HR post ablation, resting and maximum

I'm wondering about the "collar" now placed around my HRs, resting being higher and maximum being lower.
Post ablation, PVI and SVC, my resting HR is up from 50 (no beta-blockers) to 75. And my maximum is down from 160 to 130.
If one assumes that the SA node is isolated from Vagal control it could account for the increased resting rate. But it seems unlikely to me that catecholamines would not still affect the SA node to increase the rate as needed/demanded by exercise.
I also wonder if this effect might be a temporary one, and furthermore if it is will it correlate with the possible recurrence of a-fib?
I'm interested in other people's experiences in this regard.
Thanks

Hi Buckywood,

Welcome to the forum!
While your question is very valid, please be aware that this issue of post ablation HR elevation is truly one of the most common repeat questions we get on the forum and thus there are no doubt legions of very complete answers to your inquiry already handy for you simply by using our forums advanced search feature with something like ‘post ablation elevated heart rate’ and selecting the ‘all dates’ filter ... or some such variation of that question .., and you will find all the in-depth discussion and answers on this topic one could wish for.

Since you are new to the forum, here is a quick summary; “post ablation elevated HR is absolutely common, it is almost always transitory, though it can last a prolonged time in some folks before gradually returning to one’s previous general normal resting HR range over time that you experienced before your ablation, and such a transient post ablation elevated HR is both benign and is a strong positive indicator that you had an effective ablation.”

It’s generally a very good practice, too, when a new question arises for any of us, be it a newcomer to all this or a seasoned afibber, to please first ask the advanced search feature (using ‘all dates’ as the time frame for your search) and see if you don’t get a long list of great answers and insights to pop up, before posting a new thread.

To be sure buckywood, your question is a very good one, but it’s so common you will find all the info you need on the subject instantly via the very handy search feature.

Thanks again buckywood, and to all posters for remembering to try the search feature on the forum first when posting a question, especially if you think your question might be a common one.

Cheers!
Shannon



Edited 1 time(s). Last edit at 10/21/2019 11:15AM by Shannon.

Your atria are swollen. They got branded from the inside with the equivalent of a soldering iron, assuming your ablation was RF catheter. Imagine if you took a red-hot poker out of your fireplace and pressed its tip against your upper arm, held it there for a few seconds, and then released it. How long would that be red and swollen? Could you do push ups same as before? Of course not. It takes time to heal, but heal you will. We all have.

Welcome to the forum! Sorry you had to be here, but so are we all. It’ll get better.

How long wolfpack? My ablation was 5 weeks ago and now my ankles are swollen this week and I gained 5 pounds in my legs alone. My daughter flew into and I was stupid enough to think I could walk from an underground parking lot to the elevator . Today I seriously feel sorry for myself. My heart is pumping from 90s to 120s. I’m concerned I will wear out my already leaky valves and high hr can only enlarged my already enlarged atrium. Sorry for venting. I got stuck from the parked car to the elevator so I took a market electric cart. So I am venting. I can’t stand my heart beating from the 30s to 130s back and forth pvc. I had aggressive cancer diagnosis in 2014 and never felt sorry for myself because I could walk. I feel weaker than going through chemo. I am hoping it will pass because I feel like a cripple ready for an electric wheelchair.

It totally depends on the patient and probably how much burning was done during the ablation. It wouldn’t surprise me one single bit if it took a year. Patience is key. Of course, let your doctor know if you’re feeling really uncomfortable.

It may well seem like it can long time for cardiac myocyte tissue to heal in some folks after an an RF ablation, but the typical reality is that the vast majority of tissue healing is largely over be the end of the blanking period. Some degree of subtle cellular healing can still continue up to a max of around 6 months post ablation, but by and large this final late stage cellular healing is largely asymptomatic and rarely interferes with their day to day life. Like nearly everything in medicine there can be rare outlier exceptions, but the vast majority of folks I’ve followed are almost always past such physical symptoms related to lesion healing by that phase.

And Wolfpack, your analogy is certainly valid of the ablation catheter as a hot poker or branding iron burning the intended lesions in the left and right atria, but keep in mind the relatively tiny size of each lesion due to how small each lesion is.

It’s helpful to look at the metallic tip of an ablation catheter up close in a photo and realize that the burning-end of the metal tip is only about 3mm in diameter, max, and in most cases only the very tip of the metal sleeve is even in contact with the atrial tissue. With the advent of first irrigated catheter tips around 2007, and more recently with addition of contact force catheter designs as well, combined with half-saline used as irrigation fluid ... all of these advances have led to wider, deeper and overall more uniform lesion creation leading to significantly greater odds for full transmural lesions (meaning the lesion scar will will penetrate through the full thickness of the atrial wall from the epicardial to endocardial surfaces of the atria resulting in more effective ablations often with reduced total work required.

In any event, my sense is that well before the one year post ablation mark is reached, and truly no more than 6 months, there should be essentially no more tissue healing symptoms at all.

Best wishes
Shannon

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ajr1960
I have since found out that My vagus nerve and ganglia fibers were damaged (which are unrepairable) and now I’m left para sympathetic dysfunction. Due to this outcome - my BP bottoms out (I never a BP issues prior to my ablation) and I can’t stand more then a few minutes without severe Tachycardia/ BP issues and symptoms. I can be sitting or laying in bed and my heart rate will suddenly spike from the 60’s to 130 in seconds (I’m on beta blockers to keep it from being in the 90s 24/7 now) . It’s sinus but only a person with brain damaged would believe a 100% increase in rate within seconds of doing nothing to cause it doesn’t affect you both physiology and mentally. My quality of life sucks and every physician but the one that caused it feels horrible for me.

I wish in hindsight I read your post two months ago. I’m being told symptomatic PVC’s is nothing to be concerned about. I can self trigger to a higher symptomatic PVC by simply drinking water, eating hot or cold foods or not slow motion sitting up and getting out of bed. So it’s a force of will to drink because I have to hydrate knowing my heart will be a freak show afterwards. It’s very vagal. I’m up now from 4:45am because I didn’t slow-no getting out of bed to pee.

I voiced my concerns twice pre-ablation that I have been always vagal and AF from throwing up, bendinIg over, etc. i asked after my ablation if my ganglia was burned and the answer was yes.

I am on Multaq for the blanking period. The drug has given me such side effects that I endured because AF is worst. GI issues and PAIN, burping marathon when I wake up, rashes (see photo to demonstrate I’m not crying wolf), itching from scalp, eyelids, inside ears down to toes, dry cough. I’m up because my GERD is fierce. I had to take a second Prilosec at midnight because of my 10pm dose of Multaq.
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"I am on Multaq for the blanking period. The drug has given me such side effects that I endured because AF is worst. GI issues and PAIN, burping marathon when I wake up, rashes (see photo to demonstrate I’m not crying wolf), itching from scalp, eyelids, inside ears down to toes, dry cough. I’m up because my GERD is fierce. I had to take a second Prilosec at midnight because of my 10pm dose of Multaq."
[i.postimg.cc]

Susan:

I would relay this to Dr Natale's office. If it was me, I would propose to Natale to get off of the Multaq, at least temporarily, to see If I could maintain NSR without an Anti-Arrythmic, and to see if the PVC's abated. Then if I went back into AFIB, then I would get Cardioverted out of it if I did not convert on my own after several days. Then I could add a different Anti-Arrythmic.

Obviously your not me, but in response to your postings about these symptoms, and I see 3 options here.

1) Stay on Multaq and endure, until blanking period over.
2) Withhold Multaq on a trial basis
3) Stop Multaq, and substitute another Anti-Arrythmic on a trial basis.



Edited 1 time(s). Last edit at 10/26/2019 04:55AM by The Anti-Fib.

Quote
The Anti-Fib
1) Stay on Multaq and endure, until blanking period over.
2) Withhold Multaq on a trial basis
3) Stop Multaq, and substitute another Anti-Arrythmic on a trial basis.

I agree with this. In fact, #2 is exactly what I did following my ablation. I tried stopping the Multaq at 3 weeks but the ectopics increased, so I resumed taking it for another week and then tried again. After stopping the second time, it was nothing but pure NSR from there on out.