heart rate staying high after afib episode

[hartbeast]

I have been wrestling with paroxysmal a fib since a stroke in 2018. I had a cryo-ablation in 2018 and a pulse field ablation this past June. I’m F, 67, and recently had to switch to dofetilide when the flecainide ceased to keep the rhythm in check.

Since beginning the dofetilide in late December, I had one episode in February, one in March, and one today. My standard procedure is to wait 30 to 60 minutes to see if it stops on its own, and then to take 25 mg of metoprolol just to keep the rate under while I wait for things to settle. So far, it’s always stopped within a few hours, and if I had to take a metoprolol, sometimes the rate goes pretty low for while once I’m back in sinus.

My resting heart rate is usually 60 into the low 60s.

Today, I flipped back into sinus rhythm about two hours after I took the metoprolol. But for the first time, the rate has not slowed down that much. It was floating around 100 well I was in a fib, and now that I’m in sinus, it is still floating a little over 100 even when I was in a fib (after I took the metoprolol) but now that I’m back in sinus, it is still floating around 100 even at rest, 7 hours after I popped back into sinus.

I’m waiting to hear back from the on-call EP, which may take a while. I can take another 25 mg of metoprolol (I’m not on any daily beta blockers at this)

I’m just a little freaked out (or at least surprised) that the pattern is suddenly different, and wondered if anyone had comparable experiences to share, while I wait to hear back from the doc.

I slept very badly last night, and I’ve been trying to hydrate and rest all day, but I that lack of sleep is a significant factor.They say he should call within 45 minutes, but we shall see.

thank you in advance for any sharing of your experiences.

[Afibflipper]

Hello, sorry you are not feeling too good! I can’t comentó on your medication as not familiar with the ones you take. I’d say yes keeping well hydrated is good. Can you pinpoint a trigger (I see you say lack of sleep) for this episode. That has been a big issue for me as I’ve had insomnia for years. Do you have low salt, alcohol, caffiene, sugar? Have you had a recent infection/ virus? These are all my triggers. I’m convinced my flu vaccine has caused one or two episodes. I know it’s not a live vaccine but possibly the reaction such as inflammatory response. Since Oct last year I’ve taken Magnesium Taurate & personally I feel, it has had major beneficial effects for me. It’s turned around the 160 HR & AF rhythm very quickly (it’s taken every night & also benefits my insomnia). 2 days ago the 160 took 24 hrs to be back at 60bpm & back to NSR. Maybe have a look into that (check with your medics). Also slow breathing relaxation techniques can sometimes help lower HR. Hope you feel better very soon

[hartbeast in reply to Afibflipper]

Thank you for your thoughtful reply, flipper.

Those are some great suggestions. I do sip magnesium water throughout the day, and I no longer take any caffeine or alcohol and low salt and low sugar, although I have had to add more salts/electrolytes back in in order to help stay hydrated. But I do think that insomnia maybe a more insistent trigger than I like to admit. I meditate and do breathing exercises daily - I teach both, actually. Usually, they are very effective for me in bringing down the BPM number, although they don’t stop my a fib. But for some reason, I seem to be stuck today. I did speak to a doctor who was on call at the hospital last night, and I’m waiting to hear back from my regular electrophysiologist today. I think I need to seriously address the insomnia, in any case. And because I take a different kind of magnesium and you’re not the first person who has recommended magnesium taurate, I will ask my doctor about that.

Thank you again for all the good ideas!

[Afibflipper in reply to hartbeast]

You’re welcome. I actually have been prescribed Zopiclone which I use very intermittently for the insomnia ( sometimes I go days with out sleep so when I know this is the case I use to get at least one good night. The taurate was very noticeable for helping sleep initially. Best of luck & update us with the EP outcome