Heart rate question

[NorthLeedsJohnny]

Hi all. New to this group. A week ago, I had a catheter ablation because of a high number of ectopic beats, which were making me light headed and exacerbated my breathing during asthma attacks. They haven't yet settled down but I know that this can take some time.

Since the ablation, I've found that my heart rate sometimes rises to around 150, ever when just walking around slowly. At the other end of the scale, my resting heart rate can be as low as the upper 30s. It's usually around 55.

Before the procedure, when discussing options with my cardiologist, I mentioned that I had a heart rate monitor on my fitness tracker but that I wasn't sure how much faith to place on its readings. He told me that it is surprisingly accurate. These wider fluctuations have only occurred since the procedure last week.

Does anyone know whether changes like these can be as a result of the ablation and, if so, what can be done about it? I'm not due to see the consultant for almost 2 months.

Thanks.

[Prada47]

Hi

Sorry can't help with the ablation question but curious as to how they tried to control your excessive ectopic beats with medication, prior to going down the ablation route ??

Regards

[NorthLeedsJohnny in reply to Prada47]

Hi. They said the usual route would be beta blockers. However because I have relative bradycardia, with a resting beat below 60, that would lower my rate too much. Ablation was the only way forward.

[mandm65 in reply to NorthLeedsJohnny]

Thats interesting, my RHB was in early 50s when my cardiologist recomended that i should go on BBs!

Now RHB is in early 40s and sometime below 40s, managing just about ok.

Sorry unable to help you with catheter ablation.

[NorthLeedsJohnny in reply to mandm65]

As you say, interesting! I wonder if the fact I also have asthma may have anything to do with it. He definitely told me that I can't have beta blockers and he copied me a letter to my GP saying the same thing. Thanks for replying.

[mandm65 in reply to NorthLeedsJohnny]

I guess thats the only key differentiator we have, it’s a long short but perhaps best possible guess one could have.

Yep, my cardio team also cc me to any communication that goes to my GP.

[Prada47 in reply to mandm65]

Just waiting for the results from my Holter from last week. I have excessive ectopic beats and I feel about 60% of them. The technician doing my last echo was quite surprised that I could look away and just tell her every time it was an ectopic. My ectopic beats improved after recent stents, but have now come back with a vengeance hence the Holter Monitor.

regrds

[NorthLeedsJohnny in reply to Prada47]

Much like myself. I get dizzy a lot with them, as well as breathless, which combined with asthma is not good! Been OK for a week or two but was at hospital 4 times within the previous 4 weeks, 3 of them by ambulance!

When my results came back, my "dizzy diary" matched up exactly to when I was having a long run of ectopics. Ambulance crews and hospital doctors couldn't believe how many. Often every other beat for quite a period of time. That tends to just about halve my heart rate, which is where the dizziness comes from.

The ablation was supposed to rectify things but as yet, it hasn't. The consultant who performed it said that ectopics are the worse type of arrhythmia to deal with. For ablation, you're laid flat on your back for several hours. Ectopics tend to die down when you're flat, so the source can be difficult to pinpoint. It may need to be repeated!

[mandm65 in reply to Prada47]

It amazing that you could predict with that kind of accuracy, i am in the opposite camp, to date i haven’t got foggiest when i get those ectopic beats, may be because mines are usually coupled or occasionally quadruples?

Do you know if your excessive ectopic beats disappear when you exercise or reach some sort of HR threshold?

Let us know once you get the results from Holter.

[NorthLeedsJohnny in reply to mandm65]

I know when mine are happening because I can feel them. A bit like a juddering in my chest. Not painful in any way. Mine vary an awful lot too. They mainly tesd to be 1 in 2 but are also often 1 in 3, 1 in 4 or 5 and sometimes 1 in about 10! Often they're all mixed in together too. Strange!

[mandm65 in reply to NorthLeedsJohnny]

Got the picture, believe the Holter could tell the accurate % of the ectopic beats. I believe if the total ectopic beats are < 5% then its no cause of concern.

Unsure about you but mine ectopic beats disappear during exercise when I reach a certain HR threshold.

[NorthLeedsJohnny in reply to mandm65]

Not sure on that one. As I mentioned when I began the post, my hr varies wildly between a resting rate of 37 and 150+, regardless of what I'm doing. Unless I'm laid down, the ectopics are usually there.

[Miaxxx in reply to NorthLeedsJohnny]

Hi can i ask u how many a day u get cause id probably get 3 or 4 a day and sometimes in clusters..but specialist says i definitely cant get ablation its out of the question he said id hav 2 be gettn thousands a day but i dont believe him and he was quiet rude

[NorthLeedsJohnny in reply to Miaxxx]

It's a shame if he was rude. No need for that.

I do get a lot of ectopics. Quite often, I get every other beat skipping for minutes on end, so sometimes around 30 a minute! More often than not, when I check my pulse, I have some, be that every other beat, every 3rd or 4th etc. I suppose that, in a 24 hour period, I probably do have thousands.

[Hidden in reply to NorthLeedsJohnny]

Did the doctor say what's ACTUALLY causing these ectopics (I'm actually quite curious) and how ablation could address the cause? I have had ectopics along with hypotension/bradycardia. I get dizziness but it's from hypotension/bradycardia, not from ectopics.

[NorthLeedsJohnny in reply to Hidden]

He said that some cells (in the ventricles in my case) emit rogue signals which then interfere with the heart's regular conducting system. The source and frequency can be very random. Structurally my heart is fine, so there isn't a physical abnormality causing them. He said that the purpose of ablation is to identify the cells in question and apply high frequency radio waves to scar the area, cutting off the route by which the rogue signals are sent out.

Unfortunately, ectopics have a tendency to fade, when you are laid down, so pinpointing the precise area during ablation can be very tricky. In my case, I was having lots when I was being wired up for the ablation but soon after. The consultant was having a hard time finding them because I was laid flat for nearly 3 hrs. As a result, he couldn't give me a guaranteed that it had been successful. If not, and that will be assessed when I see him in a couple of months, then it can be repeated.

I too have relative bradycardia but with breathless-causing asthma as well. I think it might be the overall combination which has meant I've not waited long. In the overall scheme of things.

[NorthLeedsJohnny in reply to Miaxxx]

I think they only consider ablation if the ectopics are causing some kind of problem for you. In themselves, they're said to be benign and are basically harmless. In my case, because I have so many, they cause dizziness. When they occur during an asthma attack, they add to my breathing difficulties too. For those reasons, the consultant said I needed the procedure. An ambulance crew (with me because of asthma) noticed, when they were doing an ECG, that if my breathing became particularly bad, the ectopics were triggered. So the two seem to act against each other.

[NorthLeedsJohnny in reply to Miaxxx]

They also consider that, if treatment is needed, beta blockers will be tried first. In my case they didn't try those, as they lower the heart rate and mine was already low to start with. The consultant said beta blockers would make my heart rate too low.

[Miaxxx in reply to NorthLeedsJohnny]

Ok thks for ur reply my gp started me on beta blockers...but i also hav asthma and im convinced when my breathn is not gud it triggers the ectopics or when i hav ectopic beats it triggers my breathn difficulty...i just dont no wat 2 do and dont seem to be get anywere with docs...when i feel an ectopic i get dizzy and feel a sensation goin tru my body and feel like im gona pass out

[NorthLeedsJohnny in reply to Miaxxx]

Hi again. Sorry for the delay in replying. I'm in much the same situation as you. A couple of days ago, I spoke to an arrhythmia nurse (given contact details after ablation). He told me not to be worried about numbers (high or low hr). He said they would be more concerned if I was feeling unwell when the hr is very low or high. Generally I'm OK but do still get a lot of dizzy spells. Previous tests have shown that to be at the same time I'm having ectopics. He did ask me to wait to see if they settle down and discuss things with the consultant when I see him in about 7 weeks! So, he wasn't too concerned about my dizziness. If yours is worse (it sounds it as I've never felt I'm about to pass out) I would think you need to be knocking on the doctors door again!

[Prada47 in reply to NorthLeedsJohnny]

Hi

Just looking at my previous Holter

Heart Rate between 52 and 118 BP medication on 10mg Bisoprolol at the time, along with the usual Cocktail of Meds.

Ventricular Ectopic 8.1 % of total recordings and Atrial Ectopic 3.4 % of overall readings. Not sure if you add the two together 11.5 % of all readings were Ectopic. On my diary I had recorded short of Breath and Dizzy which matched Sinus Rhythm with Premature Ventricular and Atrial Ectopic beats at the time !!!

If you take 60 BPM as the average it would = 3600 Beats per Hour X 24 = 86400 so I had about 9600 Ectopic beats in the 24 hours of monitoring. Anyone know if that is the correct assumption ??

Regards

[NorthLeedsJohnny in reply to Prada47]

That looks right to me. I was told by the staff on hospital that some people have many thousands a day. Probably myself included. That said, I was told there was a strong correlation between the ectopics recorded and entries in my "dizziness diary" just like you. What I wasn't told was the relative incidence of them over the 24 hrs. Mind you, because I feel them, I have a pretty good idea anyway!

It's now around 11 days since my procedure and, if anything the frequency of ectopics has increased. On Saturday I felt dizzy more than 25 times! I might get back to the arrhythmia nurse and check that out.

[bantam12 in reply to NorthLeedsJohnny]

You were lucky to have your ectopics and dizziness taken seriously, I've been ignored for years ! tests shows runs of 9 in a row but I'm just told it's normal and not important.

[Prada47 in reply to bantam12]

If you have ectopic beats 1 every 5 it's called trigemini ( I think that's correct ) not sure if it is the same word for any other combination ? I have had CABG surgery and recently had some stents to open my LAD. When I saw the Cardiologist I mentioned my ectopic beats had changed so she said straight away " I will order a 24 hour monitor to see what's going on ". So from that I take it CABG or Stents can change the way your heart beats !!

[NorthLeedsJohnny in reply to Prada47]

I've read and been told that bigeminy means that ectopic beats happen after every normal beat, so it's every other one. Trigeminy means 2 normal then an ectopic, quadrageminy is 3 then an ectopic. The length of time that the pattern continues varies for me. Sometimes it bigeminy for 5 minutes, sometimes a combination which seems completely random.

It does sound from your experience that procedures can affect subsequent ectopic frequency. I'll chase it up.

[NorthLeedsJohnny in reply to bantam12]

Yes, I've been very fortunate. I'm assuming it had something to do with the fact that the ectopics seem to affect my asthma. During late Aug and early Sept, I was at A&E and admitted) 3 times, with a 4th ambulance at home only. When I saw the cardiologist (during that month) he said the procedure would be late Nov or Dec. A couple of weeks later, I got a letter confirming 3 Oct.

[NorthLeedsJohnny in reply to bantam12]

Yesterday, I phoned the BHF helpline for advice about ongoing problems, was told speak with my GP straight away, saw her, had an ECG and she arranged a 7 day monitor on an urgent basis. She emailed my consultant, to keep him in the loop. This morning he rang me at home and said he's prepared to do the ablation again - tomorrow afternoon! Things certainly do see to move quickly for me.

[bantam12 in reply to NorthLeedsJohnny]

Being a chap helps as Drs take more notice of men, sadly us women are generally told we are neurotic hypochondriacs so nothing wrong !

Hope tomorrow goes well, good luck.

[NorthLeedsJohnny in reply to bantam12]

Thx. I would hope that's not the case!

[NorthLeedsJohnny in reply to bantam12]

Just a quick update. I've been lost in a cold for the last few days. Despite that though, the second ablation last Friday (4.5 hrs) has been a success! Immediately after the procedure, when lying flat in my bed, I had the odd ectopic now and then. Since the next day though, nothing - including no dizzy spells. The only setback I have had was that I had an asthma attack the day after the ablation at 4am while still in hospital, then the cold, then another asthma attack yesterday involving an emergency ambulance and A&E. Throughout all that though, no ectopics!! 😊😊

[bantam12 in reply to NorthLeedsJohnny]

I'm glad to hear it went well and despite the other hiccups you are doing ok and ectopic free 👍

Stay well 🙂

[Cat04 in reply to NorthLeedsJohnny]

Your ectopics sound just like mine were, but since my ablation 9 days ago haven't had hardly any. I was getting them frequently prior to ablation.

Get better soon.

[Calico93]

I had an ablation of avja 4 years ago and you will be monitored and parameters altered as need be. It did take time for the healing and settling so be patient with yourself and the process. I had a ddr pacemaker to regulate me but I knew that was my process before the ablation. Hope that helps