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Tachycardia after Mitral Valve Repair?
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Tachycardia after Mitral Valve Repair?

Hi,

I had a Mitral Valve repair at the end February 2012. Before surgery, my normal BP was 120/70 and my resting heart rate was 70. I am 49 and in great physical/athletic shape.

Now, four weeks after surgery my BP is 90/50 and my heart rate is 115! My cardiologist now tells me this is common in about 50% of patients and is most likely a temporary issue. I sure hope he is right. They had me on Metoprolol (12.5mg 2 x day) for 3 weeks after surgery, but took me off last week because my BP was too low and I was having bad side effects (insomnia at night, totally wiped out during the day, no sex drive, dizzy and lightheaded, fell down a couple of times, etc.).

Anyway, they wouldn’t let me start cardiac therapy until my HR is below 100. So, now my cardiologist is having me start 5mg of Bystolic at night to get my HR down and allow me to start cardiac therapy.

Here’s my question: Does anyone else have experience with this? Is this really a temporary (less than a year) situation until my heart settles down? Or, is it permanent condition I am now stuck with for life? I don’t want to think that my doctors fixed one problem and then created another, which would require beta blockers for the remainder of my life. Living with those kind of side effects is not what I call quality of life.

Thanks for any support and guidance,

Matt
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612551_tn?1247839157
I had a mitral valve repair in November 2007, at the age of 67, so my experience may not relate well to your question for the reason of my age.  I was still running (I call 3 miles in under 30 minutes, running) up to that point.  Prior to that I was in normal sinus rhythm with an underlying atrial fibrillation problem.  In any case I was able to run, and my resting HR was about 60 when in NSR.  The surgery was required due to an ongoing enlargement of my left atrium (possible cause of AFib) due to a leaky mitral valve.  I also underwent a mini-maze procedure while my heart was open to stop the AFib.  

Following surgery my HR was high, I think in the 70s don't really recall, and my heart was in NSR.  I went home after 5 days in hospital and was on a low dose, I think 25 mg of metoprolol and an arrhythmic control drug called Propafenone (Rhythmol patent drug name).  About a month after my surgery my heart went into atrial flutter, with my resting HR at about 130.   Both my surgeon and my cardiologist wanted to lower my HR and so I went on high dose metoprolol (BB), as high as 200 mg a day (in two doses at 12 hr intervals).  There was some hope that when my heart healed I might go back into NSR... that didn't happen.  I guess the only hard connection to your question is, yes, I think it is very possible that you HR will slow down and you will not require a beta blocker.  I say this assuming you do not also suffer from AFib.

I am currently on 50 mg slow release metoprolol and a high dose calcium channel blocker.  My blood pressure has returned to near normal levels.

I did participate in a several week (forget how long now) hospital cardiac exercise program.  I was in AFib the whole time and my BP was very low due to the heavy BB regiment, I was not taking any CCB at that time.  I had to stay after the program a few times while the nurses watched my BP, they didn't want to release me until it came back up to just real low.

Again, if you do not have any other problems, and the surgery was successful, it is my guess that you will fully recover in a few months and be able to return to your normal physical life.

Good luck.
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Avatar_m_tn
Jerry,

Thank you for your thoughts, insight and help!  

Matt
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Avatar_m_tn
Hi
I had the same surgery as You.
Im 47 years old and I have exercised all my life.
My rest heart rate before the surgery was around 45 and after the surgery
maybe 65 but most often around 80.

I did my surgery 14 february 2012 and its still the same with or without bisoprolol and te doctors say its ok the way it is..?

Brg
/Patrick
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Avatar_m_tn
I had mitral valve repair in september 2011, but it didn't take. My regurgitation got progressively worse until I went in for surgery again in March 2013. Before this second surgery, I was on Metoprolol 50 mg twice a day and had good blood pressure and resting heart rate. This surgery, though required mitral valve replacement with a tissue valve. I was released after a week with somewhat high blood pressure and heart rate, and borderline anemia. After being out of the hospital for two weeks, I developed arhythmia (atrial flutter and/or atrial fibrillation). Now my blood pressure fluctuates from super low (95/60 to high 140/100) and my heart rate fluctuates from 65 to 120.  I am tentatively scheduled for cardioversion sometime in a few weeks to restore sinus rhythm. Has anyone had any experience with that. Like the OP, I am worried that the doctor's fixed one problem to develop another that I might be saddled with for the rest of my life. I am 44 and was very active before the first heart surgery and still pretty active before the second. I want to be able to get out and play again.
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Avatar_m_tn
I had a valve replacement is Sept. 2012, they put a mechanical St. Jude in, I was very active prior to the surgery (i'm 45). I have had the cardioversion 4 times, 3 before and 1 after surgery.As of this morning I was sitting and my heart went to Afib again. The shocking does help but your doctor needs to have you on the right pills,  Metoprolol always made me feel worse. kinda surprised at your age a tissue valve was used since they only last 8 to ten years. I will say the shocking should work, I had it last for 18mo before it needed to be redone
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5422220_tn?1367730442
I am still in the hospital as of this moment...i was operated last april 22 for mitral valve replacement...before the surgery, my HR ranges from 80-98 and after, ranges from 98-118 but mostly stays over 100...i am so worried...hoping this tachy will be eliminated...
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Avatar_m_tn
Hi,

I obviously can't speak to your situation, but if you read my initial post I was in a similar place a month after my MVP surgery a year ago.  I can totally empathize with where you are.  Hopefully, this post will be of some comfort, however, what I'm about to share is my unique journey and is not to be construed as a recommended course of action.

Emotionally, it was a very tough place for me to be - thinking this now my life: a resting heart rate of 100+ and the need to take Beta Blockers for the rest of my life.  I felt scared and I felt alone.  I also felt abandoned by those I trusted.    My surgeon's answer was "talk to your cardiologist."

My cardiologist's only answer was "well, it is what it is and now you have to take meds for the rest of your life."  I was freakin pissed!  I didn't like that answer and didn't see myself as a guy taking meds for the rest of his life; meds that had bad side effects, not the least of which was eliminating my sex drive.  

So, I did A LOT of research, found a Naturopathic Cardiologist (two actually) who had better solutions and starting taking natural supplements.  Oh, and I stopped taking ALL Beta Blockers and prescription meds in June of 2012 against the recommendations (and scare warnings) of my original cardiologist.  

So, fast foward to today.  It's been 14 months since my surgery and I will say things are better, much better.  My resting heart rate is now usually 75-80-ish, sometimes a bit lower, sometimes a bit higher but much better than a year ago. I expect it will continue to go down as time goes on.  

I work out -- intensely -- 4-5 times a week.  In fact, I did a 4 hour extreme mountain hike yesterday.  I feel great.  

So, I think -- for me -- a big part of this was/is simply time.  Remember, they are cutting our hearts open and that takes time to heal.  You only learn this by going through it or talking to others a few steps ahead of you.  Also, my attitude played a big part.  I simply was not willing to accept the doctor's assessment of my situation.  I had a different vision of who I am and will be, and that didn't include taking meds for the rest of my life, nor letting any of this slow me down.  Again, I don't recommend anyone else follow that path...this is my journey.  

I wish I could look into a crystal ball and tell you it will all be okay and I certainly hope it is for you.  As difficult as it seems right now, go easy on yourself and let go of the fear!  Really, you have no control of any of this right now -- except your thoughts, attitudes and how you respond to what is.  That you can control.  You just had major surgery.  Understand that it will take time to heal, maybe more time than you anticipated.  I know that is hard to hear, but once you accept that, it gets easier.  And, hopefully this time next year you'll be the one here giving us all a good status update and something to look forward to.  

Be well my friend,

Matt






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Avatar_f_tn
Holy **** Matt.. I feel like you just described my situation. I' had mitral valve surgery on Aug. 5 2013 , I'm 45 yrs old and prior to surgery worked out 5x a week, worked full time and went to school. Now my heart rate is 110, I have horrible insomnia and I'm so tired all the time. I have no energy to do anything anymore.to lower my HR docs have me on metropolis and atenolol and they all say the same thing to me it should get better soon.. Well what is soon?  I feel worse now then I did before surgery.. Besides the physical issues. also still have a lot of pain left side of chest and left arm weak, the emotional issues are kicking my ***...everyone said ul feel so much better after, well I'm still waiting for that to happen..I haven't even been able to go back to work yet, just sit her and feel old! Lol
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Avatar_f_tn
Hi
My name is Nancy and I had mitral valve repair surgery on June 21, 2013. I am concerned about the same things you and everyone else is. I am a female, 45, active (I even ran a 1/2 marathon before the surgery, with my cardiologist's approval) and thought my blood pressure has always been low and still is, my HR is always in the 90's/100's. On a good day it might be in the 80's. I was told not to stress over this in cardiac rehab, as my blood pressure is low and it counters the elevated HR. My cardiologist also says it's normal for someone who's had surgery, and it may take months. Soon it will be 5 mos. since I had the surgery. I am on Metoprolol 12.5mg/day, which is an extremely low dose but it works. I don't feel any
'fluttering' unless I am exercising intensely, which I try not to, not yet. But I am also worried this might be a permanent condition. I dislike the idea, and like you I dislike taking medicines. What worries me is - I worry this puts a strain on the heart, even though my cardiologist says it doesn't . I'm just hoping for the best. Good luck to you all.
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Avatar_f_tn
I  also had the mitral valve repair in June 2013. Not sure what my resting rate was prior but  after 5 months its averaging about 90bpm. Dr recently tokk me off of the 25 mg metropol and the dizzyness has subsided but heart rate remains the same. I was also told it may come down in time. Durring rehab workouts i hit about 157 (im 50 years old). Hope it comes down soon!
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Avatar_m_tn
I recommend searching for "The Milner Acetlycholine Protocol".

After my AVR my pulse would be down at 84 minimum with 4 beta blockers per day, and often over 105. This was just when sitting down and resting, and no amount of breathing exercises had the slightest effect.

I searched for information on the Parasympathetic Nervous system and its transmitter - Acetlycholine.

The Milner protocol gives you daily doses of Choline Bitartrate and Vitamin B5 powder, all mixed together in a dinkk (I call it my chill juice).

It has enabled me to get my pulse down as low as 64 on occasion, and has calmed the ectopic beats completely.

Look it up and chat with a friendly cardio to advise you of any pitsfalls (e.e. if you have the vagally mediated form of Atrial Fibrillation this will hinder, not help you)

It takes a few days to work and a few days for your body to respond to dose changes if your pulse is too low/too high.

Good luck.
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