and your earnest EP want for you. No fibrillation, no further structural damage to your cardiac substrate and no potential valve deterioration, particularly the mitral valve between the left atrium that fibrillates and the large powerful ventricle below it...that the atrium feeds.

@gloaming
Thank you for the very informative explanation of the ablation process. It may not be for me because while I have tachycardia, I don't have a-fib, but it gives me something to talk to a cardiologist about!