Rythmol after ablation low blood pressure

Hello, I’m new. I am a 58 year old male. Exercise every day. I had my first AF episode on February 14,2018. I didn’t know what it was so didn’t go to the hospital until a few days later. I was put on Eliquis for about a month and then cardioverted successfully. I didn’t have another episode until May, 2020, then again September, 2020 and then again January, 2021. Cardioverted successfully each time. Started having noticeable ectopics at about that point. Maybe anxiety related as started to worry excessively about my heart due to what I thought was a poor echo result based on my own expertise (not very expert really). Anyway, had another AF episode in Spril, 2021. Went to hospital and was unable to be cardioverted after 3 try’s. Spent 3 days in the hospital. Finally cardioverted after 300 mg of Rythmol the night before. BTW, had another echo and apparently all is good with not structural abnormalities. Went on Rythmol 300mg twice a day but had to scale back to 150mg but still crappy side affects. Mostly dizzy. Was only on them for a few weeks as had my ablation moved up. Ablation went well. Back on Rythmol 150mg twice a day, edoxaban and proton pump inhibitor to protect my esophagus. Once home had many visual migraines ( which I am prone to), twitches in my head and face which went away. Now 3.5 weeks post ablation and having dizziness caused by I think low blood pressure. Fine lying down or sitting but drops upon standing and feel dizzy. Drops 10-30 points systolic and or 10-15 points diastolic. Not every time though but always st least a small drop. My hear rate goes from 75 to maybe 80 upon standing. Post ablation my heart rate was 80 resting. Pre ablation it was 60-65. I am dizzy when I stand up. Dizzier when I get to the top of the stairs. Not faint dizzy, but pretty dizzy. When I walk in the neighbourhood or forest my vision goes jiggly jumpy and I get dizzy when I go up hills. Flat is fine. Riding my bike is fine maybe because I’m sitting. Dizzy after I stop. Cardio capability is compromised too I guess due to Rythmol. So my question is does anyone have low blood pressure when on Rythmol or similar drug? Anybody have a faster resting heart rate after ablation? Anybody suffer from visual migraines more often after ablation? Is it really necessary to take antiarrythmia drus for 3-6 months after ablation? I am extremely anxious over all of this which likely makes matters worse. Thank you for any tips or advice or reassurance you can provide.

Fidrych,

I have kind of a simple question for you. Are are you drinking lots of water? Not sodas, etc. Sounds like you have orthostatic hypotension; blood pressure lowers upon becoming more upright. Maybe you can offset the side effect of Rythmol (hypotension) with lots of hydration - so simple, but often overlooked. Water is life indeed.

Hang in there. Stay connected. Talk to your doctors. Knowledge is power. Thanks for sharing.

Jeff

Hi Jeff. Thanks. I drink quite a lot. Never soda. Water or Gatorade. Or Milk. I’ve kind of upped my salt too. I find it unsettling due in part to Orthostatic hypotension being a otecurser to other more serious issues. But is the OH simply due to the anytyarrythmic I hope. And I will try an hydrate more to see.

Prior to my afib ablation 2012 i would use 600 mg propafanone as pip at episode onset only. It became pro arrhythmia giving me right flutter which was also ablated in 2012
After my first ablation i took nothing but warfarin which i was resistant to and after 2 weeks took nothing. After my 3/29 atypical flutter ablation i was on eliquis and 2/20 mg of propananol only. Now im scheduled for a 7/7 procedure with Dr Natale as ive had more flutter and irregularities since 3/29
Your increase in resting HR is typical I do agree with the water idea. Sounds too simple but its more critical than i ever realized. I now consume alot and the Natale group over the phone advised strongly to ! The Rythmol most likely lowering your BP and dizzyness

I had the same thing. I was told to wear DVT compression stockings and i felt way better. Drinking water is key. Stay hydrated.



Edited 1 time(s). Last edit at 06/29/2021 10:56PM by susan.d.

Hi Poppino....thanks for the response. Your having done without the AAD gives me s little confidence. My EP responded today to an email I sent him on Friday and has advised me to stop the Rythmol. As well I now have blood test, echo and stress test next Wednesday and follow up with him on August 3. I guess I’ll see how I do with the training wheels off starting tomorrow. I am new...who is this Dr Natale. He sounds like the MVP or MVEP. BTW I’m going to try and up my water and electrolytes.

Hi Susan, Thank you got the reassurance. I am very wimpy when it comes to tolerance to stimulants. Even coffee makes me too jumpy and anxious. Do you still take the Rythmol?

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Fidrych
I am new...who is this Dr Natale.

He is arguably the best ablating EP anywhere, at least in my opinion. His home base is in Austin TX USA [tcainstitute.com], though he also spends a couple of days a month at two hospitals California, one in LA and one in San Diego. He is the guy that people go to when others have been unable to fix them.

I took Tenormin (atenolol). I may go back on a small dose. My hr has been >90 and usually 104-140s walking. Pacemaker (running 98.4% of the time) is not designed to lower my hr.

Yes as George says: many like me finally realize that going to the best is really a no brainer. I just wish id done it sooner
After this 3/29 left flutter ablation i have not been the same. My EP has not one time corresponded ! Which surprises me and gives me reason for concern?
Soon ill know what my story is. 7/7
Getting to Austin is alot easier than I expected. Shannon a huge help. Do i wanna go? No but i need to. I hope you do well and resolve and you certainly may
Like Jackie said a long time ago! We re experiments of one. And its 100% true