Overmedicated after ablation? (long post - my apologies)

[Bluz]

I'm in the USA, just had my second ablation (a more complicated PVI Cryoballoon Cath) and not knowing ahead of time that I was getting a different kind of ablation, was shocked to find that I am not supposed to lift over 10 lbs. or do anything that might strain my chest muscles for 8 weeks. OMG.

All that aside, I had complications with the first one, one complication being bradycardia quite soon after going home. No one told me to expect that, but I texted back and forth with the electrophysiologist til I got my meds adjusted and got back to a normal heart rate (it had gone to 37 hr at one point and I didn't realize then that this was so dangerous).

This ablation, it seemed I had dodged that bullet for the first week post surgery, then it happened again. Bradycardia in the 40's and 50's . Was not getting an answer from the electrophysiologist, so I went to my primary and she cut my Amiodarone in half. Got a text back from electrophysiologist later that day (2 day lag). Next morning, bradycardia again - when it hit 38, called the regular heart doc's office and they sent me to the ER. Went in to see the NP at the heart doctor's office and she left the Amiodarone at half and replaced the metoprolol with Carvedilol - w/ instructions to not take them if my hr was below 60, and with a 48 hour heart monitor. But she stressed that if my heart rate was above 60 at bedtime, I should take the Amiodarone. Again next morning - bradycardia, although in 50's, not so bad. Today, I decided not to take the Carvedilol again and see if things were all right with the half Amiodarone I took before bedtime the night before. Did fine for a couple of hours this morning, then dipped below 60 again.

I had asked the NP specifically why they didn't anticipate this problem and adjust meds right away, and she told me it wasn't a normal reaction, that most people stay on the same meds at the same rate as before the ablation with no problem (to keep the af from coming back during the recovery period).

Haven't found any other info on this online, so just wondered if anyone else had had this problem and what the solution is? Sorry for the long post, didn't know how else to explain the situation, and now that I understand more about the bradycardia, I'm worried about which is more dangerous between the two (tachy or brady) and about keeping my meds regulated.

[BobD Volunteer]

Different countries different ideas I guess but our fact sheet on recovering from ablation mentions raised heart rate post ablation not lowered (typically around 85) so yes your reaction is unusual I would say. Similarly here in UK (and most of Europe) Amiodarone is a drug of last resort due to its toxicity and dreadful side effects so all in all difficult to comment .

Bradycardia really depends on the person. I once tested a chap with a normal rate of 36. He was in his eighties but had been a lifeboat man all his working life and was extremely fit. Scared me more than it did him! lol. Similarly athletes may well have resting rates in the low forties or even lower. I will leave it to you to decide if you fall into either category.

Normal HR is considered to be between 60 and 100 but we are all different so strict adherence may not be such a good idea. Worry solves nothing.

[Bluz in reply to BobD]

Thanks for the reply, Bob. I didn't worry too much til I was sent to the ER by the NP, and that did spook me. I didn't realize that my hr was that much too low for me in particular. I'm 73 and overweight, but was very fit for my age before the first ablation (although I was getting so short of breath I couldn't handle all the yard and house work plus my junking business which involved a lot of lifting and loading). It's was better after I recovered from the first ablation but basically gone downhill since the af returned, while I was still trying to regain some of my former strength. That 8 week restriction on my activities this time is the scariest thing, worrying about how much fitness back sliding I'll do while not continuing my normal routines. And, yes the Amiodarone concerns me, too. Their intention is to keep me on it another 90 days (and been on it a couple of months already).

[BobD Volunteer in reply to Bluz]

Never had any lifting limitations after the first few weeks once the groin healed. Had my fourth ablation in August and building gearboxes again after two weeks.

[Bluz in reply to BobD]

Fourth abalation??? OMG.

[BobD Volunteer in reply to Bluz]

3 x AFib 1x Atrial tachycardia.

[Shcldavies]

Yes I had low HR and lifting restrictions. Following my ablation in February EP but me on 2.5 Bisoprolol and 5 Digoxin and said to see how they work. I kept monitoring my HR which went to low 40s overnight and in the 50s in the day. After 4 days went to Docs who said to come off all meds, was fine for 5 weeks when HR and BP gradually increased, went on 1.25 Bisoprolol and everything been good since. Regarding lifting, I would recommend you really do not lift anything for a good few weeks, I tried not to lift much at all, then after 3 weeks when I thought all was well I just lifted 8 dinner plates and had a sharp pain in my heart (may have prolonged my recovery). Look after yourself, take it much easier than you think you should and you will recover.

[Bluz in reply to Shcldavies]

Thanks, I was beginning to think I was some kind of anomaly.