Increase in skipped beats post ablation concerns

I am now 3weeks and 3 days post ablation for AV node reentry, atrial tachycardia and atrial extrasystoles. The slow pathway was ablated as was the atrial extrasystoles and the atrial tachycardia.  For the first 2 weeks or so after ablation the only symptoms I experienced were an occasionl skipped beat(maybe 12 to 24 per day very well spaced) and daily gradual increase in heart rhythm (not abrupt and would only get up to 100bpm or so.)  The last 3 days things have changed.  I now have skipped beats much more frequent.  They will come in runs that lasted an hour or so the first day and an hour or so the second day and yesterday it started at 4pm and did not let up at all untill I finally went to sleep around midnight. This am they are gone but for a few now and then. I was very hopeful that my ablation had worked and now some doubts are starting to creep in.  My common sense tells me that the skipped beats should be decreasing, not increasing.  I am wearing a loop monitor and was told that these beats are from the atrium and they called them early beats or skipped beats.  My question:  Is it possible that I am getting the old problem back: the old problem being bigeminys and trigeminys daily, 7 days a week and of course tachycardia; or is this just post ablation irritation.  They get so bothersome that I have a difficult time getting to sleep.  I take Alprazolam which does not help for the above. I was never bothered much with skipped beats prior to ablation.  Should I be calling my EP at this point?  Thanks for this great forum.

[CCF-M.D.-RCJ]

Glassheart,

Thanks for the post, and follow-up.

It is very common for patients to experience a transient increase in palpitations for the first 3 months (and sometimes up to 6 months) after an ablation.  We think that this is due to increased inflammation from the burning (or freezing) used to perform the ablation.

It certainly could also be that the sites that were ablated are now recovering, which also sometimes happens.  Only time will tell which of the 2 mechanisms is in effect.

The best thing that I can advise is to wait and see, which I realize is difficult.  Further therapy at this point, however, may be too hasty.

It certainly would be fine to contact the EP.

Good luck.

[glassheart46]

Sounds extremely familiar.  I see your ablation was for afib.  Mine was for AV node reentry and some tachycardia originating from another spot and also for extrasystolies from yet another area.  I am very down now as I thought the ablation was the cure all; at least I was lead to believe that.   My EP doc never once mentioned post ablation symptoms or the possibility that it could come back or cause yet another problem.  I certainly wish he would have informed me of all of the above as I did ask lots of questions but it never entered my mind that once it was over it might not be over.  After all the ablations he has done over the past 15 years he should diffinetly be talking to his patients about that part.  My skipped beats come and go.  Sometimes in runs that last for up to 4 to 6 hours and are every 10 beats or so and sometime every once in awhile.  This not knowing and this wait and see part is so very difficult.  I am tempted to start on my Verapamil again.  At least I might get some relief but I don't dare do that without asking the doctor first.  Sorry to hear you are having a hard time as well.  This certainly does change one physically and mentally.  I have tried to exercise and it just brings them on even more so I gave up on that too.  I live in Minnesota and there is nothing but snow and ice on the ground now and I live out in the country so walking is out.  However, I do make an effort to walk around the house as much as I can for some minimal exercise.  
The part I hate so much about all of this is the calling the doctor part.  They make one feel like a big baby and that you should suck it up and not worry.  The shoe needs to be on their foot and then they would understand the anquish one goes through.  Thanks again for the post.  I appreciate hearing from others who are going through this.

[LynnSB]

Hi.. you KNOW I know what you are going through. I definitely think you need to call your doctor first thing tomorrow. The good news is there can't be anything dangerous going on, because the event monitor would have caught it and the technicians would have sent you to the ER. So hang in there! I hope things are better soon.

You wrote:

>>>>My EP doc never once mentioned post ablation symptoms or the possibility that it could come back or cause yet another problem. <<<


ditto for me

[Momto3]

Hi Hank! After my first ablation (right side), I was not instructed to take aspirin.  But, after the second ablation (let side), I was advised to take one aspirin a day for 45 days. They explained that it was because there is a little more risk of clotting problems when working on the left side. They also told me that because I was healthy and young (a relative term...lol), it would be OK. They said it is not always prescribed to patients because it can interfere with the healing of the cathether sites.

Funny thing is, after the first ablation I had more "post ablation" activity. After this one, practically nothing. Of course, that could be because they got the dang culprit!! hahahaha....Interesting theory on the anti-imflammatory aspects of taking an aspirin.

[glassheart46]

I hope you are right Hank as I have been taking aspirin most days since the ablation.  Granted, it is not one aspirin but two.  I take the aspirin for the pain I get in my shoulder (rotator cuff tear) and my neck (stenosis.) I will now take aspirin daily instead of just when I get the pain and see what happens.  I'm so happy you shared this with me and the rest of us post ablators.  I appreciated all of the posts as they are always so encouraging. Thank God for this forum.  There are days I just don't know what I would have done without them.  It is such a shame that doctors just don't seem to realize how emotionally devastating these things can be.  Also, I now am watching closely what I eat.  I am especially paying attention to foods and drinks containing aspertame.  I had been chewing sugarfree gum on a daily basis since the ablation and a lot of it.  Reason for it was because it provided a distraction from the rhythm of my heartbeat. I think aspertame can cause palpitations.  I still have not tried coffee.  I know I am grasping at straws but I will try whatever I can to see if it works.  
I won't be talking to my EP for a week now as they are on vacation so I would like to ask if you or anyone reading this post has been perscribed medication post-ablation to get one by until the healing process is over or is that contridictory?  Would that hinder the healing process or would it in someway keep one from knowing if the ablation worked.  Also, I am confused on this issue; maybe someone can answer:
I had AV node reentry which produced tachycardia for a year and a half.  However, the month prior to my ablation my heart went into trigeminy's and bigeminy's which lasted the entire month and was terminated upon ablation.  My question:  Did the tri's and bi's have anything to do with the AV node reentry or was that a seperate thing.  I got three burns and the report stated they were for AV node reentry, atrial tachycardia and atrial extrsystoles.  I'm sitting on pins and needles worried that I will get the trigeminy and bigeminy back as the Verapamil I was on for AV node reentry did not help that at all but did help the tachycardia.  If I got the tri's and bi's back, what kind of medicine would I be put on?  Sorry for all of the questions.  Hope you just might have some insight into all of this as I sure cannot get much out of my EP.  Thanks so much for your help.

[dammit]

i just had a ablation on 11/21/03 for SVT but when they tried to map out the problem it would not happen in 1998 my heart went to 276bp per min for about 2hours after that i would get it alot but never that fast maybe about 130-110 but as for the ablation they could not ablate any part of my heart cause i was the 2 out of the 200 rare case so i'm off my meds and my condition is gone so far on it's own with a ablation i get skip beats here & there but thats ok. you can e-mail me if you want i know a great doctor who did worked on me he even goes around the world teach other doctors and does all the big guys like the president of the usa and mayors congress of all parts of the world my email is ***@****

[Momto3]

Hi Glassheart!! I'm wondering if the aspirin is helping with more than just "clotting" issues. However, because it is only one per day, I'm not sure. I do know they are careful in prescribing an aspirin post ablation because aside from wanting the heart to heal, etc. they want the cathether sites to heal...As for taking meds post ablation, I asked my doctor if I could take Inderal for "breakthrough" episodes and she and the others said that would be "no problem". After the first ablation, I had a HORRIBLE pvc day about 2 weeks post ablation, and when I asked if I could have taken two Inderal, the answer was, "absolutely". I only take 20mg as needed, and so far, I have not needed any of it. I am truly amazed at how well this recovery period has been. I do not find myself as winded after climbing a flight of stairs, I am not waking up half the night, and chocolate is GREAT!!  : )

[glassheart46]

Wow, I am so happy to hear how well it is going for you.  I don't dare eat chocolate or coffee and I love both of them.  I'm just afraid it will make things worse.  I thought I'd be able to enjoy a cup or two of coffee again but that was before I knew about all of this post-ablation stuff.  It seems like every post I read is about ablation is rather negative.  Are there truly any successful AV node reentry ablations without having to go through more then one?  I truly hope so.  
But enough about me.  I'll bet you are truly elated.  Man, after going through the first ablation and having all of those PVC's afterward, this must be pure heaven.  I can only imagine it!
And it's so great to hear of all the energy that you have.  Now you can really enjoy life a little better as that is the way things are meant to be.  I was on Verapamil before the ablation and it did not help the tri's and bi's, but I don't have them yet, or the tachycardia which it did help, just the pacs which are very bothersome as you know.  I won't be able to talk to the EP doc until next week as they are all on vacation.  Maybe by then things will have calmed down anyway.  I hope so.  I don't dare take a verapamil without checking first.
You take care and have a great day!

[Momto3]

Hi Glassheart! Thanks for posting....I know, I am amazed at how my pvcs are nearly extinct! I am SO enjoying the chocolate : )
I hope your extra beats begin to fade soon.  I don't want you to miss out on chocolate!! It does seem as though a lot of people need more than one ablation. In my case, the doctor told me that up front...She said they were going to be very conservative and she has since said, they will "chip away at it". I'm thinking that we're done chipping!!! YEAH!! Even though I had the 2nd procedure, I know my first ablation was successful. So try to keep thinking positive thoughts and maybe the extra activity will subside. Has your doctor ever mentioned a possibility of a 2nd ablation? As Dr. RJ said, try to give it time.

You are right, I am elated to be pvc-free after all these years! It feels so strange....I was in bigeminy, trigeminy, etc. so much that I just chalked it up to my unique beat.  I do keep wondering if the improvement is helping the heart muscle...time will tell. Maybe you can ask your doctor about taking a beta blocker to help calm down the pacs? Yep, they can be a pain!! Talk to you soon...Have a GREAT Thanksgiving!!

[LynnSB]

I remain in the same boat -- having skipped and just plain weird beats post my ablation on Sept. 15. However,I have far fewer than I had before the ablation. But when I have a brief run or flurry of these things -- especially of fast heartbeats -- I get so worried and depressed that either the ablation didnt work or there's something else wrong.

I went to a great EP doc but he told me nothing, NOTHING about what to expect.. only mentioning when I finally got him on the phone briefly after the ablation that I could expect "transient" skipped beats.  I've tried to call him since but was told " he can't answer questions. He's too busy." It is very annoying.

The Cleveland Clinic doc is the only medical source I've heard or read saying this is possibly normal for, possibly, many months so that gives us all a ray of hope.

Again, I'm glad I had the ablation because at least i can feel that my heart was finally checked for malignant arrhythmias as best as it can be checked; and I feel , finally, validated that the atrial tachycardia reentry focus was documented and "zapped" after being treated like someone who was making up the rapid heartbeat for the better part of the past 20 years; and, truly, I have less palps. but I sooooo want to be one of those people who can live life without worrying about the next feeling that my heart is momentarily " stopping" or skipping and beating wildly or suddenly speeding up into double or triple time, even if it is only for a few seconds.

Happy Thanksgiving, all.

[Momto3]

Your doctor won't take your call?  I can't believe what I'm hearing! That's unacceptable! Without the support of my doctor, I can't imagine going through all this stuff. She has even told me to let her know when I'm doing well. To be waiting and wondering if what you are feeling is "normal" must be exhausting. After my first ablation, when I was experiencing pvcs again, the doctor ordered an event monitor to capture what I was feeling.  Is that an option? So, like Glassheart, your doctor did NOT discuss what to expect?? Did he/she call you to follow up? I think another call is in order....If you are not permitted to speak directly to the doctor, maybe you can find an understanding nurse or receptionist who can relay your concerns to the doctor and get back to you. In what area of the country did you have your ablation?

[glassheart46]

You know why I think that most doctors don't tell about the post-ablation skips, blips, speed-ups, etc.  Because if they did, a lot of people might opt to not have the ablation for fear of a new arrhythmia and that would cut down on their business.  I have read several articles that state the following:  Ablation success rate immediately following procedure is 95% and drops to 75 to 80% in the long haul.  In other words, as many as 20% cannot be counted as successes after 6 months to a year but are counted as successes immediately after ablation.  The 95%> success rate is the figure that is always used but really is not correct.  I wonder how true this is to many procedures.

[glassheart46]

I just am in total shock and now have grave doubts about my EP Doctor.  I have been wearing a loop monitor for 2 weeks and the results are in.  My Ep told me today that he seen on isolated episode of atrial tachcardia that lasted only 16 beats, and a few episodes of sinus tachycardia that got up to 120 bpm.  Also stated there were a lot of early beats or pacs.  He told me my three options were:  Live with it, get another ablation, or take a beta blocker; he wants to perscribe Toprol, 50mg per day.  WOW!! WHAT THE HECK HAPPEN TO THE 2 - 3 MONTHS HEALING PROCESS!!  According to all I've read, the above can occur for up to possibly 6 months.  Afterall, I was ablated in the first place for atrial tachycardia, so how does a 16 beat episode qualify for another ablation.  I also thought everybody experiences sinus tachycardia at times in their lives.  Well, don't know what to do now.  Can anybody tell me how well one can tolerate Toprol?  (not sure of the spelling)  Before my AV node reentry ablation I was placed on Pinedol (Spelling again) and it made my heart rate go way up and beat hard.  Is it in the beta blocker family?  Should I not take the Toprol and take and wait and see attitude and see if the ablation worked.  My EP doctor actually left it up to me.
I am totally crushed.  Anybody help me here with some informative answers.  Input greatly appreciated!  Also, does this mean that I can expect to get back the trigeminys and bigeminies?  I don't know how the tri's and bi's fit into the picture.  I only had two episodes of them before the ablation.  The first episode lasted 6 weeks and the second episode happen one month prior to ablation.  I have not had any tri's and bi's since.  I was looking forward to a least drinking a cup of coffee per day but was told that was totally out.  Also, no alcohol, but that wasn't a problem.  Hope someone can provide some insight.
Thanks!

[Momto3]

Hi Glassheart,  Just finished reading your post, and I'll admit I'm somewhat taken aback by what you are telling us. So, did the doctor call you? Or, did you finally get in touch with him? Sounds as though you actually spoke to the doctor. So, let me see if I understand...You had an isolated episode of atrial tachacardia (16 beats), and a few episodes of sinus tachy (up to 120bpm)and a lot of pacs? Like you, I also thought occasional sinus tachycardia was OK in an otherwise normal heart??? Hank, any word on that??

I understand that he is telling you that you have 3 options, but what is his recommendation?  When my doctor asked if I was up for a 2nd ablation, I asked what she actually recommended. She said she would recommend the ablation, but she could also prescribe beta blocker (or another RX) if I did not feel ready or whatever. I have never taken Toprol, so I don't know much about it. I've taken Inderal (with some success), Tenormin (awful side effects after one dose) and sectral (don't recall much about that one). For me, the Inderal was best, but everyone is different.

AND, you are right...WHAT THE HECK HAPPEN TO THE 2-3 MONTHS HEALING PROCESS?? Does this mean that the ablation was not a success, or that you have new "stuff" originating from a different foci? I really think you may want a second opinion at some point...How woudl you feel about that? Not that your doctor isn't qualified and very good, it's just that the 2nd opinion might clarify some things for you. I'm thinking that trying the RX might be worth it...But, is the doctor saying without an ablation you will have to stay on RX??

When you say trigeminy and bigeminy, do you mean the pacs? I'm a little confused...You said you only had 2 episodes of them before the ablation. Do you mean persistent trig's and big's?

Did your doctor say you could not drink any coffee?  Did that aggravate your arrythmia in the past?  

Hang in there Glass.....we are all here for you.

[arthur]

It took me a good 3-6 months before the increased level of PACs (and one episode of bigems) dropped to a reasonable level after my ablation for PAF.  Note that I had very few PACs before the ablation.

Now it's been about three years since the ablation, and I can say things appear pretty normal.  I choose to ignore my pulse in order to avoid the anxiety loop, however, once in a while, there are some bumps and even a few minutes of chaos which are not possible to ignore...but nothing persistent, and these are relatively rare occurences.

Focally originating arrhythmias require a pathway between the focus and the pacemaker system(s).  As I understand it, ablations are designed to electrically isolate those foci (originally I thought the ablation toasted the focus itself).  So, after isolation, chances are they persist in producing electrical noise, but it doesn't go anywhere.  Eventually, these isolated foci are thought to slow down their signalling.  However, if there was a gap somewhere in the isolation procedure, or there are other foci in the neighborhood, some new signalling may get through and cause a new arrhythmia...I also understand this to be relatively rare.

So, the general picture is that most of the time an ablation will isolate the focus responsible for the arrhythmia.  In the process, tissue is scorched and the local nervous system is irritated.  The irritation can last for a very long time (like for me)...it lasts longer than the healing process for the scorched tissue.  One of the things foci depend upon to send through their abberant signals is the state of the nervous system surrounding the heart.  The more irritated it is, the easier it is for the foci to send the signals through the cardiac tissue.  (This is why fear often causes the heart to skip...it's simply the nerves affecting the cardiac tissue which in turn allows focal signalling to jump through).  

So, bottom line...I would wait a while longer to see if your original arrhythmia is gone. It does sound like irritation and some simple skips to me.  The Toprol is not a bad idea, since it would help ease you through this period of recovery.  I used it along with Tambocor to help control my skips.  BTW, Tambocor is a rather unique med since it works by affecting the ease with which electrical signalling travels through cardiac tissue (essentially counter-acting the scenario I described above).  Above all, discuss those three options with your EP and point to the obvious prematurity of making a decision to have a second ablation. (the EP may be thinking that although your original arrhythmia is gone, there are leftover foci that it would be nice to toast).

Take care, I am sure things will work out well for you.
-Arthur

[LynnSB]

Arthur wrote: >>So, bottom line...I would wait a while longer to see if your original arrhythmia is gone. It does sound like irritation and some simple skips to me. ..Above all, discuss those three options with your EP and point to the obvious prematurity of making a decision to have a second ablation. (the EP may be thinking that although your original arrhythmia is gone, there are leftover foci that it would be nice to toast). <<

I agree.

If it is any consolation, my ablation was for atrial SV note reentry node tachycardia and I've had some runs of fast beats that I bet are atrial tach..but they are few and far between.

I do not agree that ablations are being done willy nilly. In fact, it took YEARS for my docs to agree to an ablation ( and, no, i wasn't pushing it) because they wanted the "hard evidence" which is , in fact, hard to get from an event monitor which only has 2 leads. Sometimes atrial tach can look  like sinus tach and vice versa, the EP doc told me. And without very rapid, sustained rates of either, no one wanted to do anything invasive, no matter how relatively safe.  The advantage to having an ablation to atrial tach is not only to make you feel better -- a quality of life issue -- but because it can increase your risk of developing a-fib. Also remember that while most cases of WPW can be noted via clinical signs and symptoms and an EKG - that's not always true. And it's a good idea, I think, to make sure with an EP study that WPW isn't going on.
So all in all, I hope you can look on the proverbial bright side and I hope things calm down for you palp-wise -- and me , too!

I'm having fewer episodes of those dreaded sensations although I've had days where I was absolutely sure nothing was "fixed". My EP doc, in our one brief phone conversation 2 days after my ablation, said the a tach COULD come back but it would be " very, very rare .. one in many, may hundreds of people".

Remember also the words of another EP doc to me -- he said there are very, very few things that can be "cured" in cardiology. But an ablation IS a cure for many people. So when people talk about about 70% over time versus 98% or whatever, you have to stop and think about it. SEVENTY PERCENT  is still a whopping fantastic stat! ( I actually think the cure rate for atrial tach is much higher.)

About the drugs -- certainly ask your doc about beta blockers, etc. But, for me and lots of peopel, the side effects are horrendous and although I wanted it to work SOOOOOOOOOO much, they actually made my palps worse.. so much so that I ended up back on the event monitor that caught my atrial tachy "officially".

[glassheart46]

Thanks you guys for your input.  I have decided to take a wait and see approach and I am not going to take the Toprol until I talk to my Internist.  I normally have low blood pressure (112/58) so I am not so sure Toprol is a good idea.  About the tri's and bi's.  I had two long eipisodes of them.  The first episode was 24/7 and lasted 6 weeks and then just tripped back into a regular sinus rhythm.  I went along just fine after that for about 2 years and then I started to have the fast tachycardia that awoke me at night.  At that point I was put on Verapamil which controlled it completed for a year and a half.  Then I went into my second episode of tri's and bi's 24/7 which lasted up until I had the ablation 3 weeks ago.  
My Ep did not speak to me personally.  He never does over the phone.  I only got this info second hand from his nurse.  She stated that he had looked at my strips from the loop monitor and seen one isolated incident of atrial tachy that lasted for 16 beats..and said he seen a number of sinus tachy episodes with beats up to 120.  Also many early beats or pac's.  I think he feels the original ablation worked but that this is new arrythmias.  I am so depressed.  I think the doctor should at least speak to his patient.  The choices he gave me are not too good.  I have low blood pressure already, Toprol would make it lower and I have never handled beta blockers very well in the past; lots of pac's.  And another ablation; don't think my insurance company would go for that.  My best option right now based on what I feel is best for me would be to wait and see how it goes.  I will work my way through it without meds as best as I can.  Thanks again you guys!  I really appreciate the support!
I hope the EP is wrong and it is just irritation from the ablation.  I am going to bank on that at least for another two months.

[glassheart46]

I was awakened around 3 am this morning with a rapid rhythm.  I got up and the rhythm went even higher.  I recorded it on my loop monitor and was told it waw sinus tachycardia recording 160bpm.  I was told to call my doc so I called my local hospital and spoke with the doctor on call.  The only thing I had on hand at home was an 80mg fast acting Verapamil.  He told me to take that and in about 10 minutes or so it started to slow down to around 98bpm.  He also had me take a 240mg SR Verapamil(had on hand as well) which I did and also an Alprazolam.  By the way the above episode rate stayed at 160 for over 15 minutes which is the longest tachy I have ever had.  I finally got to sleep only to be awakened (after a bad dream) one and one half hours later.  This time it went to 120 bpm and lasted for about 10 minutes and is now around 85 or so.  I can't go back to sleep for fear it will go sky high again.  Does all of the above sound normal for sinus tachycardia?  I am also having a few pac's along with it.  What are treatments options for sinus Tachycardia?  Toprol betablockers or Verapamil and what in the world cause sinus tachycardia.  My heart never went that high when I had AV node reentry or did it ever last as long.  Is sinus Tachycardia dangerous?  I think I will have to go on some type of medicine because ever since my ablation I have had many episodes of fast heart rates (up to 100bpm) substained sometimes for up to 4 hours.  I just chalked it up to post ablation irritation.  But now that it has gone this high I am not sure what to think.  Any input appreciated.  I will be speaking to my EP sometime today.

[glassheart46]

Thanks again for your positive response.  I got another question in tothe the Cardio on this board this morning.  Waiting for his post.  I am concerned about the Toprol mixed with the Verapamil as I am to start the toprol today and I still have Verapamil in my system.  Yes, I was very upset last night before going to sleep.  I was so hopeful that this ablation would work for me.  I have had these episode and much more since I was 15.  Many, panic attacks as well.  Don't know what is best anymore but will keep trying.  Thanks to the help of this board and all of you great people.  Learning to relax is extremely difficult for me.  I worry about everyone and everything.  I know this is my downfall!

[Ryman]

I am sorry your going through this.  I strongly sense that you don't trust your EP.  I believe that is one person you need to trust.  Don't be afraid to see someone else.  As Hank said the mind is a powerful thing. Do anything you can to relieve the stress, and don't let them make you feel like a fool for being concerned. This is your heart and your life. If it means anything, I was feeling great 1 week after my procedure and then got worse. I felt the worst around the 3-4 week mark and since then have had peaks and dips, but each peak and dip seems slightly less severe than times before.  I hope you will also notice improvement.

[Ryman]

In response to the aspirin theory, I took it for 6 weeks post ablation and still had somewhat frequent symptoms. That's not to say that it didn't help, but as with each procedure, I suppose it depends on the individual and situation.

[LynnSB]

Just checking in... after a few days with few palps, the last two have been awful... probably at least one brief episode an hour. Soooooo down and trying to believe that the skipped beats will lessen over time. My ablation was Sept. 15, so it's just a little over 2 months.  -- Lynn

[Ryman]

Hi Lynn. I think Hanks advice is good. I too have had ups and downs, often lasting for a few days or a week or more. I know how hard it is to be patient. Hang in there.  BTW, you said that you're getting palps every hour or so. How long does each episode last? Do they feel like the SVTs that you experienced before the ablation?

[LynnSB]

hi there... I have had days where -- yeeehoooo ! -- I only note maybe 2 brief skipped beats. And I've had days where I've had many, many. I don't think any episodes have lasted more than, say, 20 seconds.

The weird thing is they are so varied.. a thumping on the left side of my rib cage.. what seems like very brief quick beats. One time, I felt my heart beat hard and fast ( but not as fast as pre-ablation) for maybe 20 beats.  Other times, I can move my head, brush my hair and do other arm movements and feel a "blip" -- some irregular beats. Sometimes that's all I feel. Other times, I'll have that momentary " i'm dying" weak feeling that passes in a second or two.

I have only felt what seemed to be a flurry of very fast beats once since the ablation.

In general, I have fewer palps. I know I am very adrenaline sensitive. My cardiologist ( not ep doc) whom I saw 5 weeks post ablation said i'm probably de-conditioned if i improve my vagal tone the palps should get better.. but I'm still so worried and depressed that I"m not "fixed" by the ablation, on the days I have what feels like waaay too many palps, I just can't get going, you know?  I'm also very fatigued and worry that's my heart but it is probably just sleep deprivation for lots of reasons, including my stinker puppy.

Lynn

[Ryman]

Hi Lynn.  I know this response is a little delayed.  How are you feeling now?  Have you had any sort of heart monitor lately? I was prescribed a loop monitor and was able to make several recordings. It showed an occasional PVC, SV ectopy, and bigeminy. I'm seeing 2 cardiologists this week so we'll see what they have to say about that. My EP had a look at my charts and told me there is nothing wrong and wouldn't seem to accept the fact that I feel far from normal. I'll be seeing another EP soon.  At least I have some charts with some concrete results. Hopefully they'll come to good use.
   I have a question for you and Glassheart. Often my heart beats feel a little strange. The rhythm seems normal, but there's this strange sensation, almost a sensitivity.  It's dependent on what I'm doing and what position I'm in and is a constant reminder of my situation.  Do you experience this at all?

   BTW, sorry Glassheart to digress on your thread. I do hope that this conversation helps all of us to feel that there are others who relate to some degree.  I hope you are improving.

[LynnSB]

I can't get the EP doc or my cardiologist to call me back.. i'm supposed to go back to my cardiologist in January so I'm going to try my best to wait until then before I totally freak out and decide the ablation didn't work. I'm still having palps.. not many but several a day.
Last night, just  as I was drifting off the sleep, I awoke with my heart beating rapidly with some irregular beats thrown in and I thought , OH NO..the ablation didn't work.. the fast irregular stuff kept up for 20 to 30 seconds... then it stopped and I felt a few irregular beats as I finally went to sleep. This a.m. I had a few irregular beats here and there.
The thing with me is I had a month long holter in June that showed nothing dangerous ( mostly PACs, rare PVCs and "inappropriate sinus tach" and one brief run of SVT that the EP doc wasn't sure was really SVT) and then I had another month long holter in August to right before the ablation -- that's the one that caught the runs of atrial tach and that's why I got the ablation. However, with all the tests I've had over the years and with the EP study and ablation, I think my docs are so sure , so convinced there's nothing serious going on with my  heart that they just aren't interested in my palps. but they are driving me NUTs.  I was reading about SVT and apparantly you can get it ectopic SVT without a reentry site ( which is what i had ablated) so I'm thinking maybe these rapid beats are ectopic and not the return of the problem that was ablated. I don't know. i stay so confused and worried. and , yeah, i feel my heart feeling " weird"... I think it may be blood pressure ups and downs. my cardiologist, at the ablation follow up visit, suggested that that could be causing some of my palps -- and i needed to get in better condition to improve my vagal tone and to lessen any dysautomia.

[armyman]

Iam 23 years old, and according to my cardiologist I have SVT.  Since I was 11 years old it has happened 15 times to my memory, 2 of those times in the past year occuring 2 weeks apart.  The 2nd time I went to the ER to get an EKG done so I could find an end to this.  The cardiologist told me I'am fine, its not life threatening, and if it happens more often he could recommend treatment.  

That part I was fine with, as it didn't happen very often, and while I was on active duty it never happened.  What is concerning me now, is for the past 6 months my heart has started to "skip" beats.  Sometimes it happens 4 or 5 times in a row before returning to a normal heartrate.  At the worst times, it happens near 20 times per minute.  It is causing my entire life to degrade and all my cardiologist tells me is that i'am fine and won't even give me an appointment.  I have a wife and kids and my own father died when I was 3 years old, I can't allow myself to do the same to my kids.  The town I live in only has one cardiologist, and at the present time I can't go get a second opinion.  He didn't give me any details aside from I have SVT.  These "skipped" beats are destroying my life and I'am taking it upon myself to discover as much as possible about them.

I don't know exactly what type I have, because as I said the cardiologist didn't tell me much of anything.  It feels like its in the lower part of my heart so I guess its ventricle.  Which according to what i've read is the most dangerious and life threatening.  My wife tries to understand but she has no idea, and although I don't get tired playing or running around, when it happens, as it does all the time now, I just can't function because of the fear my heart is going to stop.  Sometimes I have chest pains toward the middle of my chest, but I just tell myself its not my heart its my lungs or something else.  

If anyone has learned something that I haven't found on my own, or has gone through similiar expierances any information would be great.

[Ryman]

Hi Armyman. If your cardiologist said that the palpitations are not dangerous it would probably indicate that your tachycaria is not ventricular. The term SVT stands for Supra Ventricular Tachycardia in which "supra" means above the ventricals. This means it's in the Atrium. Ventricular tachycardias are considered more dangerous and would be a red flag for the cardiologist. Fortunately most SVTs are not life threatening, but can be a bit freaky. I too have experienced them since childhood. I know you said there is only one cardiologist in your area, but I would really sugggest you try to find an Electrophysiologist(EP). They specialize in the electrical system of your heart which is most likely the source of your tachycardia. I very strongly urge you to do as much research as possible regarding your options. This forum is a great source for feedback from people who have attempted to deal with their own irregularities. In reference to having skipped beats, it might help to think of it in different terms. Usually what we perceive as a "skip" is actually an extra beat. The skip you feel is because usually the irregular beat creates a longer interval of time until the next beat and thus has more blood to pump through. At least this is how I understand it from my own research. You should double check on everything I have mentioned because I am only a patient. I hope that some of this helps your understanding a little. I also hope that you can find an EP or atleast a cardiologist that can see you. When you do make sure to jot down all of your symptoms and make sure they hear what you have to say and answer all of your questions.
Not having answers can drive you mad sometimes. Best of luck.

[Ryman]

Hi Folks. I saw my cardiologist today and she agreed to do an ultra-sound to check out my overall heart condition. She was very attentive and assuring. After having a loop monitor for the past month she was able to deduce that most of my skipped beats were justs APCs with a few PVCs here and there.  I also showed one bigeminy which I perceived as a flutter. There were even times when I thought I was skipping a beat and was not. She said that was evidence that my heart is a bit over-sensative now and is picking up every little disturbance. She is also very hopeful that this sensitivity will subside.
   Although I'm still struggling with this, I have to say that seeing a doctor that really seemed to care was a wonderful experience. She sat down with me, asked a lot of detailed questions and reponded to all of mine(I had typed up a list of symptoms and concerns)without making me feel foolish. She confirmed that I'm not crazy or paranoid and am reacting very naturally to what I've been through. When we were wrapping up she said warmly,"I hope I was able to answer all of your questions sufficiently. It seems that, more than anything, that's why you're here." I thought, "Wow, she's absolutely right, and she really seems to want to help me." It really lifted my spirits. I guess I'm writing this to support what I mentioned earlier in the thread about finding a doctor that you can trust, and can help relieve the tension.

[GES]

Armyman, Don't worry.  I train a lot of full contact fighting and Jiu Jitsui.  very intense cardio training.  I have PVCs constantly and I am still alive.  I went to different cardio's and they all said I am healthier than them.  Just quit worrying about them and deal with them.

[JohnAlex]

Hello everyone.  I found this site and found it very helpful.  I've recently started experiencing PVC's and it's driving me crazy.  All my tests however (echo & stress) have come out normal, so my doctor says not to worry.  Easy for him to say.  I don't use caffeine, I eat choclate rarely.  A month ago I never even heard of a PVC . . . now I could write a thesis.  I'm learning, slowly, to ignore them.  My doctor told me to try to loose weight and get my blood pressure down, , , it may help.  I would be interested in hearing from any of you who are experiencing the same problem, and if your doctor has given you any advice on how to lessen them.  It would be GREATLY appreciated !  Thanks very much.  JohnAlex

[comatt1]

I recently had an ablation (Dec 10) for an AV nodal reentry tach. (although they found another arrythmia, which they only explained as being lower).

A bit of history, when I was 20 I experienced my first catheter ablation for an attypical arrythmia, I guess within my right atrium I had two circuits that were sending energy the wrong way and were opposing eachother, in any case, this was fixed. And following the procedure everything was fine for about a year - when the new arrythmia started.

However, with this last catherization I know I could have expected an increase in the number of arrythmias for a few months, however, I seem to have arrythmias that are coinciding with fits of coughing.

I was a little sniffly before the procedure, but not that bad. After the procedure, when on my pain meds (hydrocodone), I had a lot of green mucus coming up. Having stopped the meds, yesterday, I now am just coughing intensly, and it feels like the phlegm is stuck in my chest it won't come out.

I don't have a fever, but I feel sick, I feel like I am working with one lung.

Should I see the doc again, because my arrythmias are causing me to get lightheaded.

[LynnSB]

I am BEGGING you to call your doctor.  I have no clue whether your problem is related to your ablation but you sound like you have an infection and you need to be seen by a doctor right now. PLEASE call your doctor.

[mandj905]

A related discussion, Okay Is this gettin nerve racking or what??? was started.

[Tearose33]

A related discussion, a-fib ablation was started.