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post cardiac ablation and exercise
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post cardiac ablation and exercise

I am a 45 year woman who had an ablation 3 & 1/2 weeks ago. I have dealt with pvcs for the last 18 years and was having 31,000 extra heartbeats a day. The procedure was relatively easy for me and I was back to work after 4 days rest. It has been great to have regular heart beats and no sensations of pvcs of palpitations.
Here is my question: A few  days ago I went back to the gym to start exercising again (I have been getting a good walk every day, but not a lot of cardio.) After only 3 minutes on the elliptical machine, my heart rate was at 140. I was not out of breath, dizzy or tired - and I was on the easiest level. More than anything it made me anxious, so I backed off.
Have not had a chance to speak with my cardiologist yet, but I did speak to another an on-call doctor today who suggested we do a holter monitor as soon as possible. He said that sometimes there can be nerve irritation from the ablation that causes a rapid heart rate with exercise.
Has anyone experienced this when getting back to exercise?
  
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187666_tn?1331176945
I've had 3 ablations for my arrhythmias and know from experience that it takes several weeks for the heart itself to heal. You feel good, the incisions heal up in no time but all that zapping and burning in the heart takes much longer. And the rhythms can act up during the healing process. I've read that it takes 6 weeks, some say as long as 3 months.

You can exercise but just pace yourself and if the heart acts up, give it a break. Don't push yourself. You'll be back to speed before you know it.
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Avatar_n_tn
Had same thing for 3 months after ablation for PSVT in April, was told the heart can take awhile to heal.  I just walked at an easy pace then.  (Just when I thought things were getting back to normal, looks like I'm dealing with IST and POTS, oh well . . .)  Good luck!
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Avatar_f_tn
I'm almost 3 mos post procedure for SVT and I'm just now feeling like my heart rate is trying to "stabilize" when I stress it. I would even have a really high rate just when going from sitting to standing! Nothing too extreme, but from low 70's sitting around to around 100 BPM when standing and then down to around 85 - 95 just walking around the house.

The last couple weeks I finally started walking for exercise and in the last week have been throwing in 1 minute intervals of jogging for every 4 minutes I walk. My heart rate doesn't seem to be skyrocketing (although I do take low dose Beta Blockers) but I notice I am still easily fatigued -- probably b/c now I'm a bit out of shape from not doing anything for nearly 3 months....

Anyway, I did a lot research pre-ablation and have heard this same experience from many, many ablation patients. If it continues and worries you, I would def call your cardio and ask about -- it may help to have them know what is going on and be able to either check you out or reassure you. I've already had a 24 hr holter (just 5 days post ablation) and a two week event recorder just finished a few days ago (in prep for my upcoming 3 mos post ablation check) as standard post procedure care and it has been reassuring to know that those came back with no major concerns. Best Wishes!
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Avatar_f_tn
Thanks so much for the encouragement - it really does help to hear from other's experiences. I should be getting a holter sometime this week, so hopefully I will have more information as to what is going on as things heal.  
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Avatar_f_tn
It's so good to read your post because I had an ablation in August of 2008 and the same thing happened to me as you.  I would go from sitting to standing and see a 30 beat increase and it would come down by about 15 beats after a few seconds.  But just walking around I would be running about 90.  Prior to the ablation I was in great shape so it was shocking to see this.  I started feeling better about 6 months out and now am pretty much back to normal.  I just think I am more sensative to my heart so it's more in my head than anything.  The doctor's were never able to tell me anything as to why it was taking me longer to heal than others so it is nice to hear that someone has a similar experience.
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Avatar_f_tn
Thanks for much for adding that helpful post! You can't help but wonder what's going on when you have weird, subtle or unusual symptoms after this procedure -- especially when it seems like everyone else is (or you are told that you should be) back to normal in a week or two!

Since my procedure supposedly went so well, I have been surprised at how slowly I seem to be recovering. I have done some research on this and have read this is actually not uncommon, just unpredictable and not talked about much. It may be caused by effects of ablation on the parasympathetic nerves in the heart -- which are interconnected throughout the heart, but concentrated in certain areas. Interrupting these "pathways" while destroying the "bad" pathways or spots causing arrhythmia can affect rate and response in the heart depending in part on where in the heart the ablation was done.

So while you may just be more sensitive -- I'm always being told that myself -- it could also just be that your heart (and mine) are taking longer to "feel normal" due to healing and reorganizing signals related the parasympathetic nerves in there.

Again, thanks very much for that reassuring bit of info -- I am so glad to know that after 6 months you began to feel normal again!
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996946_tn?1416866031
In the post above, by parasympathetic nerves in the heart being ablated, do you mean the Vagus nerve?
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Avatar_f_tn
Hi Linda,

Remember, I am not a medical professional, but from doing some on-line research due to symptoms, it's my understanding that the nerves affecting the parasympathetic nervous system are not necessarily "ablated", just interupted by the procedure -- I'm not sure they have a total understanding of how this is so, just that it MAY be so. This interuption of may be partly responsible for affecting heart rate variability post ablation until things heal and reorganize themselves in the heart.

he vagus nerve is not actually ablated during cardiac ablations (well, except in other very rare circumstances!) but nerves that may be in contact with, connected to, or affected by the vagus nerve may also be unintentionally affected by ablation. There seem to be some specific spots in the heart that are more likely to result in this effect when ablation lesions are made in those areas.

Heart Rate Variability (HRV) is a potential measurement of heart health. There are several anecdotal references to HRV being affected by ablation in literature available through Pub Med / NIH, European Heart Journal, etc., but one of the best descriptions I've found of what this is and how the various nervous systems (parasympathetic, autnomic, etc.) work with the heart is at this link below.

http://www.biocomtech.com/hrv-science/heart-rate-variability-basics
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996946_tn?1416866031
Thanks a lot for the info.  It makes you wonder just how resilient your Vagus nerve really is. And thanks for that link.  I need to get my head back into the books so I can get back on the focus of the "Whys" and the "Causes" of some of these reasons thongs happen the way they do  I have a full notebook of Vagus related facts and it is all so very compellyng, very fascinating.
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