I had an cryo-ablation done end of May this year. Stayed on all meds until 3 month follow-up and felt normal the whole time other than HR increased about 10 beats a minute from 62 pre ablation on sotalol to 72 after ablation still on sotalol. After the 3 month follow up the Doctor told me I could start weening myself of Sotalol 80mg 2x day. Told me to go to 40mg 2x a day for a week then stop. Since then... a week and a half ago.... my heart rate has climbed to anywhere from high 90's low 100's at rest to 125-130 when active. My Kardia just tells me anything over 100 is tachycardia. My blood pressure machine says my BP is good but shows the high heart rates..... but I am always in normal sinus rhythm.
Sorry for the long post but should I be concerned with the heart rates this high. Or will this normalize over time.
Thanks in advance for any and all responses
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MRH_1984
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Your rise of +10 even +20 post ablation is quite normal but resting rates of 100+ should perhaps be looked at it they persist. Never having taken sotolol I don't know if this may be rebound effect which will settle but best discuss with your doctor .
Hi “MRH_1984” Health Unlocked sent me a (probably automated) note asking if I have any comment to make since I also have had some experience with Sotalol.
Since I don’t know anything about you (except that …I am guessing …you might’ve been born in 1984, which would mean I’m about twice your age…) I will list the differences that come to mind between my circumstances using sotalol and yours:
I don’t know your history, but mine, before taking sotalol was:
Perfectly normal and very healthy heart rhythm all my life, including about 25 years of daily slow running until about age 55.
During those 25 years of running, I did zero competitive running. I also did zero running to try to improve my speed or time over any given distance.
I only did long, slow, leisurely running. Usually between one to two hours a day, sometimes three hours or a little more in one day session.
In hindsight, that was extremely healthy and beneficial in many ways.
At about age 55, I decided to switch from running to rowing. Without going into any but the most basic, relevant detail, I became competitive. I won many races and was in the top single digit percent in every event.
After 10 or 15 years of unguided, excessively competitive indoor rowing, I started to develop irregular heart rhythm and it became atrial fibrillation.
After the two years or so of increasingly irregular heart rhythm and my denial of it being any problem, it became constant and I participated in a medical study sponsored by Apple, with Stanford University, using the Apple Watch and was diagnosed and confirmed with atrial fibrillation.
My wife discovered a book whose title is, “The Haywire Heart” and she gave it to me as a Christmas present. That book has three authors, all of whom are medical professionals, and who are (or were) also ardent, competitive triathletes.
Each of those three authors developed atrial fibrillation during their years of highly competitive and perhaps excessive training for triathlons. Another thing they each have in common was that they are each 6 feet (1.83 meters) tall or taller.
So from that book, I concluded that I had developed atrial fibrillation for the same reasons they each had. (If you wonder what a person’s height has to do with atrial fibrillation: the taller, a person is, the larger, the heart and the larger the heart, the more cells it has, and the more cells it has, the greater the possibility that some of them will become “rogue“ cells and transmit electrical signals at the wrong time … which will result in irregular heartbeat. )
Si I tried treating the Afib myself by switching back from rowing to running. The reason I did that was because I had read of a study that looked at the adaptability to change of the hearts of competitive runners versus competitive swimmers versus competitive cyclists. That study found that the most adaptable and therefore, in that respect, healthiest hearts were those of the runners. There was another study that only looked at the adaptability of the hearts of competitive rowers. The results of that study indicated that the rowers hearts were the least adaptable of all.
So I thought that switching back from rowing to long slow running, might reverse the problem of atrial fibrillation. But apparently I was too late for that “therapy.”
Instead of making things better, I developed atrial tachycardia with heart rate, stuck at about 150 bpm.
The cardiologist put me on metoprolol succinate and an anticoagulant. A few weeks later he did a cardioversion which brought the heart out of tachycardia and also put it into normal sinus rhythm.
Within a couple weeks or so, heart rate went back into atrial fibrillation, but not tachycardia.
A cardiac ablation was done that put it back into normal rhythm.
Before that ablation, I had started flecainide, but had to stop it after about three days because it gave horrible side effects.
Within less than a month, heart rate went back into atrial fibrillation and then again into atrial tachycardia. It became stuck at about 160 bpm.
That is when the sotalol was tried.
I thought the sotalol worked amazingly well. The prescription was 120 mg twice a day. (Before starting sotalol I had read a little about it and learned that very commonly it will be started ONLY if the patient is in the hospital for the first few days and close observation.)
in less than 24 hours the tachycardia rate decreased quite a bit from 160 BPM. After two days, heart rate had plummeted to much more normal rate in the 70s and seemed to be sinus rhythm.
After three days, the cardiologist told me to stop it and come to the clinic for an ECG.
He noticed a puzzling preponderance of “T-wave inversion.
He told me not to take any more sotalol.
So that was my brief experience with sotalol. I can only guess that he correlated the development of the undesirable “T-wave inversion“ with the Sotalol.
After a short period of a couple weeks or so, heart rate went back into atrial fibrillation, I had a second cardiac ablation, and it has been almost a year now since the second cardiac ablation.
I’m using the Apple Watch to monitor heart rate constantly for atrial fibrillation and it makes a report every seven days of it’s reading of “atrial fibrillation load.“ the atrial fibrillation load varies from week to week from as low as “2% or less” to as high as 12%.
If your resting heart rate is about 100 BPM, my non-professional opinion based on personal experience is that that is borderline tachycardia, but it’s not so high to be exceedingly dangerous for a few weeks or more duration well, you give your heart a chance to adjust to the reduction/eventual total absence of Sotalol.
The only medicine I am currently taking is an anticoagulant and 25 mg 2X daily metoprolol tartrate (NOT the time-release succinate version).
The metoprolol tartrate’s purpose is to counter the inclination of my heart rate to get too excited with adrenaline and go at too high a rate when I go running or bicycle riding.
So with the metoprolol tartrate … instead of rapidly going up to 150 or 160 bpm when I go out for it long slow run on a warm Arizona summer afternoon of 95 to 110°F or more, my heart rate goes from its resting zone of between 50 to 70 bpm up to a little over 100 and then gradually over the course of 2 miles or more, reaches a higher rate of somewhere in the 140s.
if your doctor believes you should “wean”yourself and stop taking Sotalol, then (based on what I have read about it) I am sure he is correct.
May God bless and help you as you go through the process.
Postscript: after posting this and then reading it I notice that there are quite a few errors which are due to wrongly transcribing what I verbally dictated to the smart phone. If you can forgive those errors in grammar, etc., I think you can understand the intended sense of everything.
I had an ablation last Wednesday. I had to stop Sotalol after the last dose,on the Sunday night before. and early on the Tuesday morning, my AFib started, so down to A&E, Drs orders, as my heart rate and blood pressure soar, when I get it. The Drs said it was caused by stopping Sotalol. They gave me a very low dose of I think it was bisoprolol,which stopped it and later, I was transferred to the hospital doing my ablation. My blood pressure and heart rate stayed high, until I was able to start taking Sotalol again. They went back to normal when I started taking them again. I They have reduced my evening dose from 120mg, to 80mg, which has been ok, so I assume they will eventually stop it. I will do it my own way, though.Fortunately, I have about 6 weeks or more worth of spare tablets, so will do it much more slowly than they’ve told you. I’ve been on Sotalol for a long time. I should imagine your heart rate could have increased because you’ve lowered your dose of Sotalol. I shall reduce my doses very slowly, one at a time, not both doses at once and by 20mg not 40 mg and over 2 weeks or more. Will have to work out how long my tablet supply will last. I’m hoping that will prevent any problems, especially as I’ve been on them a long time. I had to stay in hospital for 3 days when I started them, as it can lead to prolongation of the QT interval. It would be good to stop them, as long as I get no problems. Good luck and hope you continue to be AFib free.
Thanks everyone for the kind info...I contacted my Doctors office on Thursday but have not heard back from him yet....over Friday & Saturday my resting heart rate has dropped into the high 90's and goes to about 125 when working, walking, longer distance etc. It appears it may be starting to regulate somewhat the longer I am off the Sotalol so may just be a rebound effect of stopping the medication to quickly....here's hoping...and again thanks for your responses
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