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Post Catheter Ablation

Hello, I'm 25 years old, 5'10, 190lbs. I workout 4-5 times a week. I have a pretty healthy diet. When I was around 19 I started experiencing sudden triggered tachycardia. I've played sports my whole life and never had any issues. These sudden episodes always happened when I would play a sport with friends. I would be fine until I jumped and landed flat footed, and I could immediately feel like something was jarred inside around the bottom of my heart and top of my stomach. Immediately my heart would go into tachycardia. I describe it as if you roll your tongue very very fast. That's how fast my heart rate was. I would chug water, cough, any attempt to make it stop. One episode I was headed to the ER because it would not stop, my arms were extremely tingliny. About half way to the hospital I burped and my heart rate went back to normal. After years of going to docs and them doing blood tests, echocardiogram, holster monitor, upper GI, and them telling me everything was normal. I changed docs and wore a monitor a second time and was told I had SVT and had a catheter ablation. It's now 2 years after the ablation. I have skipped beats and fluttering everyday. Like every single day... Sometimes I have what feels like a skipped beat but it's times a million and feels like a huge jolt in my heart. Like something shocked my heart. These happen more after I eat big meals or when I'm lifting weights in the gym. Sometimes I can workout and I just have subtle skipped beats and just ignore them. The sudden flutters started about a month ago and only happen when I workout. Sometimes my heart will flutter, stop, flutter again. Sometimes for 15-20 mins. I now have symptoms of vertigo as well. I get light headed and dizzy randomly when standing or walking. Feels like pressure is in my head and I'm off balance. I've even felt a big skipped beat and what felt like a nerve quiver in my stomach. I'm now on a monitor again. It's been a couple weeks and nothing abnormal has been noticed. I'm wondering if this could be related to my stomach or vagus nerve that is triggering these jolts or skipped beats. My heart will also beat extremely hard after eating, but it doesn't feel like its in my chest. I feel it beating hard in the bottom left part of my heart. I can't lay on my left side without skipped beats or hard beating. I apologize for rambling, I just want to explain every symptom. If anyone has experienced anything like this after catheter ablation or has any advice or input id greatly appreciate it....
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1423357 tn?1511085442
Lifting, especially squats were a big trigger for me, and rightly so.  Rising up from a squat induces huge momentary internal pressure differences.  Just a moment of inadvertently holding one's breath instead of blowing out creates a Valsalva.  That can start an episode just as it can to stop one.

If your Holter doesn't catch any anomalies, you could use a 30 day monitor with hope of catching a number of events.  Many of us have worn them with a lot more success than a 24 hr. recorder.

I had a stress echo prior to my electrophysiology.  The cardiologist had me run until failure, for me about 13 minutes into the standard Bruce Protocol Stress Test, then literally almost had to carry me onto a table where they looked at the structure of my heart.  As expected, they found nothing.  The source of your problem is most likely electrical in nature, and there is really nothing that can be employed to "see" that except an electrophysiology study.

Yes, there can be a connection between hiatal hernia, and other GI problems which can aggravate various sorts of arrhythmias, especially in terms of bodily position. So lying down to go to sleep can sometimes, due to anatomical anomalies like hiatal hernia, aggravate certain arrhythmias. In fact, this is pretty common, especially in terms of premature ventricular beats (PVCs). It can also help trigger independent SVT.

It's very possible that another EP study is in your future.  But you've don't it once, so the second time should be a walk in the park, right?  You're young, and you'll bounce back quickly, get it behind you and get on with life.  I certainly wish it were available to me when I was 25.
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Avatar universal
Thanks for all of the feedback. It really helps hearing from people that can relate. I played football and baseball since I was 6 yrs old. Started lifting weights freshman year of high school. So staying active is in my blood. When this started it has disrupted my life in a big way. I play golf, walk, sit at home and watch tv and my heart "skips beats"... If they were subtle I wouldn't worry but they are usually hard hitting jolts. I'm wearing a holter monitor now and hoping this gets resolved some how. I'm wondering if there are any other tests that can be done other than the normal echo, EKG, monitor, blood work. Would a stress test or anything else be helpful. Also... I use to dip tobacco, for about 6 years. When this first started bothering me, before the ablation. My heart would race as soon as I dipped and it never did before. I don't know why it would just randomly start having that effect on me. Caffeine as well. If I drink coffee now. My day is ruined. I've even looked into possibly having a hietal hernia because my dad had that. Thought it could be possible it's pushing into a nerve or nerves and is causing some of the problems. Explains why it's worse when I eat. Any thoughts?
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Avatar universal
I think medical professionals in general do not know much about the cause of ectopic beats.  You can ask the same question to 10 different docs and get 10 different answers.  There's probably nothing wrong with your cardiologist, it's just that there is not a consensus on treating ectopics...which of course is one of the many reasons whey they're so frustrating.
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1423357 tn?1511085442
Hi Alex.  Everything you describe is familiar to me..... to us.  We've all experienced this.  Your describing the flat-foot landings made me chuckle because that was often a trigger for me as well.  Twisting my torso like when getting out of a car or rolling over in bed could do it as well.  I learned to convert mine and did this for 54 years before getting it fixed three years ago.  Like you, I occasionally get a brief run of SVT or a skip here and there.  I've learned to take it in stride.  I have more jumpiness at rest rather that at high physical output levels.

You have to remember that regardless of the type of SVT, AVRT or AVNRT that you had there was merely a barrier of scar tissue placed across the path.  The path is still there.  It just can't make the connection.  If there is a sliver of conductive tissue remaining, or if conditions are just right, you may get occasional brief, feeble conduction, and you'll get these "old feelings".  It's also possible for the path to heal over and begin support conduction again.  A visit with your cardiologist may be in order to allay your fears.  Perhaps a couple of weeks on a long term monitor will catch what you're feeling and allow them to more accurately diagnose what's happening.
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212161 tn?1599427282
I went to my cardio dr yesterday, ask her if all of a sudden could my vages nerve be causing my pacs, she said No

So now wondering if the Drs know what they are talking about,

Wondering if I need new Dr
Helpful - 0
1807132 tn?1318743597
I should clarify that I do not mean to imply that exercise isn't good for us.  It is but the heart is a muscle and like any other muscle in the body it can get overworked.  I know with me I really notice my pvcs after I straining to do physical things like shoveling heavy snow but light running I am fine.  So continue to exercise but maybe take stock of whether or not you feel you might be pushing just a bit too hard as well watch the stomach issues and stress.  Take care.
Helpful - 0
1807132 tn?1318743597
I had an ablation for an svt avnrt which was an extra muscle fiber in my heart that allowed the signal to get caught in a loop.  After I had it ablated it seems as though I have a lot more ectopiic beats than I use to, pacs and pvcs.  It is possible you are having runs of ectopics beats though I can't say for sure if they would be pvcs or pacs but if you are not passing out and your heart is generally healthy they may pay them no mind.  It is possible your heavy physical activity is irritating the heart and contributing to the ectopics being more noticeable.  The vagus nerve can indeed be involved.  Not sure why but eating big meals or meals high in carbohydrates seems to irritate the vagus nerve which then causes the heart to act up so maybe watch what you are eating and how much you are eating in one meal and see if that helps.   But considering all the symptoms you are feeling it is good you are being checked out again.  Best of luck and do keep us posted on how you are.
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1807132 tn?1318743597
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