AFib Ablation and Heart Rate Variability

Hi, first post and I look forward to contributing and learning

Background: 42 years old, athletic and in good shape, diagnosed with paroxysmal AFib and underwent an ablation last august. Thankfully have been incident-free since

Situation: Heart Rate Variability (HRV) is strongly linked to all cause mortality. All things equal, the higher the number, the better. I used to wear a Fitbit pre AFib and recently dusted it off and started using it again. Reviewing the historic data, my pre ablation HRV was consistently in the 70’s, month in month out. Now, after 6 weeks of data, it’s ranging between 10-12ms, which is horrible.

Question: Has anyone else had a marked reduction in HRV post ablation, and did it ever go back to normal? The fact that I’m
a year in makes me concerned, as all the data I’ve seen on this subject indicates it’s a transient phenomenon that resolves after a few weeks



Edited 1 time(s). Last edit at 08/06/2023 01:28PM by Johnnytiger.

Quote
Johnnytiger
Situation: Heart Rate Variability (HRV) is strongly linked to all cause mortality. All things equal, the higher the number, the better. I used to wear a Fitbit pre AFib and recently dusted it off and started using it again. Reviewing the historic data, my pre ablation HRV was consistently in the 70’s, month in month out. Now, after 6 weeks of data, it’s ranging between 10-12ms, which is horrible.

Question: Has anyone else had a marked reduction in HRV post ablation, and did it ever go back to normal? The fact that I’m
a year in makes me concerned, as all the data I’ve seen on this subject indicates it’s a transient phenomenon that resolves after a few weeks

Another real possibility is that your Fitbit is not giving accurate readings. I also have a Fitbit and sometime this past Spring is stopped giving accurate HR readings—maybe they changed their algorithm?

Are you on any meds? If so, what are they?

When I had afib my HRV was awesome. Think about it.... heart rate variability. Very variable in AF. Verified very variable.

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Johnnytiger
Reviewing the historic data, my pre ablation HRV was consistently in the 70’s, month in month out.

Per Pavan's point, were you having any afib or ectopics pre ablation? It doesn't take many ectopics to skew the data.

I’m one month post ablation, fortunately Afib free. My one month average HRV is 20 and one year average HRV is 40. My HRV shot up to 150 when I was in Afib prior to ablation, contributed to higher yearly average of HRV.

I should have prefaced everyone, the “before” readings were pre AFib and pre ablation. No symptoms whatsoever

The Fitbit itself works fine. Resting HR, active HR, Sp02, estimated VO2 max, etc are all accurate

I would guess you had some ectopics that made your HRV look good but not enough to show up as AF. When I look back after knowing I had AF, I believe there were signs that I ignored or discounted for 5+ years before I had a diagnosis.

Are you on any meds and if so what are they?

Nope, nothing. I was on Flecainide pre-ablation

I’m 7 months post op from a Natale ablation and my heart rate is 20 beats higher and my HRV is running 10-20. When I look at the charts of my HRV pre ablation it was running 40-70 and that was with AFib. So whatever burning they do has to cause some issues for HRV. I wear an Apple watch and a WHOOP and they are both consistent. It does cause me concern especially with the latest research on HRV. I know Dr Peter Attia talks about it frequently.

Before my first ablation, when in persistent afib my HRV on the Apple Watch was 140-150. Then right after the ablation it dropped to an average of 10, where it stayed for about six months. I started to have some episodes of flutter and tachycardia and each time the HRV would go up again. It did level off again after second ablation in May, and has remained at an average between 10-15.

~ Linda

My index ablation was done by Natale on June 14 and my HRV is down in the toilet. My nightly readings from my fitbit range between 9 and 12. Heart rate is about 10 bpm higher than before. Still fairly early in the blanking period though, but I'd like to see some improvement.

"Pulmonary vein isolation results in significant sustained changes in the heart rate parameters related to autonomic function. These changes are correlated with procedural outcome and are independent of the ablation technology used."

"Atrial fibrillation ablation is associated with a significant increase in daytime and nighttime heart rates and significant decreases in heart rate variability (measured as SD of average normal‐to‐normal intervals); these changes were dynamic over the first 3 months and persisted for >1‐year post‐ablation."

Autonomic Alterations After Pulmonary Vein Isolation in the CIRCA‐DOSE (Cryoballoon vs Irrigated Radiofrequency Catheter Ablation) Study

I (foolishly) stopped taking Taurine and other heart supportive supplements after my Jan 2023 ablation and Feb 2023 cardioversion--both by Natale. Mid November I got COVID and my heart rate went up 20 bpm average. I am taking Eliquis 5 mg daily plus Mg and K. Boosting the K to 20 MEQ (Rx) twice daily decreased Afib episodes before COVID. "Recovery" took 3 weeks. I use the quotes because I don't feel recovered. My AW9 and Welltory app show my HR has gone down 10 bpm to 93 bpm but my HRV has dropped from 42 average to less than 5 recently (same timeframe as re-starting Taurine). Interestingly, my AFib average has dropped from mid-20% to 2% since re-starting Taurine on Dec 20. Tonight Welltory shows HRV = 1. If HRV is correlated to all-cause mortality, does that say I could die in my sleep when my numbers are at their worst? Or, just that HRV is not currently useful for me?