Post Ablation luck running out? HELP/ADVICE

I had my 2nd ablation 3/29 (first 2012) this one redid PVI and went after Atrial Tach/Atypical Flutter. The first 5 weeks were near perfect, HR 63-70 no PVC PAC Tach Afib, now for the past 8 days except one Im getting runs of higher HR 74-80, last night I had several Tach at 90 all reg rhythm
Almost all terminate with vagal maneuver which has never worked for me. But its becoming multiple times a day. Yesterday was good all day I did drink last night 2 beers and boom tach at 90.
Through the portal my EP office says unless I get sustained over 100 they're not concerned

I have reviewed my ablation: 5 pages very tech but I get a lot. I had 121 application (burns) Aytrial Tach was terminated twice as after burn one it restarted. I know its not super fast but its the variable rates driving me crazy, Using Mag Gly and Angstom Mag, CoQ, some K and staying hydrated.

6.5 weeks now total, IM 67 fit 5'10 160

I drink some coffee every AM but use alcohol some too thinking I can get away with it.

Grasping for thoughts.
Tom in NC

I know it can be annoying, but your EP is right. There's really nothing to be concerned about and nothing to be done about it. An elevated heart rate (80s/90s) is extremely typical following ablations, but usually it just goes high and stays high rather than swinging around. In fact, it's actually a bit unusual to have a HR in the low 60s after an ablation, so what you've experienced so far isn't really the norm.

It's also possible these episodes are flutter or atrial tach, but as long as they're not over 100 and they're terminating on their own, they're nothing to be concerned about. Some episodes of flutter late in the blanking period are also common. They'll most likely just go away on their own in the coming weeks.

Are you on any meds other than an anticoagulant?

Thanks Carey. Yes 5 mg eliquis and propananol 40 mg 2 times a day. Correct its strange cause i stayed low
For 5 weeks then began periodic jumps to 73-79 and they convert
With a vagal maneuver! Just baffling and yes i think its
Atrial tach albiet low. Appreciate your thoughts! Back in 2012 my HR went up
But i had no gadget lol. I was 80 for a yr. now im like ocd ckg it

I think you're good and these episodes will subside on their own in the next few weeks. Keep us posted how it goes.

Used my Kardia this am: 114 says tachycardia my wife is in Chicago
Im
Here with our dog. I honestly dont know what to doubt

You don't need to do anything. Just keep taking the Eliquis and propranolol and call your EP if it's still going on Monday morning.

Thanks again Carey. My propananol brought it down
To low 70s but its just not perfect smooth so its not right
I think its the left atrial flutter again. 5 weeks perfect now this
Im losing hope that atypical flutter cant be cured. I love my
EP Dr Holshouser but he told me 3 yrs ago that it’s challenging
For him to say it thats saying alot imo

Quote
Poppino
Im losing hope that atypical flutter cant be cured.

Yes it can and I'm living proof. It took 7 years, 4 EPs, and 6 ablations but my atypical flutter has been completely eliminated for almost 4 years now. If I had gone to the right guy in the first place, I'm confident it would have been solved in a matter of months by 1 EP and 1 procedure, 2 at the most.

But you're jumping the gun here. Way too early to declare defeat. Would you be willing to let me see a Kardia recording of this rhythm? I'll send you my email address by PM.



Edited 1 time(s). Last edit at 05/16/2021 12:39AM by Carey.

Yes be glad to Carey

Well i converted 2 hrs ago while talking to a friend
On the phone 115 to 59 like a switch. Will see if it holds!
Duration about 30 hours

It did not hold. Lasted 2.5 hrs. Back to 120. Ill call my EP monday am
For direction. Meds ? Cardioversion? Im miserable. Since my 3/29
Ablation this is the worst ive ever been dating back to 2006

Nobody has said this on this thread, and some will debate it....but coffee and beers certainly aren't going to help your situation, and very possibly could trigger what is happening. Maybe it has nothing to do with it, but I suspect it does, at least on some level.

Yes im not very disciplined and need to change. I do so many things right but have some bad habits i hate to give up
Im in day 7. My EP nowhere to be found. Today an appt with PA! For ekg and cardioversion schedule. My tach has now morphed into more
Like afib. Still fast until i take meds
In the meantime im scheduled with Dr Natale july 7. Im not right. Im worse
Why my EP completely redid my old pvi???? 121 burns and afterwards he told me only
2 spots developed small gaps. Besides ive had almost no afib for 9 yrs

So im flying to Austin july 5. Im the most miserable ive ever been since 2006

T

You could not be in better hands. The time to start feeling miserable is after Natale is finished with you + you still have not found peace. Until then keep your chin up + count the days before July 7th/8th and do not take anything that happens from now until then too seriously.

Good luck Tom!

Quote
Poppino
Why my EP completely redid my old pvi????

T

I’m not familiar with your EP, but it may be as simple as that’s the limit of what he knows how to do. You could have new areas that are generating AF rhythms outside the PVs, in which case re-isolating the PVs won’t do anything.

You made the right choice going to Austin.