Tachycardia after PFO closure

I underwent PFO closure a few months ago.  Initially I had some palpitations that cleared up.  Then I started having some central chest discomfort that was a squeezing sensation.  A trainer at my gym suggested I take my pulse and I was truly surprised to find it between 120 - 150 bpm since I exercise 5 - 6 times per week.  I am very active and not overweight.  He suggested a polar monitor.  I started wearing it and discovered I am between 110 - 160 bpm all day with 115 being an average.  If I lay flat on my back I can get my heart rate down to 85 - 95.  When I exercise I try not to go over 180.  The chest pain seems to come on around 150 bpm, but not during exercise.  I accidentally found that I can significantly lower my heart rate by doing a type  of sit-up. My heart rate will drop from 150 to 50, but it creeps back up again.  I am not lightheaded or dizzy, but occasionally I break into a sweat for no reason. My thyroid labs were checked two months ago and were very normal.  Is it dangerous to have a continuously high heart-rate?  I am intolerant to beta blockers and would prefer to do nothing about this if it isn't dangerous.

[Michael J. McWilliams, M.D.]

It depends on what the heart rhythm is.  An EKG or a 24 hour Holter monitor should answer the question.  If it is normal rhythm, many doctors will try to slow your heart rate down using beta blockers or calcium channel blockers.  If it is another heart rhythm like an atrial tachycardia or atrial flutter, this can often be fixed with an ablation procedure.  There is a lot of clinic judgment that goes into deciding if you might benefit from medications or not.  I don't feel comfortable with what I have read commenting on your need for medications.  Probably best to ask your cardiologist or an electrophysiologist for their take when they can review your records and heart rhythm strips.

[codiver]

Thank you.  I didn't want to follow up on this, but I suppose it would be best if I did.