Resting heart rate stuck at 80BPM from 56BPM

I have always known I would have to return to the forum one day for advice after many years being free of arrhythmias however I did not expect to be asking this question that I don't ever remember being asked before so here goes.

Cleared of Afib, Right Atrial Flutter and Left Atrial Flutter since ablations in India and Bordeaux - five in total - between 2007 and 2010 I have enjoyed life to the full including exercising in the gym and hiking around the hills here in Hong Kong. Unfortunately two days ago whilst starting up on the gyms Concept 2 rowing machine I quickly noticed I was missing the usual zip after the first minute so I gradually eased the pace to complete my usual 2000mts. I decided right away to skip my final exercise on the treadmill and put it down to having a bad day. I checked my heart rate on the treadmill and it was at 157BPM NSR which is well above my usual safety limit of 145ish max, I am 69. I had the sauna and shower and headed home thinking nothing of it as I felt comfortable enough. On reaching home I tested my blood pressure and heart rate on my Omron machine to find my heartrate was at 122BPM regular which was very high after around 45 mins since exercise. An hour later my heart rate was 80BPM regular and it has been stuck at 80BMP nearly every time I check over the last two days. My normal resting heart rate is/was 52 - 56BPM. Thinking this was a case of Atrial Flutter I finally went to the local Hospital and the doctor said the ECG? showed no Flutter or AF however she was a young doc and I believe mistakes can be made when reading the ECG printouts. As I had gone to the hospitals A&E I probably was also not talking to an heart specialist and simply put she said 80BPM is considered normal. To keep the story as short as possible I have virtually no sense of anything wrong apart from maybe just a feeling of light headiness no doubt due to the big difference between a normal rate 0f 56BPM to 80BPM which is a rise of around 30%.

A&E have given me a referral letter to see the top cardio at the hospital with scheduled meeting date of June 2021!!!!!!!!! unless the specialist decides to advance the appointment.

So, anyone got any ideas what could have gone wrong to raise the resting heart rate from 52 - 56BPM to a solid consistent 80BPM, I can't ever remember a post on the forum of such a case.

P.S. Regards to all the posters I remember from years back still passing on good advice to the 'newbies"

Barry G.

Was the HR from the ECG at the Hospital also 80? I don't trust BP Machines for accuracy. I think just counting your Heart Beats via checking your Pulse with a finger is probably a better way to measure HR.

My resting HR does fluctuate from around 68-90, I don't know why. I don't think there was as much variance when I was younger.

Also you could upload your ECG printout on here in this Forum, to get opinions on whether it could indeed be Flutter, or just NSR.

Sounds like flutter. The 157 would have been 2:1 conduction, then it dropped to 3:1 producing 122, then it dropped again to 4:1 producing 80. Flutter is an easy diagnosis to miss because it looks just like NSR if you don't look carefully. It often doesn't present on ECG with the classic sawtooth pattern. I've had more than one ER doc and my own primary care doc miss it and call it sinus tach even though they knew I had a history of flutter.

Not surprised you felt perfectly fine, especially at the lower rates. I used to have a flutter circuit that produced rates in the 120-130 range and I was never even aware of it unless I felt my pulse. I don't think it's anything you need to worry about immediately. Just keep an eye on your rate and see if it happens again, and how often.

An appointment with the top guy two years out?! That doesn't sound very useful.

I'd guess flutter while you were in the gym which converted on its own by the time you reached the EKG machine. Your atria were still stunned after the alleged flutter episode and had shortened refractoriness. This is very common when converting from either AF or flutter. Every time I've done it, my resting HR will hover in the 70's for half a day or so until it calms back down to its normal 50-ish rate.

Hi Barry,

I concur with Carrey and wolfpack. Flutter is the likely answer.

PS, I recall all of your ablation stories from years ago.

Cheers,

George

Good to hear from you Barry, sorry that it is in these circumstances. Hope you get it sorted soon.

Gill

Hi The Anti-Fib. I would certainly upload my report if I knew how to do it, tried copy paste etc but no can do. I am very aware there are guys/gals on this forum that know more about arrhythmias than most cardiologists.

That does seem a big difference in your resting heart rates, almost the same as mine so do you get slight light headiness at the higher rate?

I have had my Omron machine for at least 10 years and yesterday it was recording my resting heart rate at 80/81BPM whilst the hospital machine gave a reading of 80BPM twice. Whilst in the waiting room I downloaded a heart rate app and that recorded a solid 80BPM at least 90% of the time otherwise 81to 83BPM. It was this constant 80BPM that convinced me that I was in Flutter and not in random fluctuating NSR.

Cheers, Barry G.

Sorry your having issues Barry. In sure you will get it sorted.
As to your image. You will need to upload your image to a hosting site like postimage. Once you have don't that you can insert a link to that image in your post.




Edited 2 time(s). Last edit at 06/07/2019 12:08AM by rocketritch.

Hi Carey. Fairly conclusive stuff regarding the conduction rates which appear to follow a definite path stepping down to the 4:1 80BPM.

The bottom line on my reference letter states.....ECG: SR 81, No ST changes. ?regular atrial wave at 300bpm with 3:1 block. No idea why the ?is at the beginning of the word regular above, but then I am in China so mistakes easy to happen with local translation and possible typos. The Cardiograph printout states..... Sinus Rhythm. Abnormal q Wave (111).

I have now been in this condition for three days with no change whatsoever in the 80BPM heartrate, I feel OK but certainly have the feeling that should I do anything exercise wise the heart rate will immediately begin to soar. Spent 4+ years battling constant Right/Left Atrial Flutter, Atrial Fibrillation Bigeminy, Trigeminy, Quadgeminy and every other Jimmy, absolute nightmare.

Yes two years until I can see a specialist unless the guy advance's my appointment in the next two weeks however if push comes to shove I will be off to Bordeaux again. I asked the doc at A&E if they could just zap my heart back into rhythm as they had done successfully 10 years ago but she said no it will cause more damage than good. 10 years ago it took me three months to get zapped because my warfarin readings kept varying too much over the testing three weeks period, so I had to carry on taking the warfarin for another three weeks testing to fail yet again and start over once more. Took over three months suffering with none stop Left Atrial Flutter before they finally zapped me and stopped the flutter within minutes. Note my Omron could not measure the Left Atrial Flutter but apparently my heart rate was at around 100bpm all through that 3 months, tired out all day every day and in bed by 8pm latest, what an hideous affliction these arrhythmias truly are.

Not worried too much as will simply contact Bordeaux if needs be.

Cheers, Barry G.



Edited 1 time(s). Last edit at 06/07/2019 12:24AM by Barry G..

Barry:

Most of the time my HR is like 66-78, but sometimes as high as 90. I don't get lightheaded as a result of the higher HR's.
I am sure I am not currently getting flutter. I used to get it when I was on Flecainide about 5-6 years ago. My Flutter was fast and very steady at about 85-88.

Right now I am having alot of PAC's, I just went through a 90 minute workout in the Gym, with PAC's every 2nd or 3rd Beat. I didn't have as much energy on the Cardio Machine at all. I do get light-headed if the PAC's are before every Beat, or every other Beat.

Hi Wolfpack. Unfortunately the highly suspected Flutter has not fully converted these last few days and still remains at 80BPM. I have had 5 previous ablations and certainly in the first two the Docs zapped the Right Atrium big time so I believed Flutter was done for good, but apparently not so.

In my experience 10+ years ago Right Atrial Flutter either converts to AF or certainly in the case of Left Atrial Flutter never converts at all on its own. If I remember correctly my forth ablation successfully removed AF however with 3 months I started getting the Left Atrial Flutter almost certainly the result of the damages necessarily inflicted for the extensive ablation of my very difficult AF.

I am certainly hoping that with rest the Flutter will convert back to true NSR but at this stage I fully believe it will need the Electric Shock Cardioversion or another trip to Bordeaux. :-(

Cheers, Barry G.

Hi Gill, thanks for your message. Yes I will sort it out though just knowing I may well have to go through it all again if the Flutter? does not convert on it own is a bit daunting even for this seasoned Afib warrior. The thing that stops me being sorry for myself is the fact that I have at least the financial assistance to possibly buy my way out, via Bordeaux, whereas so many others - my eldest daughter included - do not and will struggle forever with this demoralising health issue. Note: I previously offered to pay for my daughter to attend Bordeaux but she refused as she also has had a kidney transplant and wanted her ablations (six failures) done in the UK on the National Health System.

Trust you are still scuba diving in far off exotic places.

Barry G.

Hi Rocketritch. Thanks for the info I will certainly try later today.

Cheers,
Barry G.

Hi again George. Just reread your post and noticed you mentioned my many 'stories' from years ago. Yes they were stories rather than messages and the one that sticks in my mind was Bordeaux Diary from May 2008 and will be in the 2008 archives I should imagine. Any 'newbie' interested in the Afib journey all the way to Bordeaux and back will find this somewhat interesting/informative for a prospective attendee at the hospital.

Cheers,
Barry G.

Quote
Barry G.
The bottom line on my reference letter states.....ECG: SR 81, No ST changes. ?regular atrial wave at 300bpm with 3:1 block. No idea why the ?is at the beginning of the word regular above, but then I am in China so mistakes easy to happen with local translation and possible typos. The Cardiograph printout states..... Sinus Rhythm. Abnormal q Wave (111).

The Chinese company Contec makes a 12 lead Holter that is commonly sold on eBay, including software. You might want to get one and get more info. You might have to spend time really learning to read it as flutter can be hard to see. <[www.ebay.com]

Cheers,

George

Hi again Rocketritch. Although I am on the computer every day I manly stick to the simple stuff so not having much luck with creating an image here on the BB. I downloaded postimage and followed the instruction best I could but only finished up with the url above which did include my heartrate printout. No problem though as I fully believe I am in Atrial Flutter and will follow up with the local hospital hopefully to get a cardio conversion asap.

Barry G.

PS. Looks like it worked after all :-)



Edited 1 time(s). Last edit at 06/07/2019 10:46PM by Barry G..

Hi again George. Thanks for the info but I don't really get into the details of arrhythmias too much but I know that you used to. Basically, even though I have been AFib free since early 2010 I can tell almost immediately if my blood pressure has risen or maybe a few (not very often) PACs /PVCs flip in and out. I now believe due to your and others input that I am in Atrial Flutter and will be pushing to get permission for a cardio-conversion from the local hospitals main cardio Doc within the next two weeks. The downside to the cardio conversion ( for any newbies reading this) is that I will have to go on warfarin and be tested every week for three weeks. I must visit the hospital and get a warfarin level test score of around 2 once a week for 3 weeks. Should I fail the test level i.e a score of say 2.3 on week 1, 2 or 3 the whole test procedure must start all over again. The one time I did have a cardio version for none stop (99BPM) Left Atrial Flutter it took 3 months before I got the three necessary consecutive weeks with a warfarin score of 2. If the cardio conversion is unsuccessful it looks like another ablation on the horizon but would that be at the high cost of going to Bordeaux or via a local Hong Kong hospital, very clever these Chinese.10 years ago I was under the impression that ablation of Atrial Flutter is so simple Professor Jais in Bordeaux could probably do the ablation using a candle ;-)

Cheers,
Barry G.

Barry, see my reply on your other thread about that ECG.

Quote
Barry G.
I was under the impression that ablation of Atrial Flutter is so simple Professor Jais in Bordeaux could probably do the ablation using a candle ;-)

Cheers,
Barry G.

Right atrial (typical) flutter, yes. Left atrial (atypical) flutter, no. That is a briar patch. Even the best in the world will be in there for hours trying to sort it.

Hi Wolfpack, I believe you are totally correct. I suffered Left Atrial Flutter for 3 months and considered this none stop very high heart rate arrhythmia at least as distressing as heavy Afib. The LAFL was almost certainly caused by the extensive burning needed for a successful but very difficult Afib ablation carried out by Professor Hocini in Bordeaux.

The LAFL was cardio converted after a three month struggle getting my warfarin levels accepted by the local Hong Kong hospital Cardio department. I spoke with Bordeaux after the successful cardio conversion and they more or less said the Flutter could be lying low worst case. That was enough for me as the possibility of another three months of LAFL would have had me jumping off a bridge. I finished up travelling to Bordeaux again - third visit - for ablation No. 5 this time by Proffessor Jais, arguably the best ablator in the world at the time. I think the ablation took just under 2 hours and the last 40 minutes or so I could see Dr Jais was getting very restless, I thought here we go again. Finally he said he was closing the procedure and I finished up back in my room not knowing whether the ablation had been a success or not.

An hour or so later in comes Professor Jais and said I didn't get it all as the heart tissue was too think however when he revved my heart up to 300BPM at the end of the procedure no Afib or Flutter could be found. His parting words were something along the lines that I would never get my heart rate anywhere near 300BMP so its was considered a success as indeed it proved true.

Cheers.
Barry G.