Sinus tachycardia

[Aegean56]

Last week I posted 2 bouts of palpitations that Kardia was recording as sinus tachycardia, each lasting about 10 minutes with HR coming down over that time. I was observed in hospital telemetry New Year's day for 36 hours for the most recent one : No tachycardia no A fib and was sent home.Here's the follow up . Metoprolol was kept at 50mg bid with pill in pocket approach if an event occurred. Since then I'm tracking and recording . For the past week everyday like clockwork early evening I am having an episode of about 30 secs of HR going up to 90s-105 after getting up from sitting or lying. No Afib on Kardia or smartwatch . Episodes resolve complete on sitting back down and is followed by mild to moderate HA that last for about 15 minutes ( feels like my usual migraine but much shorter). My diagnosis of Afib was back in 2012...well controlled on Flecanide for 8 years with only one breakthrough ( which also was tachycardia but no A fib recorded) episode in 2020 at start of Covid . Flecanude was stopped to concerns for posdible more serious arrhythmia. Now just on Metoprolol 50mg bid. I’ve been advised to up the Metoprolol dose to 75 bid.

But this sounds and feel more like POTS ....very curious. So this AM I started monitoring thrught the day . Before getting up : NSR at 62bpm . Sat up on side of bed for 5 minutes was 71bpm NSR and will see what happens later this evening.

FYI . My first migraine attack at age 56 was was layered over an Afib episode . Since then my autonomic nervous is supersenitized!

I'm curious if anyone's else has had these "POTS like" symptoms absent Afib or had similar pre migraine like phenomena?

Seeing docs on Thursday .

[Thomas45]

I expect my heart rate goes up when I stand up. I don't believe it's a sign of POTS. I don't have a Kardia. I go on how I feel. This morning, now I'm drinking my first cup of tea of the day, back in bed, I feel fine.

[Aegean56 in reply to Thomas45]

Thank you for your response. However this increase in HR is accompanied with more than the expected 10-15 bpm above baseline its more like 40 bpm ( from mid 60s to over 100) and an onset of a HA, then immediately abates on sitting or reclining.