Something's going on with my heart...

Background:
• Ablation #1 – Aug 2019 – unsuccessful.
• Ablation #2 – Feb 7, 2020. On Eliquis 5mg BID and metoprolol 12.5mg BID. In NSR till June 24.
• HR in 80s and 90s till mid-March, then mostly in 70s till June when I come off metoprolol.
• Next 2 weeks HR in 80s with spikes in 90s.
• Laser eye surgery and dental implant surgery in mid-June.
• Day after implant surgery, HR skyrockets to 140s and stays there. EP diagnoses A/flutter.
• Back on metoprolol 25mg BID.
• HR stays elevated for 3 weeks. Can’t get ECV right away because I interrupted Eliquis for dental surgery.
• BP is very low averaging 84/60. Normal for me is about 95/60.
• Successful ECV mid-July. Discharged with new prescription for bisoprolol 2.5mg. Remain in NSR.
• HR in high 80s and 90s for 5 days, then drops to low 70s and high 60s till mid-August.
• Start to get higher BP readings of 91-101/60ish.
• Last 2 weeks HR inching back up into the high 70s, with a few in the 80s.

Today, HR in AM was okay at 75 with BP of 106/65. But two readings this evening were at 90 and 94 and BP is way higher than normal at 119/72 and 127/68.

Anyone know what might be going on? Should I be concerned? Hell, I am concerned!

Well, sounds like you had a rough go of it for a while, but I'm not seeing the problem now. An elevated resting heart rate is perfectly normal and to be expected for many months following an ablation. Your BP is to be envied, even at what you think are elevated levels. I would not be concerned in the least if I were you.

Possible reaction to implant?

Carey- upon reading her story of dental surgery while possible being in flutter or AF, without even thinking of LAA isolation, but instead a general question for folks being on Eliquis and have an af history, does someone bridge for dental surgery or just go off Eliquis for stroke prevention?

If you're not at high risk of stroke (LAA isolated, very high CHADS score, etc), you just stop the anticoagulant for the few days the surgeon recommends. For the average person with AF, stopping the anticoagulant for a few days is a trivial risk.

Define high chads risk? Doesn’t clots form after 48 hours? I had to prove before Eliquis I was in nsr the prior 48 hours to be ecv without a TEE.



Edited 1 time(s). Last edit at 08/28/2020 12:41AM by susan.d.

Hi Susan,
Theoretically a clot can form in as little as 5 hours after onset of a sustained AFIB episode, though more typically such might occur in someone with elevated stroke risk. But it's not common for actual strokes or even TIA's to occur so soon.

Yet even at 48 hours after start of an ongoing AFIB episode the odds are still in one's favor of not having an actual embolic event by then, though indeed, the risks are starting to climb by then.

Hence, why 48 hours typically marks the dead-end line in the sand after which neither an ER Doc, nor Cardio nor EP will electro-cardiovert you without you having first taken a blood thinner for around 4 weeks.

Cheers!
Shannon

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Carey
Well, sounds like you had a rough go of it for a while, but I'm not seeing the problem now. An elevated resting heart rate is perfectly normal and to be expected for many months following an ablation. Your BP is to be envied, even at what you think are elevated levels. I would not be concerned in the least if I were you.

Well that’s a relief! I will stop fretting then. 😊

While I was prepared for my resting heart rate to be elevated for a time following ablation, I did not expect that it would fluctuate to this extent. I thought it would start out high and then gradually get lower, which is what it had been doing until recently. I didn’t expect that after a stretch of lower heart rate that it would go way back up again. And, while you say the BP is to be envied, it’s much higher than my normal, so I thought something had to be amiss.

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GeorgeN
Possible reaction to implant?

I suppose it could be a delayed reaction perhaps. The implant was done on June 23 and I’m sure that’s what caused the A/flutter. ECV was done three weeks later on July 17. Heart rate then and for next few days in the 80s and 90s. Thereafter, dropping into the 70s and high 60s. It’s only been the last three days that it’s spiked back up into the 80s and 90s, nine weeks after the implant.



Edited 1 time(s). Last edit at 08/28/2020 10:29AM by Lorraine.

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susan.d
Carey- upon reading her story of dental surgery while possible being in flutter or AF, without even thinking of LAA isolation, but instead a general question for folks being on Eliquis and have an af history, does someone bridge for dental surgery or just go off Eliquis for stroke prevention?

I was in NSR at time of dental surgery and had been for four months following the ablation. Dental protocol was to hold anticoagulant for 3 days, which my EP agreed to. No bridging.

Quote
Lorraine

Carey- upon reading her story of dental surgery while possible being in flutter or AF, without even thinking of LAA isolation, but instead a general question for folks being on Eliquis and have an af history, does someone bridge for dental surgery or just go off Eliquis for stroke prevention?

I was in NSR at time of dental surgery and had been for four months following the ablation. Dental protocol was to hold anticoagulant for 3 days, which my EP agreed to. No bridging.

I’m truly happy for you! Like many who posted, it’s common after an ablation for elevated hr. I’m envious of your BP! Good luck!