Adrenalin/exercise after ablation

I am now seven weeks out from my ablation by Dr. Natale. Three days ago, I went to the ER because after having a bazillion ectopic beats all morning, my heart rate went to approximately 180 with a BP of 160/111. Fluids were given in the ER and things were returning to normal but I became somewhat upset when it was mentioned that I may have had a TIA. IV Ativan was given, I was taken for a CT, nothing showed on the scan, and then discharged home. Two days later, I saw my EP who said I did not have a TIA, blood work was perfect, and so was the EKG done that day. He then had me do a treadmill stress EKG. I reached 96% of maximum target rate and probably could have gone longer but I was just apprehensive about doing so. He told me that I most likely have too much adrenalin circulating and that I need to get a personal trainer, do some weight training, etc and get more fit. Plus, he said to expect the arrhythmias, etc to continue for at least another month or two, and no more ER visits unless I'm having chest pain, nausea, fainting. So now I feel pretty stupid for apparently getting myself into a panic over nothing--I'm 75, I should know better. Anyway, I know there are lots of fitness experts on this board so I'm wondering if you agree with the adrenalin/exercise diagnosis and/or if you have any suggestions.

Laura,

Have you by any chance tried going on a tablespoon of granular lecithin per day yet? It may be helpful with the ectopics.

Laura,

Did you call in a recording for the event monitor that Natale has his patients use? I would think they would have directed you to go to the ER with a rate that high. Are you on any meds since the ablation?

Hoping you're feeling better,
Mary

Laura
I can't comment on your adrenalin/exercise question but I'd disagree with you feeling "stupid". I'd say your EP is one insensitive guy who probably hasn't experienced a heart out of rhythm or ectopics. You are only 7 weeks post ablation and you had a TIA shortly thereafter...no wonder you get concerned. I don't think a panic attack would raise your HR to 180 (although I am not a physician). BP up...Yes.
Anyway, I wouldn't be going crazy with exercise at 7 weeks. It took me a year to finally let go of the anxiety of afib. Be kind to yourself.
Just my 2 cents worth.
Take care
Cyndie

Laura, have you got some potassium gluconate powder [from Hans' vitamin store or wherever]? Because if you do, a useful thing to do would be to mix one teaspoonful of it with a big glass of water and drink it right down the next time you feel that tachycardia, or the next time you feel any random thumps and bumps that feel kinda like afib but maybe not quite afib yet. When i do that, the whatever-it-is goes away and is replaced by sweet NSR. Our friend and correspondent May did that recently, and here is her post about the experience:

[www.afibbers.org]

Try it, it might work for you too.

PeggyM

Laura,

Your EP is correct in saying that cardio exercise (at your target heart rate) will shift the balance of your autonomic nervous system from adrenergic towards vagal and thus hopefully help prevent episodes caused by an excess of adrenaline.

Hans

Thanks everyone for your help, I really appreciate it.

Mike: I'm going to pick up some lecithin today and we'll see if that helps.

Mary: It sounds as though you are feeling better--that's good. I have sent in the recordings to Natale's office. Apparently there have been two episodes of flutter but nothing else significant; I sent a recording when having the fast heart rate but I don't know what that showed. The only medication I'm on is warfarin, with propafenone to use as a PIP for afib, which I haven't had to use.

Cyndie and Peggy: Thanks so much. I do use the potassium gluconate and it has helped. I'm having palpitations today but just had 1100 mg of potassium in my V8 juice so I'll wait until later to take the gluconate.

I have to be honest--at this point I am really sorry I had the ablation. Before, I only had afib--very few ectopics, no flutter, not nearly as symptomatic. And now that I've "vented", one of these days I need to stop feeling so sorry for myself. You all are so kind--thanks again for listening.

Hans, thank you for taking the time to respond. I very much respect your comments and advice.

Laura

Laura

It's way too early to be sorry about your ablation, it may take as long as 3-6 months--maybe longer--for your heart to settle down. Don't be discouraged, many people have had great outcomes despite a stormy post operative period. Be sure to follow Hans' anti-inflammatory protocol and take your supplements. We're rooting for you!

Louise

Laura,
I have had similar feelings about my ablation. I think part of it is that so much of what I read was so positive, and yet I've had a pretty hard time with my recovery. After my major episode they put me back on the sotalol, with its accompanying side effects that I hate, and have scheduled a second ablation Feb. 10. I can't say that I'm looking forward to it, but having begun this journey of seeking a cure rather than control by meds, I am trying not to lose heart and to trust that I'm under the care of one of the best. The heart monitor is one of my biggest helps--if I'm unsure of what I am feeling I just go ahead and record and call it in. That's what they are there for, and I don't feel guilty about "bothering" them. Hang in there.
Mary

Laura,

How about meditation or yoga? I agree that the cumulative effect of exercise will shift the ANS to be more vagal, during exercise it is adrenergic.

I'm certainly very vagal, however one time I was scheduled for a lithotripsy in the afternoon while having a court date in a business civil trial in the morning.

Though the court proceedings only had our lawyers involved, it was very stressful time. During my pre-op at the hospital, my BP was something like 180/120. All from stress. My blood pressure today is 96/56. So certainly mental stress can have an effect.

Also, I agree that getting the electrolytes correct can help keep the ectopic count down.

George

Louise, thank you for your encouragement, it means a lot to me.

Mary, thanks for sharing your experience. Dr. Natale also told me that my procedure was more complicated than he expected and that he had to do "a lot of work". Perhaps that is why you and I have had some difficulties in recovery. And I will make better use of the heart monitor--I think I will start taking it with me when I'm out because the arrhythmias have often occurred when I'm not home. I'm sorry you have to undergo a second "procedure" and I wish you only the best. You're right, if you have to go through this, having Dr. Natale on your side is as good as it gets.

And George, I appreciate your suggestions. I go to a meditation group once a week but I need to get back to a daily practice. Before the ablation, I attended yoga class and perhaps I need to get back to that as well. Thank you, and I hope the lithotripsy was your first and last. (My husband has had kidney stones--he shudders at the mere thought of another attack.)

Laura

Hi Laura,

Actually, I had one more procedure after that. Then I asked the urologist how I could prevent kidney stones. He said, "drink lemonade." While there are data to support that answer, I thought it was a poor response. I then spent many hours at the local medical school library trying to sort it out.

The reason lemonade works is the citrate. I subsequently found that consuming potassium citrate could reduce the incidence of calcium oxalate stones by 85-95%. When I ended up with afib, and started designing my supplement program, I preferentially used potassium citrate for the potassium portion of the program. It has a dual function for me - keeps me in afib remission and keeps the stones away, too. It has been nearly 10 years since I've had a stone and my afib program has been working for 6 years. Magnesium also has a role in both afib and stone prevention.

Stone prevention comes down to urine pH and chemistry. If you can keep these in line, then the stones don't form. Staying hydrated also helps by keeping the urine dilute.

Best regards,

George

George, you are amazing. Thanks for the kidney stone education; I'm going to start my husband on potassium citrate today--just happen to have some on hand, and I'll even share some of my magnesium with him.

Laura

Laura,

I don't have the figures at hand, but I think they used something like 700 mg - 1000 mg potassium as citrate/day in the kidney stone studies (I've added the info below From Urocit-K: 540mg-1640mg).

Here is a med they prescribe: [www.urocit-k.com]
[www.urocit-k.com]

[www.missionpharmacal.com]

2 DOSAGE AND ADMINISTRATION
2.1 Dosing Instructions
Treatment with extended release potassium citrate should be added to
a regimen that limits salt intake (avoidance of foods with high salt content
and of added salt at the table) and encourages high fluid intake (urine
volume should be at least two liters per day). The objective of treatment with Urocit®-K is to provide Urocit®-K in sufficient dosage to restore normal urinary citrate (greater than 320 mg/day and as close to the normal mean of 640 mg/day as possible), and to increase urinary pH to a level of 6.0 or 7.0. Monitor serum electrolytes (sodium, potassium, chloride and carbon dioxide), serum creatinine and complete blood counts every four months and more frequently in patients with cardiac disease, renal disease or acidosis. Perform electrocardiograms periodically. Treatment should be discontinued if there is hyperkalemia, a significant rise in serum creatinine or a significant fall in blood hemocrit or hemoglobin.

Urocit®-K yellowish to tan, oral wax-matrix tablets, contain 5 mEq
(540 mg) potassium citrate, 10 mEq (1080 mg) potassium citrate and
15 mEq (1620 mg) potassium citrate each. Inactive ingredients include
carnauba wax and magnesium stearate.


Here is a Google search on the topic:
[tinyurl.com]


George