Pulse rate high..should I be worried?

I had my ablation on Sept. 5, 2013 with Dr. Natale, and it seemed that it went very well. I have since been using the heart monitor that they send out to you afterwards, to send in recordings at least twice/week - more if there are symptoms. I've been feeling like my heart is a little "off" a number of times (especially in bed) - but the people in the monitoring session always tell me everything is fine.

When I checked my pulse this morning, it was difficult for me to get a clear reading. So I used the monitor again, once while lying down and once sitting down. Again, they said everything looked OK. I asked how my pulse rate was, and the guy said it was 103 on one reading and 115 on the other...! I'm wondering what could be causing that, and should I make a Cardio appt. or..?? I have been very stressed out over the past few months and again this week, as I have to go back for a second test on Monday to make sure what the Dr. saw was just benign...(mammography).

Any thoughts?

Barb

Hi barb. Sorry to hear about your ongoing difficulties. I also noticed my resting hr creep up but not as high as yours. I was about 20 bp over my preablation rate until my recent open heart surgery which altered things somewhat. If I were you I'd call dr Barrett right now to find out what his opinion is. He has access to the actual egg reading you sent to lifewatch. I recently had to call on him for what turned out to be flutter he could not have been more responsive and effective. Best of luck with everything. Dennis

Hi, Barb,

My experience has been similar to yours. Shannon has written about this here, and I also e-mailed him privately about this this week, since my resting heart rate has stayed in the 85-90 range since my ablation in mid-August (at St. Luke's, as with you). When I saw Dr. Danik right before Christmas he was not concerned. My heart rate in the office was 102, although he did comment that, in his experience, most people find their heart rate going down after four months or so. The difference, I think, is whether you had only a PVI or a more extensive ablation. My ablation was for persistent AF and was more extensive than a PVAI. As a result there is a good bit of healing that takes place over time. Shannon wrote to me, and has written here, I believe, that his heart rate stayed high for over a year after his index ablation, but that it did return to the normal range with time.

If the fast rate is not atrial flutter, and the LifeWatch recording would reveal this, I don't think it's anything to worry about. Of course, I'm not a doctor, and if you are concerned you should call Dr. Barrett. But if you are in NSR and the rate is 100-115, I would say that this is likely the continued healing. Mine goes higher in the evening, Shannon recommended more potassium than I was currently taking and this has helped. Also I have taken taurine out of my supplement routine until I'm a little further along because it was somewhat stimulating and I was much more aware of my heart beat, which seemed quite strong. This resided when I took taurine out of the mix.

I've also found that it takes time for my heart rate to go down after moving around. This is not uncomfortable, but prior to the ablation and when I wasn't in AF, my heart returned to the mid-60s quickly after I sat down. Again, I think this has to do with healing, and from what I've been told and have read at this site, it can take 6-9 months or longer before your heart rate finds its way back to a lower resting pulse. For some people, it may take longer than a year. We're all different in how we respond to the procedure.

If you are in NSR, I wouldn't worry about this and let some more time pass. Of course, if you have any concerns, calling Dr. Barrett is always the way to go. My comments here are simply meant to alleviate your fear that this necessarily means there is anything wrong.

Sorry about all the stress, and I hope you get an all clear with your other doc. From the experience in my family, those films often show something that is benign but requires more interpretation, etc, and we could wish for a diagnostic image that was a lot more accurate and a lot less stressful.

With best wishes,

Rob



Edited 1 time(s). Last edit at 01/08/2014 09:13PM by rob50.

thanks Dennis and Rob - I would think the LifeWatch people would have told me if they saw flutter, so I have to assume it wasn't..but will try Dr. Barrett tomorrow just to be sure. It doesn't feel like anything real noticeable...more like a faster, yet not strong, pulse rate...Just praying it IS just part of the healing process...not sure I could deal with much more in the medical area for awhile...

I appreciate you sharing that info from Shannon, Rob - I always feel better when he shares reassuring info

Best to you both ~ Barb

Also..forgot to mention that I have been cutting down my Flecainide recently too...to get myself completely off of it (as OK'd by Dr. Barrett), and I've had an upset stomach on and off for at least 4-5 days...

Just thought I'd put it all out there as any one of these could have something to do with the higher pulse rate. I did just sent in another recording from last night while lying in bed, and both readings were 108.

Barb

Hi Barb,

As we discuss on the phone Friday, as long as you are not in AFIB/Flutter I wouldn't worry about the high HR. Although Flex isn't much of a rate control drug it is possible that its influence on autonomic time could make the typical High HR after an ablation more noticeable for a period.

Just to share with others here what we discussed, a high HR post ablation is one of the real hallmarks of having had a solid ablation to begin with as its a direct indicator that at least enough solid burns were made, relative to an ablation in which there was no change in HR where its possible not enough contact force was used consistently enough to insure enough lasting transmural lesions were laid done to make a good foundation of protection.

In any event, after my extensive index ablation with Dr Natale I was in Sotalol for about 5 months after stopping the drug my HR ranged from 105 to 112 at first and slowly declined over the next 6 months or so but took a good year and a half to return approximately to my normal rate just above 60 around 62bpm on morning wake up. In my case, since I also had a pacemaker set at a minimum rate of 60, its possible my new normal resting HR could have drifted slightly lower after a year and a half post ablation were the pacer not making a floor at 60bpm.

In any event Barb, don't be concerned about the high HR unless you have a documented AFIB/Flutter reappearance once past the blanking period.

If the temporary higher HR is annoying as it very well can be at those levels, then talk to Dr Barrett, Dr Natale or your local Cardio about getting you a temporary script for a low dose beta locker like 2.5mg Bystolic or a calcium channel blocker like verapamil or Diltiazem to take either daily for some months maybe even as long as a year, if needed that long, or just as needed when the rate gets on the higher side during this gradual the adaptive phase as the hearts pacing cells lining the atrial endothelium recover their normal pacing function after do many had been zapped by the ablation burns.

This adapting process can take anywhere from as little as 4 months up to 2 years to gradually take place, though its rare to last as long as 2 years. There are some extremely rare cases of a few whose HR never make it back to their old normal range, though almost invariably their HR will also reduce considerably from their post ablation highs.

Shannon

Thanks for the reassuring words and information to clear up what has likely been going on. I haven't really found the higher pulse rate to be disturbing, other than when I lie down on my left side..and ocassionally on my back. Currently I've been taking about 12.5 mg. of Atenolol, and will jump it up to 25 or a little more mg. if it feels too fast or a bit uncomfortable. I'm not sure that some of the higher rate may have been tied to an upset stomach for about the past 5 days - which may have been tied to my nerves. Had to go back for a repeat mammography....all is OK, thankfully.

Anyway, I like hearing that a higher rate may be a good sign

I guess this all takes a lot longer to heal than we'd like to think! ~ Barb