atrial tachycardia and vtach post ablation

[37Polly]

I am almost six months post PFA ablation for persistent afib and atypical aflutter. I have been doing well recovering from ablation with zero heart events despite a bad procedure outcome of pneumonia, collapsed lung,and resulting fluid in chest, requiring thoracentesis. Finally nearly resolved. 😮‍💨 sigh.

However since Christmas, I began to have frequent brief runs of very high tachycardia, eventually daily. Might be middle of night, or at rest reading, or mid activity. Finally after three weeks of daily events, I called the cardiac center device clinic and requested review of my pacemaker reports. Sure enough, Id been having atrial tachycardia AND 3 clear events of v tachycardia, with major alarm signals on report. And I had to call them. ( and ask for report to be sent to my doctor, in same bldg)

That was two weeks ago, and all I have is a brief note telling me to take metoprolol, as needed. And by the way no more tachycardia events! Someone or something altered my pacemaker, which I suspect was causing my tachycardia. Meanwhile crickets. Am I obsessing? I don’t need major hand holding, but I feel I need information and guidance.

Anyone know about pacemaker algorithms? Or post ablation changes?

[Whataperformance]

The Pacemaker can only be changed if you attended the clinic.Vent Tachy can only be sorted if you have an ICD Capability Device, then the rate has to fall in a Zone so it Anti Tachy Paces first, then if that doesn't correct it shocks.

If you have a non ICD it won't do that.

As you are sure it wasn't Fast AF? Have you got an Anti AF pacemaker? is the capability set up on Device, to ATP it?

Probably the Meds? Or Ablation is settled.

Me thinks best bet, check with your clinic to ask for explanation.

Don't worry too much at least you are feeling better.

Best wishes

[37Polly in reply to Whataperformance]

Thank you for your response. I need to know more. I spent some time on the phone with the tech who performed the on line interrogation of my pacemaker ( 37 pages, most of which is well beyond my comprehension) . She was not very forthcoming, so tomorrow I will try my best to communicate with my EP or his assistant. You are correct they could not adjust my two lead pacemaker without an in person appointment and no one has suggested that.

She indicated that despite the report saying I had v-tachycardia, the graph does not agree, and also feels despite the report indicating pacemaker mediated tachycardia, that’s not likely either. I am really doubtful that three weeks of tachycardia daily would simply stop within hours of the interrogation, but it appears to be the case. I am delighted but still concerned.

I doubt medication is a factor since I stopped rhythm meds with ablation and only take a low beta blocker for rate control and tremor, along with long term blood thinner.

I appreciate your knowledge and thoughts, as I see little discussion about this subject. And no one educates patients . I know I have a dual lead pacemaker that has about 4.5 years left after 5 years use.