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Heart Disease (Expert Forum)
Severe Attach of Sinus Tachycardia Post Ablation
Answered by
Cleveland - OH
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Severe Attach of Sinus Tachycardia Post Ablation
by glassheart46, Nov 26, 2003 12:00AM
Three weeks ago I had ablation for AV node reentry, and two other sites as well for atrial tachy and extrabeats. Ep said he got it all. Two weeks ago was put on a Loop monitor and my EP said he seen one atrial tachy 16 beats total and a number of sinus tachy, one up to 120bpm and a number of pac's. Well,last nite around 3am I was awakened from a sound sleep with the worst attach ever,even before ablation. I recorded and sent it in. It was beating at 160bpm+ at times with a few missed beats and was unrelenting. They said it looked like Sinus Tachy. The center told me to call my hospital which I did. The doc asked what I had on hand to take. I had an 80mg fast act Verapamil and 240sr Verapamil. I took the 80 and it slowed the heart rate down to the high 80's. Then took the 240mg. My HB is around 75 this am but it took 1 1/2 hours to get there. This no longer sounds like a normal variant of ablation does it? Also, I am to go on 50 mg Toprol 1xday after speaking with EP's office this am. and was told I could take the fast acting verapamil if it got untolerable as well as the Toprol. Can I mix Toprol with Verapamil? I took pinadole (spelling)one time prior to alation and it made my heart beat fast so was told to quit. Will the Toprol work better? What Could this sinus tachy be from. I don't have any other problems that I know of. Could this be a onetime thing due to post ablation? Can a persons heart beat that fast and long with no bad effects? Also, my bp is naturally low 112/58 usually. Can I still tolerate Toprol? Thanks so much for this board!
Doctor's Answer
by Cleveland Clinic, Nov 27, 2003 12:00AM
, Nov 27, 2003 12:00AM
glassheart,
Sorry to hear of your ordeal. sounds like it was pretty scary. You are still in a window where you may have some dysrhytmias after ablation. I wouldn't sweat this too much unless it were to start happening more often. I would also make sure you are seen by your EP so he/she can look at the event and make sure nothing else is going on.
As far as your questions:
1) Toprol and verapamil can be mixed. I wouldn't do it unless you were on a good dose of one of them first. You should be followed closely for heart rate control and have an ecg on them.
2) Different beta blockers effect people differently. Ive seen pretty profound differences in the agent among patients. Toprol may work better for you and worse for someone else. You wont know until you try.
3) Sinus tachycardia can be caused by an immense number of things. With relation to your procedure, it could be a side effect, but I would have to have proof that it is more frequent than an isolated incident.
4) Tachycardia can induce heart failure if persitant for extended periods of time. This is not a matter of days however, and probably more on the level of months to years.
5) You should be able to tolerate at least modest doses of toprol. Again, I would start low and titrate it to heart rate as your BP tolerates.
good luck
Sorry to hear of your ordeal. sounds like it was pretty scary. You are still in a window where you may have some dysrhytmias after ablation. I wouldn't sweat this too much unless it were to start happening more often. I would also make sure you are seen by your EP so he/she can look at the event and make sure nothing else is going on.
As far as your questions:
1) Toprol and verapamil can be mixed. I wouldn't do it unless you were on a good dose of one of them first. You should be followed closely for heart rate control and have an ecg on them.
2) Different beta blockers effect people differently. Ive seen pretty profound differences in the agent among patients. Toprol may work better for you and worse for someone else. You wont know until you try.
3) Sinus tachycardia can be caused by an immense number of things. With relation to your procedure, it could be a side effect, but I would have to have proof that it is more frequent than an isolated incident.
4) Tachycardia can induce heart failure if persitant for extended periods of time. This is not a matter of days however, and probably more on the level of months to years.
5) You should be able to tolerate at least modest doses of toprol. Again, I would start low and titrate it to heart rate as your BP tolerates.
good luck
I think you need to give the ablation more time to find out if it didn't work and if it ends up you need another one, that might be all it takes to "fine tune" you. So, bottom line, even though I know it is scarey and frustrating, at least you have more reason than ever to think there is nothing dangerous going on .. also the event recorder is more evidence to back that up.
hope you feel better soon!
Lynn
It's me Carrie!!
Do you know what your resting heart rate is if you were not taking the Atenolol? Just curious as to how much it really lowers your heartrate??
Thanks so much Hank!!
Carrie
I have learned to live with a resting HR of 110-120 (I am slim, NS, ND, exercise regularly). I have occasional bouts of ST to 160-180 that can last for hours. Hasn't killed me yet, and I am 46. This has gone on for about 15 years. I take no meds except for Lisinopril for mild hypertension. I do nothing when I get the tachy, except for busy myself doing something else.
Relax a bit about it, and see your doc if it continues.
I'm a 42 yr old healthy male 6'4" 220 lbs and quite fit living in England. I've had a 15 yr history of GERD, anxiety, and ectopy. Over last four years I've had 5 episodes of AF - all 3-5 hrs duration and starting in the early am and converting before getting up. I also get quite a few ectopics - 10 on a good day and a couple of hundred on a bad day: also one or two short runs of ectopics on most days - 2-6 seconds typically. I appreciate that I am a vagal lone AFr with a normal heart (echo, stress ECG etc). I am on no drugs and never have been. IMHO they appear to be very mimited as regards their 'benefits' for individuals such as myself. I am by nature somewhat anxious and obsessive, and have come from a violent and traumatic childhood at the hands of a mentally-ill adoptive father. I am somewhat hypochondriacal and VERY heart-aware! I am in psychotherapy and have been on and off SSRIs for seven years, but have recently (with Doc's approval) changed to 5HTP. I have, over this last decade, become well educated to PhD standard.
Now to my question. I have over the last 5 years had the occasional flurry of fast ectopy (?) which lasts but a few seconds (self limiting). It always originates whilst at rest (often driving) and has happened only a few times. BUT, when it happens it kinda feels like a real fast fluttery feeling in my throat and starts to make me feel a little light/hot/thick headed before it self-terminates with something of a large 'thump'. My question to Hankstar and you other folks here is what would you guess that these little episodes are?? All my Holters over the years have shown isolated PVCs (mostly up until five years ago) and isolated PACs (as opposed to PVCs during the last five years). Sod's Law says that one of these little flurries will not happen whilst on a Holter! Do you reckon that these sound like shorst salvos of fast HR SVT? I know they don't last long, but they have on occasion really had me catching my breath and getting panicky since I fear that such an episode would bring me close to passing out if it persisted for more than 10 seconds. Docs and Cardios tell me it's just runs of ectopics and that my biggest problem in worrying about it. Any views and opinions would be greatly appreciated.
Best wishes to all,
Big Mick
don't panic i know it's hard not to cause i do panic at times to but thats the most important i had my rate go to 276bpm in 1998 & was told it was SVT on 11/21/03 i had a what was to be a ablation during the mapping of my condition they could not find it so no ablation they sadi it went away but i'm still scared of it coming back just live man
you can email me at ***@**** i will the give you my number i will tell you my whole experience
i was just wondering what time u post on here. ive been trying unsuccessfully for months now:(
hope u feel better,
pan