Has anyone experienced one’s heart stopping after an ablation?

I use my Apple Watch which monitors my HR. I’m aware if my heart is super slow, it could beat at 24 which on the ekg looks like my heart forgot to beat but didn’t actually stop.

I looked at Apple’s heart app and saw week by week for six weeks prior to my ablation, my watch captured some low HR but never a zero HR...even when in AF. Post ablation I counted 22 times the watch captured a zero HR. 17 of the 22 there was a flux of zero as the slowest and 109-162 HR as the fastest. However 5 times my watch captured a zero HR with no high range. It was just zero. Probably when I was experiencing dizziness. They almost all occur at the same time each episode. Since my Apple Watch only takes a reading every 3 minutes, there are few days my heart had a zero HR 2-3 consecutive times during each consecutive 3 minute readings.

Has anyone experienced this before? I get a ZioPatch twice a year for the past 4 years and there was never a zero HR. Just post ablation.

I’m in contact with Natake’s NP because yesterday my ekg clocked a tachy @205. It was very symptomatic. I’m getting a Zio patch Monday to see what’s what. His NP rocks and once I emailed her my HR, she followed up to go to the ER but that time my HR calmed down. Now I prepare (get purse, shoes) after each multaq dose. My episodes all except for two occurred after multaq.

I’m just wondering if anyone who had an ablation experienced this or anyone on multaq had this experience? Thanks

If your HR went to zero, you would be face down on the floor unconscious within seconds. People can experience pauses, but pauses are generally only 2-3 seconds long and they immediately get the attention of a cardiologist and buy you a pacemaker. I guarantee you that if Natale saw pauses at any time you'd have been having a different conversation and a different procedure.

I don't know what your Apple watch is recording (or not recording), but the more I hear of Apple watches the less I trust them. Use a Kardia and if it records pauses, send the recording to Natale's NP.

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Carey
Use a Kardia and if it records pauses, send the recording to Natale's NP.

What does a pause look like on the recording?

Pros and cons of the Kardia (which my local EP has all of his patients enroll with a BP kit:
Lag time because I have to grab my phone, enter password, scroll for Kardia app, set it to record ekg, wet my knee and fingers. That’s in a rush a 20 second delay opposed to an Apple Watch which is instant (3 seconds) to get app and place my finger on the dial.
2. It constantly says during a violent 130s+ pvc that it’s either unreadable or AF which I am not in AF but instead pvc.
3. (Pro and con)My doctor gets a daily fax of all ekgs over 100 or under 45. He doesn’t get an ekg if I have a long pause nor does Kardia diagnoses pvc’s. It says so.
4. My local ep doesn’t like Kardia because it take the last beat when averaging my hr. I got a call my hr was 37 but with calibers they realized it was a wrong hr and vented.
Pros: it’s 6 leads and I can send a monthly report to natale office. If I see an ekg in question I can call up my local EP and his girl who only does Kardia can print it up and show my cardiologist.

Yes I know if my heart stops for a bit I would be faced down. How long is a bit? 2 seconds? But it could be real slow almost to a point before fainting. I now speculate that since the Apple Watch takes a reading every 3 minutes perhaps that second my heart pauses a beat and I get a zero hr. I still think when the Watch seek a hr maybe my heart paused a bit or I had a slow hr. I’ll get my Zio patch tomorrow. I get bleeding blisters within 20 minutes of wearing it and my skin will be extremely itchy with oozing blood for 2 weeks but there is nothing I can do. There are better brands for sensitive skin.

I was tested twice prior to my ablation for sick sinus syndrome via a Zio patch and I didn’t have it prior to my ablation. I can’t get a pacemaker. Period. I have an auto immune issue where my body fights everything foreign such as stitches, all tapes, titanium, earrings (I had to get my leg screws and clips removed) and even foreign items that touch my skin for any length of time will produce blisters. However I was lucky with my ablation plugs. They hurt like heck so after 3 weeks I had to get an ultrasound. They are dissolved now so I am ok. When I get imagining and they use contrast sometimes I have to ore med the day before and after with steroids and Benadryl.

I don’t know what material is used in a pacemaker but it’s foreign. My primary doctor once suggested I get the pacemaker shell implanted in my arm or leg and test it before it ever gets near my heart if I every need one. I am not a fan of pacemakers. It could fail. I won’t be able to get my MRI’s that I need. Traveling to Russia and some other countries would be risky. I witnessed a woman with a pacemaker asked to lean against the machine until someone would body search her. She was too closed to it.

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Lorraine

Use a Kardia and if it records pauses, send the recording to Natale's NP.

What does a pause look like on the recording?

I’m not sure this is a pause but it’s a real slow beat. I got it from taking the 3rd flecainide earlier this year. I think it’s a 27hr. Casey would know what a pause is and maybe he can share an example.

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Typo carey

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susan.d
I’m not sure this is a pause but it’s a real slow beat. I got it from taking the 3rd flecainide earlier this year. I think it’s a 27hr.

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Susan, I agree that the beat you showed corresponds to 27 BPM. I counted 11 heavy divisions and I think that 5 is 60 BPM so 60/11*5 = 27. That is slow, but how often do they occur? What is your normal pulse rate? Or better yet, what was it (not in afib) prior to your ablation? I know people that function OK with a slow pulse. I know mine can drop into the 30's during sleep & it is not an issue for me.

You should be able to track this using your finger on your radial pulse, too. Won't record it, but you can get a sense. Will your Apple watch go into continuous recording mode? My daughter and son-in-law use theirs to monitor their heart rates when then run (I don't own one).

Susan, if it is not too much to ask, could you post your blood oxygen and your blood pressure while all of this is going on?

Jim, I’ll PM you the readings the next time it’s slow. In the hospital I had hypoxia so it was low from 88-92. My BP if I recall was staying about 80/50s in the hospital ICU. GeorgeN, my hr is faster now since the ablation. It was just 108 because I was on the treadmill for 33 minutes (yeh for my baby steps endurance!)) @1.1 speed and 1.5 elevation. It’s back to 64hr after 8-10 minutes.

My hr was slow like the one I posted after taking a third flecainide in 24 hours this year. After my flecainide overdose, my heart stayed @24-37 so I was in the ICU for 3 days. My normal hr before my ablation was 55-62 because I was on Tenormin (atenolol). Now I’m temporarily on multaq for my blanking period...no Tenormin. My resting hr is in the high 60-70s, walking brings it to almost 80 to the 90s or 100s. If I lift 10 pounds or push a shopping cart it’s past 120-130s. If I get hot (overdress and warm boots) my hr is high. With pvc most of the time (I now get short windows of nsr), it averages in the 100-130s). I was pvc free for two wonderful weeks. It just came back.

I think my Apple Watch is accurate. I took two Kardia readings and my hr was spot on to my watch.

GeorgeN- the Apple Watch takes continuous hr every 3 minutes. You can see it in the health app. Obviously when you take it off to charge you won’t get any readings.

Susan, as George said, what you posted shows a slow heart rate between two beats. With only two beats to look at, there's no way for us to know if it's a pause or just a slow heart rate.

I'm not trying to sell Kardias. I'm trying to get you to use an accurate device. Never mind the 6-lead Kardia and what features it has, blah blah. Just use the plain old original Kardia or whatever you have. I simply don't trust the Apple watch's recordings. In any case, the one thing I'm 100% certain of is you did not at any time have a HR of zero. The medical term for that condition is "dead."

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Lorraine
What does a pause look like on the recording?

It's just a gap between beats that's distinctly longer than the others. A HR of 60 bpm is one beat per second, so if you see beats periodically that have more than a 3-second gap, those are probably pauses.

Carey, is this what a pause looks like on a Kardia?

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Lorraine
Carey, is this what a pause looks like on a Kardia?

Well, sort of, but those are only 1.5 seconds long so they generally wouldn't be of concern. Three seconds is where cardiologists get concerned. They're really more just part of the irregularity of afib than what a cardiologist would label a pause.

You can calculate how longs things are by counting big and little boxes on the graph. The little boxes are 200 milliseconds each, or 1/5th of a second. There are five little boxes to each big box, so the big boxes are 1 second each.

Thanks, Carey. That explanation was very helpful.

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susan.d

I don’t know what material is used in a pacemaker but it’s foreign. My primary doctor once suggested I get the pacemaker shell implanted in my arm or leg and test it before it ever gets near my heart if I every need one. I am not a fan of pacemakers. It could fail. I won’t be able to get my MRI’s that I need. Traveling to Russia and some other countries would be risky. I witnessed a woman with a pacemaker asked to lean against the machine until someone would body search her. She was too closed to it.

My Pacemaker is titanium. You can have MRIs with the newer Pacemakers—they just adjust the settings before doing one. When I fly, I just show my Pacemaker card and they have me bypass the metal detector. If (it very rarely happens) a Pacemaker fails, your heart just beats at the rate it would without the Pacemaker. Pacemakers don’t pace you all the time anyway—just within the parameters set by your EP. It is only if you have an AV node ablation that a Pacemaker stopping is something to be concerned about.

Well that’s my concern. AV ablation that I will need a pacemaker. My heart was still firing during the ablation near my AV. The ablation was terminated because of some issue. I was told if I need a touchup he would have to get to it from behind? to avoid my AV. My concern is an accidental AV node ablated. It’s only a wiggly wire.

I got my Zio patch today. It ironic because I am getting pvc almost all the time except at the EP and the minute the Zio monitor was placed on my chest. It was a pvc marathon beforehand until I walked into the office, confirmed by Kardia 6 lead. We will see how often I get pvc the next 14 days. I’m hoping I will not need a touchup ablation. Thus my concern about my AV being touched.

Natale's not going to accidentally ablate an AV node. That's not a mistake a competent EP makes, and he's far beyond merely competent. Besides, it's unlikely you'll need a touch up. The ectopy you're experiencing is almost entirely PACs, not PVCs, and that's perfectly normal at this stage following an ablation. It should calm down in the coming weeks.