Heart thumping when returning to bed after toilet visits at night

[Hamish5]

Had a cryo ablation just 3 weeks ago and 2 breakout episodes already! I have also been bothered by palpations and chest pressure when returning to bed after urinating. It starts as soon as I lie down and can persist for hours. Heart feels like in distress, and slightly achy in the left chest area but no other symptoms. Surprisingly, my heart rate doesn't rise very much (goes from 50's to 60's bpm) and blood pressure remains normal, but I find it difficult to get back to sleep. It actually happened occasionally before the ablation, but has become more frequent since. Does anyone else suffer from this?

[BobD Volunteer]

It is so early in your recovery to be worrying about such things. Do the deep slow breathing exercise and try to relax.

[jeanjeannie50]

Hi Hamish

There are a few tricks that can help prevent this happening. First it's a good idea to sit on the side of the bed for a minute or so before standing up. I use the time to take a pill that needs taking apart from others. As we grow older or hearts find it difficult to respond to the sudden movement and that can kick your heart off into AF. Also do your best not to put a lot of strain on your body when urinating.

Once you go back to bed practice deep breathing and listen to yourself breathing in and out. Now you know those boring people who talk constantly about themselves and go into great detail telling you all about what they've just done? Well imagine that person is sharing your room and you know that they've been out and will want to tell you all that happened. They're really hoping you'll move and then they'll know your awake. So really fake that deep breathing to try and impress on them that you're in a deep sleep.

Let me know if this works for you, just the deep breathing usually works for me, but I've used the last technique many times too.

Jean

[Cliff_G]

Hamish, whilst my first ablation years ago worked straight away, my second one 3 months ago didn't. It can go either way.

A cryo ablation is for the pulmonary veins, the so-called PVI, which isolates the sleeves of the veins entering the sides of the left atrium, which are a common source of the rogue beats which make for Afib. After the ablation, the heart can take a while to settle down, which is sometimes called the blanking period, typically 3 months, where the inflammation and scarring from the ablation slowly settles and the ablation takes full effect. The extra palpitations you felt before can indeed happen more often afterwards, depending on where they are coming from. They were probably masked by the Afib before. The breakouts are also a function of the scar tissue potentially not being fully formed yet.

Palps can also settle during the blanking period, though sometimes they need a little help from a med such as Flecainide (which only your EP/Cardiologist could prescribe). I needed Flec after both my ablations, the recent one my ectopic beats were really bad, but 200 mg of Flec a day sorted them out.

It's probably a little early to be too concerned about the long term, except of course the palpitations are very real and can be intrusive. Several tricks available. Firstly, lie on your right rather than your left, this takes pressure off the heart and will ease or even stop the palps. Secondly, slow breathing as others have said. Another possibility is that a *small* snack can help settle things too, due to the heart-gut connection. If that makes it better, great, if it makes it worse, then that's not for you. But sit up while digesting before lying down again.

There is a Recovering from Ablation advice sheet at heartrhythmalliance.org/afa... , as well as many others!

Good luck

[Sorre1 in reply to Cliff_G]

Interesting what you say about avoiding lying on your right. I I've suffered from AF for 10 years now, some spells worse than others.

Had Cryo ablation last November which lasted a week so put back on Bisoprolol and started on Amiodarone. Although I'm aware of the palpitations, changes in rate they don't affect my life thank goodness. I do notice however that when lying on my left the palpitations are much more noticeable whil on the right I can quite happily ignore them - very strange.

I'm due for a cardioversion in 2 weeks though and hope that works.

[Cliff_G in reply to Sorre1]

Yes, in my early AF days I used to lie on the right most of the time with benefit, but 4 years after my first ablation I broke my right collar bone and have never been able to lie on the right since. Lying on my left was ok for another 10 years whilst my last ablation held, but my open heart surgery 7 years ago set my AF off again, and now it would be really useful to be able to lie on my right 😕

[Hamish5]

Thanks Bob and Jean. I do find it hard to relax and I have tried very hard with breathing exercises in various ratios. Unfortunately they don't seem to work for me! Because of what happens I'm very careful not strain when urinating. I'm also careful to take my time and allow my body to adjust to the movement, even sitting at the edge of the bed for minutes after I return. But, no matter what, as soon as I lie down the palpations and pressure kick in. It's strange because I've usually been lying down comfortably before the short trip to the toilet!

[Cliff_G in reply to Hamish5]

Another thing to try, surprisingly and especially if slow breathing doesn't work, is to get your heart rate up a bit (not too much) - e.g. some gentle walking up and down stairs. If your afib and post-ablation state is "vagal", just being asleep or having a low heart rate can provoke things. Obviously if that doesn't help, that may not be for you.

[jeanjeannie50 in reply to Hamish5]

Just breathe normally through your nose with mouth shut and listen to each breath going in and out, with each out breath let your body go limp.

[DawnTX]

It takes time to heal number one. Number two it’s not a cure there is no cure. It sounds like you’ve got some relief although you don’t say what your numbers were previous to the ablation. I had tachycardia my lasted. about six months before a new spot acted up so he may very well have gotten the right place, but you are open to having more places breakthrough. It is what it is. I had some breakthrough palpitations, but I felt much better after the procedure until I did not. My second lasted almost a year still had issues but nothing like I had between the RF and meds. I stayed fairly steady you that you feel is how I felt. Even though I get the achy heart, I call it. I have a pacemaker. I still can feel flutter when I have an episode and I still get achy usually and acetaminophen will help. It is not debilitating. It’s annoying and there.

just having your heart worked on is going to possibly make it feel like that it’s traumatized they keep working on things maybe someday something right will work for all of us but right now you will have a good bad days like the rest of us think about if you hurt your wrist and your doctor does something for it like a steroid shot. Do you feel perfectly fine? I say a shot because I had one it hurt terribly getting it in about three days. It felt worse than it had before the shot. It took me about six months now I almost forget what it felt like. If it didn’t work at all, your numbers would probably show it. Here are some prayers, hoping and time it all goes away for a while, but when it doesn’t or if it does not, it’s just the way a fib is. You can still trigger the episodes and only you can try to figure out what they might be for the most part unless it’s MEDICAL. Slow but sure I have discovered some of the things that bring on an episode and it happens fairly quick after I do it.

I am sorry if you were led to believe you were going to be normal again. These days I pretty much feel it normal that is, but not always even with my fancy pacemaker. Some people get no relief after an ablation some get a little some feel awesome because we are all different. I was told Cryo was the least likely to make me feel better for any length of time. my the time. only gave cry one chance I’m not exactly sure why it could be the scarring. My RF still didn’t take it all away and I knew it wouldn’t. as I said, I did have a lot of relief for the following year again not perfect. I had a pioneer procedure done in Houston for my third ablation. Long story short, not only did it not work. I ended up with heart failure and a lot of. My EP would not consider another ablation because of the scarring that is why I went with a pacemaker. If I could turn back the clock, I would’ve asked for right away, but they try to do the least amount of anything to your heart to see if they can make you feel better and have a quality of life

three weeks is nothing in time, patience I find is what you must have for the hardest thing to do and but you need to not do those. If I were you, I would be thankful about your numbers and I would ask more about the ejection rate if he has not discussed it with you. It sounds like just starting your journey. Talk to your doctor and remember be patient with yourself think about what they just did to your poor. It does sound as if they got the spot for now. Just remember it’s very possible to have other breakouts. Personally, I would not want numerous cardio versions or ablations again if I could’ve seen the future. Do you want your heart to be treated with the only one you have. I can’t answer for your doctor on what he plans to do going forward. majority of time the answer for was meds. They just were not enough. I had two one lasted about three weeks the other one failed miserably. our doctors don’t know what’s gonna happen. They are doing the best they can. I would put it straight to my doctor if he more ablations like what are the odds of not getting a fib etc. you have to weigh the odds some of the meds are worse than procedures. if my last cardioversion worked, I was going to be admitted to the CCU for five days while they tried a medication on me and I needed to be monitored 2 hours a day because it is that serious a drug just like amiodarone. We are all different what you can take I may not be able to

best of luck I’ll bet you’re feeling better with your numbers holding steady including your BP. My first cardio version I went from around 200 to 82. I felt like a new person even when I woke up I knew I was better. If only it would last, maybe someday it will.

patience, and knowledge work on both of them. Try to relax yourself because anxiety for me is the worst trigger I can have. You might be the same way. Yes I know easier said than done. I’m still working on it with meditation and also finding more productive things to do than sitting, thinking about my a fib and let it ruin my life

[Buffafly]

Yes I do. Heart not properly ‘in gear’. It’s better if you sleep a bit propped up so your system doesn’t have such extremes to cope with.

[Snowgirl65]

Yes, I had that. Slow deep breathing would set it right for me, and laying slightly sideways would help. You're early in your recovery so there are bound to be some disturbances yet.

[lizzily]

This happened to my husband post ablation for flutter. He bought a plastic bottle from Amazon and hey presto problem solved as he didn’t need to get out of bed! Good luck

[Singwell]

I've had this occasionally. It's the shock to the system - you've been asleep, then gently awake prior to getting out of bed - one metabolic state- then go out to the bathroom, where its no doubt colder - another metabolic state - then lying down again. Your heart just isn't appreciating these shifts while you're healing. Lying on your side propped up a bit might help. If you don't get on with breathing exercises you could just focus on nose breathing to see if that helps calm things down again.

[Ppiman]

Returning to bed after a bathroom visit is my classic time to set off AF or gat an "inconclusive" reading on my Apple Watch. You are still in the early days. All will be well!

Steve

[Tapanac]

yes but try not to lie on your left hand side snd if possible 3 pillows. They slither down after a while but hopefully you’ve gone back to sleep then

I find after a while on the three pillows I can gradually turn to my right

All the best

[momist]

Your heart had a good kicking only three weeks ago, give it time. Mine had only settled down fully after nearly seventeen months. No events since February this year and I've been discharged from the list. Yay!