fast heart rate 1+ year after the AF/ AFL ablation

I had the cryogenic PVI ablation of AFib and CTI radiofrequency ablation of atrial flutter over a year ago. These two ablations were done in one procedure. Currently, my resting heart rate during the day is about 90. According to the article below, this is a good sign for ablation success. Indeed, I'm afib free now and not taking any medication. But sometimes I do feel lowered exercise capacity and a little chest discomfort from fast heart beating, especially after bulky meal, or walking upstairs, or low sugar. I just wonder when my heart rate could drop to my normal 60s before the Afib, or anything I can do to expedite the recovery of heart beating rate. Did anyone have the same experience and how long did it take for the heart rate to come down? Thank you!

Prognosis of high sinus heart rate after catheter ablation for atrial fibrillation, Europace (2017) 19, 1132–1139, doi:10.1093/europace/euw142
[pubmed.ncbi.nlm.nih.gov]

About a year for me, but I know an individual or two who took much longer. But what makes you sure the lowered exercise capacity and chest discomfort are caused by the rapid heartbeat? I'd book an appointment with a cardiologist to get that chest discomfort checked out. Chest discomfort is never normal.

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Carey
About a year for me, but I know an individual or two who took much longer. But what makes you sure the lowered exercise capacity and chest discomfort are caused by the rapid heartbeat? I'd book an appointment with a cardiologist to get that chest discomfort checked out. Chest discomfort is never normal.

that's nice to have a recovery in a year or so. My ecg, echo and blood work all look normal, and I can feel somewhat discomfort when my heart beats faster. I don't think I need beta-blocker, but wonder how people could go back to normal exercise level in a few weeks or months after the ablation. Thank you for sharing your experience and thoughts.

Don't let the elevated resting heart rate deter you from normal exercise. There's no reason why an ablation should deter you from normal exercise for weeks or months. I never went more than a few days and I know many others who experienced the same.

I'm not sure exactly what you mean by "chest discomfort." Does that mean pain or a sensation of pressure? If so, I would again recommend seeing a cardiologist and asking if a stress test or even an angiogram would be appropriate. Whatever it is, if that discomfort is sufficient to make you unable to exercise at normal levels then that's not likely to be caused by the ablation.

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Afibber20
that's nice to have a recovery in a year or so. My ecg, echo and blood work all look normal, and I can feel somewhat discomfort when my heart beats faster. I don't think I need beta-blocker, but wonder how people could go back to normal exercise level in a few weeks or months after the ablation. Thank you for sharing your experience and thoughts.

I am a few months out from my ablation and yes, my heart rate is elevated to about 85 at rest. But I have no problem with exercising at pre-ablation levels. Yes, my HR goes up to about 125 or so, but it doesn’t bother me. However, in the first few weeks after my ablation I had what I could call mild chest pain on exertion—it seemed to be related to inflammation from the lesions as my ablation was extensive. This passed in a few weeks though.

I do have a weird sensation in my left chest sidewall when something, in quotes, is going on. Not just the vibration or twitching that some feel with AF, but a 1/10 pain and a 'fullness' concomitantly. This was going on early in my recurrent phase after a first ablation eight months ago, and I had three or four instances of it post-ablation in the past three weeks. However, my heart, like yours, appears to stay in NSR. And, happily, I haven't had one of those almost horrible sensations in about a week.

Slowly, and more assuredly with time, I am feeling better and more confident. I think, and hope, that you should be in the same boat by now. I keep reading posts by people who are experiencing what they feel are unsettling high HR post-ablation, and the advice is always the same. If no AF is indicated, if NSR is strong and reliable, then your heart is doing what it must to respond to its current electrical stimulation, and only with the appropriate feedback mechanisms already in place and working to keep you in equilibrium.

I would go easy on the heart for the first several months, and as a guide for a heart dealing with a spell of AF and then tissue damage during ablation, I would use 200- (my age) = Exercise heart rate sustained. Later, if your heart rate upon waking (especially) is in the 75-80 range in the next months, you should be hopeful and encouraged, and you could probably safely use the more conventional 220- (my age).*

*This assumes that your heart was in good order prior to ablation. No ischemic disease, no previous infarctions, and you were already in good physical condition with a history of fitness training. Those who have led a sedentary existence, who have ischemia, or previous (and recent) infarcts should be careful and consult their physician about how much to do, and how hard to do it.

Thank you all very much for the advice. I did some strength workout on my upper body in the past, maybe that caused muscle skeletal strain in the chest. I probably should take it slow on the aerobic exercise and have some patience to see how it does to my heart rate.

If the pain is of musculoskeletal origin, you should be able to affect it with movement or pressing on painful areas. For example, stretching your arms out wide and as far back as you can. Does that provoke the pain or affect it in any way? If so, yeah, it's probably muscles or tendons hurting. But if it doesn't, it's not muscles and tendons and needs to be looked at.