Post Ablation Heart Itregularities

Hello, 58 year old male.....just back at the gym as they just opened yesterday here in Ontario, Canada. This has been an issue working out at home and now the bike and treadmill at the gym are saying the same thing. My ablation was 6 weeks ago. My heart is resting at 80, higher than preablation 65. I have asked questions about that previously and was graciously answered by you. My heart rate is not going up to where it did prior to ablation. And have done a lot of walking, hiking, and ok’ing so reconditioning shouldn’t play too much of a role. It would be backwards anyway as my heart isn’t going up orderly. It will only go up to 124 at a good clip where it would have been 130 before ablation. Then it won’t come down when I stop. After five minutes it’s back to 100 or so. I notice the heart rate monitor go down a beat or two but that I believe is a skipped beat as it comes back up the missed beat or two moments later. So my heart doesn’t adjust well it seems to me. Any ideas? Is this something I should go to the hospital about or just wait till my holter next week and EP appointment in 2 weeks. This is causing my anxious mind to ache. Thanks!

It's all perfectly normal following an ablation and you definitely don't need to go to a hospital. Your resting heart rate will be elevated for months, possibly upwards of a year. And for the next few weeks or possibly months it may be more reactive to exercise, or less reactive. And are you taking a beta blocker or diltiazem? If so, those will lower your heart rate and even put a cap on it. For example, I could never get my heart rate above 105 no matter what I did when I was taking metoprolol. Remember, your heart has undergone trauma, and so it's irritated and reactive. This will pass with time.

So there's absolutely nothing here to worry about. You can ask your EP at your follow-up, but I'm pretty sure you're going to hear the same thing.

Hi Carey....I am not on any meds except for a blood thinner. I have been on bisoprolol a few years ago and yes my heart rate was hard to get over 105. And that was a very very small dose. (1.25). So, just to reiterate my inability to get up to what I think should be my max workable heart rate (130) is not tremendously unusual considering the ablation? What worries me even more is that my heart rate doesn’t drop back down after I stop biking. My heart rate at the end is 124. After 1 minute it is still probably 124 and 2 minutes 120 and three minutes maybe 110and 100 after 5 minutes. I try to figure it out and wonder if because my new resting heart rate is higher (80) and I can only get my rate up to 124 there isn’t much room to drop ( like a person with a RHR of 60 and a Max of say 150. 124 isn’t horrible for my age I guess. It’s 78% of my max. I could prob push it a few beats faster if I wanted to really be uncomfortable (and risk death🥴). But why doesnt it go down? It makes me think I have a neurological problem where my para and sympathetic systems aren’t working right. And then the diseases that come with that. Thing is I can move pretty good. Did a 2 hour job walk through hilly forest trails last night and lived!? Thank you for your insiights. They are very much appreciated!

None of this should concern you. I seriously doubt you have any sort of neurological problem, and there's no risk to pushing yourself harder. Go ahead and do it. The sooner you do normal things, the sooner everything gets back to normal. I once did a 50-mile bike ride in hilly terrain 3 days after an ablation. (Yes, with the EP's blessing.)

Your heart rate and how it behaves will slowly return to normal over the coming months as your heart heals and the irritation subsides.

Thanks!!!!!!!!