Experiencing higher sleeping HRV after stopping Flecainide

[estesbubba]

I had a cryoboalloon ablation the end of January and was kept on 2x 50mg Flecainide during the blanking period. I had no AF during the blanking period and wore a Zio patch for 7 days just before the 3 months was over. At the appointment the APRN said my Zio came back clean, with no AF, very few ectopic beats and detected an indioventricular rhythm. She took me off Eliquis and Flecainide, and I only took the evening Flecainide dose for 3 days before completely stopping.

My typical sleeping HRV weekly average has been 70ms since the ablation. I have my Apple Watch in the AFib History mode and it takes HRV every 15 minutes. This week I'm averaging 125ms HRV while sleeping and I sent details to her about it and she said no concerns. Even though it's been higher while sleeping, I still haven't caught any AF when taking an ECG during the night or morning, which is great.

Anyone else notice higher sleeping HRV when coming off Flecainide? I feel great, sleeping great, and did a 62 mile bike ride last weekend. Looking at the HRV chart in HealthFit, my HR goes from 30's to 80's in a pattern, almost like my HR is syncing to my breathing. That same chart when in AF is totally random, so it seems different.

The downside of having the Apple Watch in AFib history mode is it no longer gives you irregular notifications. Every Monday it gives you your AFib burden for the previous week. The upside is it takes HRV readings every 15 minutes checking for AFib as apposed to every 2-3 hours.

[Autumn_Leaves]

Firstly, it’s great that you’ve had a successful ablation. Long may the good times roll! I’d say forget about HRV for now. I’m not even sure it’s that reliable for anyone with any history of arrhythmia and certainly not when they’re symptomatic. As you seem to be in NSR it’s a bit of a mystery but then your heart is still probably healing itself from the ablation as people say the true recovery period is probably a lot longer. Sometimes having these devices gives us more information than we can realistically understand and TBH these watches aren’t medical devices, they have their limitations. Just keep up the good work, sounds like it’s all gone fantastically well 😀

[wilsond]

What is HRV please? In the UK,Apixaban or similar is usually recommended for life,even after a successful ablation. I expect your risk score of stroke has been assessed? X

[Dippy22 in reply to wilsond]

It’s heart rate variability.

[frazeej]

Heart rate variability: Bottom line is a greater HRV generally indicates better fitness and better ability to adapt to physical or mental stress. my.clevelandclinic.org/heal...

[Banquo]

Gadgets are a blessing and a curse, aren't they? I'm a gadget person also...I monitor my Garmin religiously for HR and Stress (which to my understanding is a Garmin stat mostly based on HR and HRV). I also use a couple of sleep trackers. In my case, I had a clean blanking period post ablation also, but unfortunately went into AFib again pretty quickly off the meds, and am now back on..in fact higher flecainide than ever. However, back to the point...my Stress has been a bit higher overnight .. almost like the recline position does something weird. My HR is elevated compared to my pre AFib years, but slowly, slowly came down from 80s overnight to now on the mid 60s somewhere...and that's even taking a beta blocker and flec still. Your results sound fabulous to me actually. I would love to even be on flec at 50mgx2...I'm at three times that. And Eliquis now to boot. But, knock on wood, no AFib for almost two months now...waiting for my second ablation. I had horrible headaches and not a great post ablation experience so not super looking forward to a second...but in my search for no AFib and no heart meds .. it's what I need to do.

[Dippy22 in reply to Banquo]

I’m due an ablation soon and I keep reading about these headaches. Do standard pain relief meds like paracetamol help?

[Banquo in reply to Dippy22]

Headaches don't plague everyone, but it was certainly something I've had to deal with. They were less pronounced after the first few weeks, but lesser ones still pop up out of nowhere for me. I just take Tylenol if it feels like it's getting worse. Knock on wood, the headaches are WAY better now at the 6 month mark than the first couple months. My second ablation is scheduled for late this summer and I'll be curious to see if regular headaches occur again... I also had significant fever the first few days, prob from the inflammation..and then got better. BTW I had radio frequency PVI ablation. As you'll hear here, recovery isn't horrendous usually, but it can be rougher than is often portrayed by the marketing beforehand. The handout on this site does a better job describing potential recovery expectations than my clinic did.

[Dippy22 in reply to Banquo]

Hmm, yes, the pre-op nurse simply said “no driving for three days and no heavy lifting for a week”. Extremely minimal info, but as I’ve told before in hospital “I don’t want to put ideas in your head”. Treating us like idiots! I’ve read the recovery info on here and think I’ll go with that.

[Banquo in reply to Dippy22]

I think there is an element of that...just letting the people deal with what comes and let natural resilience happen...but that can backfire of course. Things like ocular migraine...I had never heard of those much less experienced one until a couple weeks post ablation. Freaked me out. While folk here will tell you they happen a fair bit to people post ablation.

[estesbubba]

Well my weekly AFib history for the week with high sleeping HRV came back 2% or less which is the lowest the Apple Watch will show, so I guess it wasn’t AFib, which is good.