Orthostatic hypotension 3 days post ablation

I had an ablation Wednesday (28th). This was my first. EP did PVI and some flutter on backside of heart. I stayed Wednesday night in hospital and was discharged at noon. My sodium level was low at 130, but everything else fine. Retested sodium on Friday and it was 135 (my baseline). On Thursday afternoon through night felt like I was retaining water. Then during the night I must have voided 100+ oz of urine. Felt better on Friday.

Saturday morning (yesterday) went to get out of bed and was so lightheaded when standing I was starting to fall. I tried this 3 times before calling EP who sent me to ED for echo to check for fluid. Echo and CT with contrast were negative. My BP when laying is 150/100. Sitting is 88/42. Standing...not happening - I start to black out. All other labs are unremarkable. In last 14 hours, 3 liters of IV fluids and still having issues.

I am 40, former cyclist and reasonable fitness prior to Wednesday’s procedure. Diagnosed with AF 4.5 years ago. No other health issues. I’m 195cm tall. My HR now is 70 ish. Former resting HR was 40. Most night on my Oura ring would be 36-38 (this is the low, not average).

Next step is transfer back to hospital where procedure took place (2 hour drive via ambulance).

Has anyone experienced something similar or have any thoughts? Much appreciated!!

Thanks,
Greg

Have you tried going very slowly with transitioning from lying to sitting, or from sitting to standing?



Edited 1 time(s). Last edit at 05/02/2021 08:10AM by The Anti-Fib.

Yes. Same effect.

Greg,

Sorry to hear of your complications. I am hoping that time, your body's wisdom, and good doctors will surely sort this out. I wish you patience and faith on the way back to balance and understanding why.

Hang in there and keep us all posted. You are not alone...

Jeff

How much did you urinate following those 3 liters of fluids? It should have been a lot. If you didn't, you were dehydrated and still might be. Do this simple test:

1. Pinch the skin on the back of your hand.
2. Let it go.
3. It should spring back to flat and normal almost immediately. If it takes >3 seconds, you're severely dehydrated, >2 seconds moderately dehydrated, >1 second mildly dehydrated.

And is it safe to assume you haven't been taking Lasix? It's often given after ablations to get rid of excess fluid because they typically infuse quite a bit of fluid during the procedure.

Good advice about the pinching. Thanks for sharing. Very useful.

Hi Greg. How’s the OH going? Did it resolve? We’re you on an anti arrythmic at that time? Are you now? I had my Pv ablation on June 4 . I’m on Rythmol. I am 58 and like to bike, hike and push my cardio. I have dizzyness when I stand. Dizziness and fluttery vision when I hike up a hill. My lying BP Is generally 130/85. Sitting. 110/70. Standing 82/58. Freaking me out. Maybe just the medication??? What do you think?