Severe Attach of Sinus Tachycardia Post Ablation

[glassheart46]

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!

[Cleveland Clinic]

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

[LynnSB]

Also remember this.. let's just say , for the sake of argument, that, doggone it, the ablation didn't work.  But the odds are astronomical that the  electrophysiology study would have shown any DANGEROUS problems with the "electric system" of your heart. So, even if your heart  is racing and palpitating, you have more scientific evidence that most folks posting here that whatever is going on  ISN'T DANGEROUS.

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

[glassheart46]

Thanks again for your encouraging comments.  I started taking Toprol 50mg today.  I sure hope I do not get another rapid rhythm.  I can handle the 110-120 but when it gets to 160 and stays there for over 20 minutes, that gets scary.  I wonder where this all came from?  I know that one of my burns was near my body's pacemaker.  Do you suppose it got damaged in some way slighty or that it is now irritated?  How long does it take for Toprol to work?  I thought the drugist said about 5 days; oh Lord, if it goes to that high beat and I can't stop it I suppose I have to go to the emergency room.  I have my grandchildren coming tomorrow and I don't want them to see me like that.  That's why I am so nervous.  Do you guys know of any maneuvers to slow sinus tachy down?  I tried cold water this am but it didn't work.  I tried to relax and all I could do was shake.  I should mention here why all of this is making me so anxious.  I have to have neuro neck surgery for some really, really bad pain, headaches and horrible arm nerve pain.  They will not do it until this heart thing is seattled.  This all has been going on for the entire summer. On top of all of that I had to have my gallbladder removed in that time frame as well.  I have had 3 epidural shots of cortisone in my neck to get me by until this is resolved, but I am out of options now as three epi's were my limit in that short of time period.  So when that pain comes roaring back, which I might add is terrible (I would go through labor 3 time again over this nerve pain in my arm) and it will, and I am due anytime now for that pain as the epi's have only lasted up to 6 to 8 weeks.  Therein is my delemina.  The ablation was suppose to fix the problem but as usual things do not always goes as one plans.  I only hope the tropol works.  My only hope for neck surgery in the very near future depends on getting this rhythm under control.  Thanks again you guys!  You have been great!

[CareBear59]

Hi Hank!
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

[nurse12hr]

I am so sorry you are going through this.

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.

[bigmick]

Off-thread I'm afraid, but REAL tough to get a Q to this board! And I'm asking Hankstar having ascertained that he is one dude who seems to know his stuff helping, as he kindly does, lots of folks here with good info.

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

[glassheart46]

Hank..I had my gallbladder removed in August of this year.  Thanks again so much for your help.  I always feel better when I read your posts.  I am now on Toprol.  I was told I could take a quick acting 80 mg Verapamil if an episode got unbearable.  Speaking of unbearable..Christie..How can you just go about your business when your heart is beating in excess of 160bpm?  My God I get so anxious and nervous that I just shake terrible.  I am one of those individuals that is aware of every single heartbeat.  That has always been the case even as a little girl.  I am 57 now. Any pointers for me and how I can deal with it?  Hank..That drug you are on..is it a beta blocker?  If Toprol doesn't work I may ask my doc about it.

[dammit]

the best thing to do is pray live life day to day i've been there & still deal with it it's scarey as hell but breath easy
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

[dammit]

i know a great Doctor in New york he worth while i think you need him you can look him up Dr. Hasan Garan trust me he treated me if you really want your condition gone
you can email me at ***@**** i will the give you my number i will tell you my whole experience

[pandora9049]

hi,
i was just wondering what time u post on here.  ive been trying unsuccessfully for months now:(
hope u feel better,
pan

[glassheart46]

I try to post around 7:45.  I live in Minnesota.  Good Luck, I hope you get your question in.  I can't believe I got in several times.  Sure is nice to have this forum!

[bigmick]

Thanks for kindly taking the time to provide me with a response - it's much appreciated.

Cheers,

BM

[Squimsy]

Just to echo Big Micks comment.  I'd like to express my sincere gratitude to everybody who very generously give their time to provide insight and timely reassurance to us all.  

It really is a good thing that you're doing.

Simon

[LynnSB]

I've had luck between 9 and 9:30 est!

Lynn

[nurse12hr]

I just don't worry about it....hard to explain.  I think it is the same as the old question about how some people aren't bothered by PVC's and some are incapacitated by them.

I often have skipped beats, too, usually have lots on isolated ekg's when I have had a strip run.  They just don't bother me--I know they won't hurt me, so I don't get upset about it.  

[mnheart]

i have see a cardiogist..27 male...little overweight..they said palps but at one point said afib//did a;; the test okay..i take atenolol 25mg once a day..i am still havig a few runs in with not feeling great.like panicky,feel heart pounding hard..etc...i can see my stomach pulsate ad throat and neck...showd i take atenolol 2 a day like you do hank..i just feel all day that something else is wrong/// my good choloesterol is 19...low...whats good to get this up..i even baught a heart rate monitr and check pulse and blood preasure all the time..i get blood shot eyes aslo..ANXIETY....

[nurse12hr]

I notice them from time to time, particularly when exercising.  I notice the tachycardia (happens about 4-5 times a year when it gets up above 160 for a few hours).  My resting HR is just plain high, 100-110s and up.  I get up to 180-190 when exercising.

Have had EKG's and holters.  Just some sinus tach, and PVC's-PACs.  While I notice them, they don't bother me and I don't worry about them.  Usually if I get engrossed in something else, I forget all about it.

However, recently after stopping my hypertension med (with  my doc's ok, as I have only have very mild HBP and it seemed to be pretty much resolved with weight loss and exercise), I started having bouts of angina.  Am awaiting another stress echo and eval into this.  And HBP is back, not too bad 140s/90, but higher than I would like so back on the lisinopril.  

But the ectopy just doesn't bother me.  Funny; my ex hubby had PVC's, and he spent every day in hell, worrying that his heart was going to stop, worrying that he would have a heart attack, and worrying about heart failure.  As a result, he is on a cocktail of meds that would make your head spin, still has PVCs, still is miserable, and still worries obsesssively about his heart.  I don't know why they don't bother me; but I just don't have a fear of them.

(Have lots of other things that I worry obsessively about, just not PVC/PAC/tachy!).

[glassheart46]

Yesterday the Ep Doctor said I needed another ablation.  The only thing they would say I had was " a type of sinus tachycardia," but of course this was by phone.  I will know more at my appointment on the 8th.  He based this on the strip from the attack of rapid tachycardia I had the other night.
From all of the postings and other info I have read it is my understanding that they can't ablate for sinus tachycardia except to modify the sinus node and then insert pacemaker.  Boy, things sure seems screwed up since my first ablation for av node reentry.  I am now considering a second opinion and maybe even a third.  I just do not want to jump into an ablation and besides that he said he wanted to do it in January.  Isn't that a bit soon afterall my first ablation was just 4 weeks ago.  Does anyone have any idea what kind of ablation he might be refering to other then what I mentioned above.  Also, Hank, is the 50mg of Toprol daily a high dose?  I take it in the morning and it seems to loose some of it effects by late evening.
Well guys, as you know I am extremely sad and disappointed beyond words.  I know others have it a lot worse and I will adjust to this new information.  Take care all and thanks for any input you might have.

[Momto3]

Hi Glassheart!  Sorry to hear about your ongoing "recovery" problems. I would NOT rush into a second procedure.  For me, I knew ahead of time that I might need more than one ablation. So it was not a total shock when the second ablation was suggested. My doctor is taking a VERY conservative approach and she has told me she would rather move slowly and carefully than jump too hastily. You deserve the same consideration.

How close are you to Mayo?  A second opinion may give you some relief from the anxiety. This is what I would do if I were you...Go for the follow up appointment with a list of questions. See how you feel after the appointment and then decide whether or not you would like a second opinion.  You have unanswered questions and you deserve accurate and compassionate answers. In the meantime, work on your list of questions...and try to relax a bit...You could curl up with a good book :)  Keep us posted....We are here for you.  Hey, just so you know this thread may run out of space and then you will have to create a new thread (post a new question) or tag onto some other thread...We'll be watching for you Glass!  Hope you had a great Thanksgiving.