Elevated resting HR post cardiac ablation procedure

[Golf1515]

Hi all. I love the comments and similar stories from folks like me who just want a little comfort but also realistic expectations! I’m 2 weeks to the day out of cardiac ablation procedure for lone AF. For the first 8 days it was absolutely perfect. Since then I have developed a high resting HR. Anywhere from 104-124. I keep hearing and reading that is somewhat expected as the heart is trying to heal and recover. I certainly hope that is the case but it naturally makes me uneasy in the meantime. This forum has been helpful and comforting in many ways. Has anyone else had a similar experience to mine and if so what advice would you give ???? Thanks to all who take the time to share their experiences!!

[BobD Volunteer]

To be honest we do mention this in our fact sheet (heartrhythmalliance.org/res... but 120 does seem higher than expected. (generally 85-90)

It might be worth speaking to your arrhythmia nurse and maybe getting an ECG done to check what it is as atrial tachycardia is also not unknown post ablation although one would expect a rate of 140.

[jeanjeannie50]

Before I left hospital after my last ablation my heart rate shot up and made me feel dreadful. They kept me in for an extra day and it returned to normal. About 6 weeks later it raced again and after talking to my AF nurse I went in for a cardioversion. It was still my most successful ablation and my heart hasn't raced to a worrying number since. Please keep in contact with your AF nurse and let her know what's happening. Be absolutely charming and appreciative of her advice, they know so much now and are worth their weight in gold. They can also suggest to your EP that you need a cardioversion and ask if they can call you in.

Good luck.

Jean

[Ppiman]

A resting rate above 100 is something that I guess your doctor will want to treat with a low dose of bisoprolol or similar. It must feel very uncomfortable to put up with that. Since my ablation, I still have what I call a "fragile" heart rate, with it easily rising to 85-100 bpm for no reason, then on to 130 bpm with any exertion. Goodness knows why as tests show all is well apart from a degree of left branch bundle block which I'm told wouldn't be the cause. I've been told to just "press on" regardless, but I find that impossible. At least it is reassuring.

I sometimes harbour mild suspicions that ablations can sometimes lead to other issues that, whilst of no concern to cardiologists, aren't altogether much fun to live with.

Steve

[IanHolly in reply to Ppiman]

Yeah, I have lbbb too but its never contributed to my hr before ... so I'd hope it isn't relevant now!!

[Ppiman in reply to IanHolly]

From all I can find out, LBBB doesn't do much at all, and that's what my GP says. The cardiologist I saw did say that LBBB with AF is a combination to avoid so if mine gets more frequent, I suppose it'll mean an ablation.

Steve

[IanHolly in reply to Ppiman]

Neither my cardio nor EP ever highlighted a negative relationship between lbbb & af so I wouldn't worry too much ...

[Ppiman in reply to IanHolly]

Thanks for that. It's reassuring. My GP is very easy with it. I think cardiologists fear negative effects on the left ventricle over time and do what they can to protect this part of the heart. I've been given losartan for this reason, despite not having high BP.

Steve

[IanHolly in reply to Ppiman]

My LBBB materialised out of the blue in 2015, and tests showed I had an EF of 33. I was relatively fit and healthy, my heart structurally was good and I was just diagnosed with idiopathic cardiomyopathy. I was put on carvedilol and then trialled on Entresto (Valsartan/Sacubitril). My AF materialised formally in 2020 but I suspect I'd had some episodes in 2019 when my HR monitor couldn't read my pulse!Anyways, thanks to the Entresto my EF is now 58, and I am diagnosed with recovered HF.

I hope my RHR drops back soon though ... otherwise ablation seems to have gone OK!!

[Ppiman in reply to IanHolly]

That's interesting - you went through a worrying time. It's good that the treatment worked so well. I have read that idiopathic cardiomyopathy is likely the reason why athletes can suffer heart problems, exacerbated now by the higher intensity of sports like football (feeding the conspiracists view that it's caused by covid vaccination!!).

My LBBB showed up first when I had atrial flutter, out of the blue, in 2019. Again, I might have had this over the years as I had had occasional weird 'panic' attacks at odd times in earlier life that never were fully explained. I know that I had a wide QRS, for example, prior to finding I had LBBB, and the two are linked. My EF dropped to 45 with AFl (or more likely thanks to the persistent 155bpm pulse) but is now just over 50, which is 'normal' according to my cardiologist, but it seems a bit low to me. I also still get times when I get mild tachycardia out of the blue, multiple ectopics and occasional AF, including brief 'AF-like' spells, whatever that means, lasting seconds (shown by a ZIO monitor). I don't know why and my cardiologist can't really explain it and tells me not to worry about it but then put me on losartan as a 'cardio-protective'.

I've come to realise that there's a lot not known about the heart that even an MRI can't explain. Mine showed a normal heart, I gather - except for the LBBB.

Steve

[IanHolly in reply to Ppiman]

We appear to have many similarities ... I had the odd panic attack too, and the odd day when I just felt so ill I could barely move ... AF never crossed my mind. My BP monitor would occasionally flash 'arrythmia' and my polar device would sometimes stop working .... when i mentioned it to my gp it was dismissed ... i now know both devices were correct!!

I think AF 50 is fine ... as we get older the physical demands on our heart don't demand high EF and providing we get exercise all should be well

I can comfortably cycle for 20km, but i do get out of breath kicking a ball about with my son for 20 mins!!

[Ppiman in reply to IanHolly]

You're way fitter than I am, but I'm eight years older, I think (your profile says you are 60). I have insomnia, too, which seems to be a contributory factor in how my heart behaves or not.

It's been lovely reading your post and your replies. Thank you! This is a tough old thing to live with at times and few understand it meaning sympathy is either non existent or excessive!

Steve

[IanHolly in reply to Ppiman]

Yea, I'm 61 now but have a 10 year old son to keep me busy and active!

Once I got over the first few months of my heart diagnosis I never really thought too much about it and just got on with things. I did retire early in 2017 though as we thought reducing stress would help (IT career was demanding mentally!!). So I became the house-dad so to speak 😀

Interestingly, after my 3rd AF episode my Cardio persuaded me to go for a Pacemaker.. but as it was during covid I had 2 appointments pulled the day beforehand .... now I think that would have been a mistake, although I understand the rationale. Ablation appears to have been a better way forward for me, esp with my EF back up to normal there's no need!

Did you ever get to see any EKG results for size and performance of your LA?

[Ppiman in reply to IanHolly]

Hi - I didn’t. The EP at Leicester just said my heart was fine structurally. Pre ablation I had some very slight mitral regurgitation but that cleared up afterwards. I did develop some chest discomfort a good while after the ablation on walking a distance and that made him do a stress MRI which also came up all okay, except the wide QRS and LBBB.

I don’t really know what causes the troubles I get. Electrical I suppose? Today for example, during a longish walk my heart rate was fine until suddenly I felt the usual slight discomfort and what I call “breathiness”. It wasn’t AF, though, but my heart was stuck at 155bpm. It dropped to 130 at home but stayed there - Kardia reported “not AF but inconclusive”, which seems to be its way with a wide QRS over 100bpm. Bisoprolol is my friend!!

Steve

[Snowgirl65]

The exact same thing happened to me after my first ablation. Think of your heart as bruised and inflamed after the procedure, so it's bound to rebel! My first week or two after seemed glorious, but then the healing began and I experienced the same as you. Take heart (giggle) -- it'll take a while until things calm down for good.

[Golf1515 in reply to Snowgirl65]

Thank you so much for the feedback. These forums are so helpful. It does make me worry and fret a little less knowing others have had similar experiences and eventually gotten past them. Thanks again and God bless!!

[Snowgirl65 in reply to Golf1515]

You're very welcome. I agree that this forum is invaluable. Only someone else experiencing similar problems can give better insight than doctors. I hope all goes well down the road.

[theohappy]

Yes, everything you wrote is accurate. Heart is healing eventually it will get better. Be patient. I was just told, however, (in the hospital right now getting home orders to follow) that if my resting goes higher than 120 to let the doctor know. Keep in mind that this number relates to my normal resting prior to ablation so specific to me. Check with your doctor what number you should be concerned about.

[IanHolly]

I'm 3 weeks post cryo-ablation. Thought all was well (rhr still mid 70s) except still sore in groin. However, noticed my rhr now up from 60s prior to 85-95 now.

Did manage a short bicycle ride yesterday.

Wonder whether to call arrhythmia nurse on Monday... although reading the comments it does seem normal!

[Golf1515 in reply to IanHolly]

I think much like you said, those types of heart rate elevations come with the territory so to speak. Mine were much higher to the Point where they started getting into the 125 130 mark. I ended up finding out that I was in atrial flutter. Thankfully that has since been resolved. It’s just like everyone on here says, your ticker is mad and it will take time to forgive you and settle down. Best wishes to you.

[Lilypocket in reply to Golf1515]

HiHow did you sort out the atrial flutter? Or did it self- resolve?

Take care

[Golf1515 in reply to Lilypocket]

So they changed my med from Flecainide to Sotalol. Low dose of Sotalol (80 bid) but it converted me after about 2-3 days of being on it. That being said, that Med is NOT my favorite….had me nauseous, short of breath, you name it. I then went down to 80 mg PM and 40mg AM. I’m currently just doing 40 bid and should be coming off that Med entirely pretty soon according to my EP. Honestly, I think the Flecainide played a part in the AFlutter as I have heard it can cause that to occur. I’m now just over 5 weeks post ablation and things are MUCH better. Hope y’all are welll!! God Bless

[ETHEL103]

Yes happening to me a lot after 3 weeks ablation for flutter.My hr can be as high as 150 but thankfully doesn't stay there.Kardia says tachycardia with possible a fib.Oh joy.