occasional high rate post ablation

[37Polly]

I am having occasional heart rates of 140-156 mostly in middle of night or upon rising that if I sit or just deep breathe resolves very quickly. I am almost 7 months post ablation for flutter and afib. This frightens me as I fear the persistent aflutter may return. Can anyone shed any light on what might be responsible? My doc simply texted that I should take metoprolol as needed?.? I am already taking beta blockers at pretty high levels and don’t know if taking more is warranted for a few minutes.

[mjames1]

Is it afib or aflutter? Or maybe another tachycardia? If you're not sure, you need to capture these events on an EKG monitor. If you're having them every day or so have your doctor hook you up with a Holter. A second choice would be the Kardia 6L. Ideally both.

Different arrhythmias have different meanings post ablation and may require different treatments. So without knowing exactly what's going on, just taking more of a beta blocker may not be a great solution, especially if you feel you are already maxed out on them. Ideally an electrophysiologist will be quarterbacking all of this. They do the ablations and they should follow up on them.

Jim

[37Polly in reply to mjames1]

Thanks for your helpful thoughts. I am not sure it’s either afib or aflutter. My apple watch has just said high heart rate..apple only identifies afib…so before ablation it often identified afib, when it was really aflutter. Had some long persistent episodes pre ablation.

These are very short but beginning to show up frequently. I also have a pacemaker, so may be time to call monitoring lab to see if my pacing is off. They will also be able to identify any arrhythmia.

Part of my dilemma is my ablation was done in another state , four hours away. I have excellent care locally with good EP, however not exactly easy to get rapid response. But I guess I must try. Again thanks. Just hoping someone had similar experience. People on this site seem to know a lot.

[Singwell in reply to 37Polly]

I think you might find it helpful to purchase a Kardiamobile device. They're very reliable, and will track a number of different arrhythmia and ectopics accurately. Worth the investment - not nearly so.much as an Apple watch!

[37Polly in reply to Singwell]

I had a Kardia device and was always getting a confused reading. It could not determine what I had, I think because I had atypical aflutter and afib with very high heart rates. Gave up on it and have counted on mt Apple Watch and pacemaker records. But perhaps it’s improved.

[Singwell in reply to 37Polly]

Might be worth checking it out in that case. You can request an analysis by paying a small fee, or create a PDF of the reading, which gives you a breakdown of individual beats and send it to your EP or cardiologist.

[Karendeena]

I have had a few runs of atrial tachycardia noted on a holter monitor I had in August last year 5 months post ablation. My heart rate is generally higher since ablation big hovvers around 72bpm

[Cello02]

Four days after my ablation at the end of January I went into AF or high heart rate constantly. I had a cardioversion in the middle of February but went straight back into AF. Recorded by my Apple Watch my average resting heart rate is in the high 90s. The EP who carried out the ablation is organising a 24 hour holter and says I will likely need to have another ablation. This would be my third. As my average heart rate isn’t too high at the moment he’s not too worried so I will have to wait a few months for further treatment. Not ideal as I am very symptomatic with shortness of breath on the slightest exertion. I have booked an appointment with a private EP next month.

[Alphakiwi]

When you have had an AV node ablation Bet blockers are no longer required. I think its because i no longer jave an AV node. That has worked well for me. Colin NZ

[37Polly in reply to Alphakiwi]

I take beta blockers for both essential tremors and to keep my heart rate under control. Not perfect but the best we have found for both. I had bradycardia before the pacemaker and the concern was that during aflutter I went too high and the doctors were afraid to give me beta blockers for fear with my natural low heart rate Id go too low. Solution: pacemaker that prevents that. It has worked, but that’s only part of the problem, obviously.

[Keepcool]

I am 8months post ablation (3rd) and suffering from high heart rate too. I’ve experienced all sorts after this ablation. Previous 2 were ok and lasted 1-2 yrs.

Exertion puts me in AF and now resting heart rate 95-100+ At one stage I was 180 after I attempted a walk. pre ablation I hovered at 60. Waiting on results of monitor and seeing cardiologist. Told to up flecainide to 300 daily but I reduced so that I could up betablocker to try reduce the 180 reads. Miraculously I have managed to up bisoprolol (1.25 used to make me very breathless) and now taking 6.25 plus only 100 flecainide. Still avoiding hills but managing my half hour daily walks albeit at slower pace.i am unsure of another ablation as 2 different EPs have conflicting ideas.

Since heard on this wonderful forum that we are not alone and tachycardia strong possibility after ablations. My 3rd was radio f and intense with a mention of 4th ablation possibility. Wish EP had mentioned tachycardia if that’s the case. Sometimes I think docs don’t wanna baffle us and think we’re all pretty stupid. I’ve lost count of the times I’ve been asked in hospital……but how do you know you’re in AF.

Well apart from heart beating out my chest…..I can take my pulse!

I think if you are only getting short bursts of high heart rate it’s wise to limit meds incase you dip too low (although I assume your pacemaker resolves this?)so I reckon your doc is right but best to investigate, sometimes paroxysmal is harder to treat. And AV node I imagine to be a more intense treatment.

I hope things settle. Other forum members have mentioned it could take a year in some cases to get over ablation so we live in hope and I wish you a speedy recovery. We’re all different but nice to gather as much info as possible.

[37Polly in reply to Keepcool]

Thanks. I appreciate all your information. It really does help. I had no idea that tachycardia was common after ablation and you have actually made me relax a bit. I have turned off all my alerts on my phone regarding news today and its the first day with no tachycardia.🙂. I am a retired professor and news “ junky”. Need to retire that too, I guess.

[Vnorkus1]

Polly, I had an ablation for AFib and aflutter on Jan 15, 2025. I was still having days of aflutter so my EP did a touch up ablation on March 4. I knew when I left the hospital that he had " fixed" the problem. Very grateful.

[37Polly in reply to Vnorkus1]

Wow that’s really impressive. I need to speak to my EP.

[37Polly in reply to Vnorkus1]

Wow. Must feel great. Encouraging. Hang in,

[lingooz]

hi, I took bisopralol to start with, felt very poorly on it, as I don’t have episodes often I was changed to metoprolol to take as and when needed, find it very good , never offered ablation even though at times heart rate was 185 . 12 years on going good, take apixaban also for around last 8 years

[37Polly in reply to lingooz]

I ha

[37Polly in reply to lingooz]

I haven’t even tried the metoprolol yet. Don’t know what “ as needed” means when tachy resolves in a few minutes but happens several times a day. Unfortunately I believe much of it is stress. I live in US. Need I say more? I also am a retired history professor..?? I am trying to avoid the news. Thanks to all who have cared.

[lingooz]

here to in uk stress, war financial , sorry but Trump is trouble , wish you well

[Coco51]

A second ablation might be the answer. I had breakthrough AF after my first ablation which became persistent.

The first procedure had been a relatively simple PVI. The EP gave me a second ablation which was more comprehensive and ablated far more areas. That has worked better. I still get episodes - like you - but they are much shorter and far less severe. Dreams can trigger them! Stress, worrying, and infections can bring it on, and so (sadly) can wine.

I too have a pacemaker as my underlying heartbeat was slow. Recently they have increased my beta blocker, Bisoprolol, saying that the pacemaker means I can handle a higher dose better. (1.25 increased to twice a day.) So far so good. I also had the sensor responder on the pacemaker reduced to minimum, as the pacemaker kicking in can feel like tachycardia.

So, depending on what the next pacemaker readout shows, they may consider another ablation. My last check showed my burden was 14%. Meantime, Like you I find deep breathing, relaxation and trying to distract myself is best. And turning away from the daily news! Trump, Putin, Gaza ... I can feel my heartrate rise as I type the names!

Good luck.❤️

[37Polly]

thanks Coco, a very helpful message, on many levels. The point about dreams..YES, I noticed that even though avoiding the news and my family insisting on NEWS BLACKOUT, I have had two dream in past several days that are about our political mess, and it does affect my HR.

I will setup my pacemaker check up, too. It has needed adjustment before when it wasn’t picking up all the flutter. I am unsure now that it’s not causing the high heart rates. They do not set off flutter as they did before ablation. They are very short…

I am also beginning light exercise at the cardiac gym my EP approved. I am pretty sure no one is going to suggest another ablation because despite pretty painless and successful ablation with a few days I was hospitalized with double pneumonia which progressed to collapse of one lung and fluid in chest and fluid removal, that I am finally recovering from. No more anesthesia for me, I believe.

Again I really appreciated your thoughts.