Tachycardia after ablation normal?

[melid]

I was diagnosed with Atrial Flutter on 6/25/10. I was scheduled for Cardiac Catheter Ablation on 6/29/10, however had a bad attack over the weekend and was admitted to the hospital and procedure was done on 6/28/10. I was kept for one night after the ablation and sent home with no meds per EP. First day home I had another attack of tachycardia, called EP and was advised that I could take Metropolol if I felt I needed to, but to try to avoid.  So I just layed down and fell asleep and woke up the next day and it was gone.  I was fine for the next few days and had another episode, lasted a few hours and was fine. Then on 7/6/10 had another bad attack, called EP after hours received no call back, so called paramedics. Was transported to ER, and while in route pulse rate was anywhere from 110-157 bpm. EKG's all came back showing no signs of Atrial Flutter, but tachy. My blood pressure was within normal range.  I was given Lopressor, which seemed to help.  I was admitted to hospital for 3 days.  My EP dr came next morning and said that it appears I had a good night, well of course I was given meds so I should have a good night with no episodes, and said he was discharging me again with no meds. Well later that day hospital Dr came to see me and was concerned because BP was high and had not been and pulse rate was high again.  She ran more tests, VEQ scan (check for blood clot), cardiac enzymes, thyroid, etc...all negative. She said could not go home with BP and Pulse high. She put me back on Metropolol while there and symptoms went away and blood pressure came down to normal. Next day EP Dr came in and said that I was going home with meds and to follow up with him. However he switched my meds from Metropolol to Cardizem 180mg 1xday, and said that alot of the episodes are caused by anxiety. Well they've given my Ativan in the ER and to go home with and all it does is make me sleepy, but symptoms do not subside with it.  I have been home a few days now and still have episodes, Woke up at 3:30am last night with pulse of 120-130. Took Ativan and fell asleep. Today continue to have episodes off and on.  I really don't want to see EP dr anymore as I want a second opinion, as I don't believe this is anxiety.  Is this normal to continue to have these episodes of tachycardia, granted the flutter is gone but now it just feels like my heart is pounding so hard in my chest when pulse goes up. I could just be laying there doing nothing and it will happen, I am at the point where I cannot function normally anymore and have a fear of going anywhere due to the episodes. Please help.  


This discussion is related to Severe Attach of Sinus Tachycardia Post Ablation.

[melid]

Thx Bromley.  Fortunately, I live in a pretty big city in AZ where there is no shortage of Dr's that I can try. I just need to find the right one. I was just back in the ER yesterday for a tachycardia again. I was referred to another EP Dr. that is ranked in the 10th percentile in the country and I see him on Friday. I am hoping that his new Dr will be able to help. But until then the ER Dr has me on Metropolol 50mg at night and Cardizem 180mg in the day. So I am just hoping that the combination of both meds helps relieve this tachycardia. Other than that while at the ER all vitals are normal and EKG was good. Thank you again for you advice, it is much appreciated.  

[Bromley]

Sorry to hear about this experience. I went through a similar upset after my ablation.  When things dont work out exactly the way we want on an ablation, it is easy to become very upset and worried. In my case, I was worried, and had an additional tachycardia that I needed diagnosed. The doc I had was using the same approach your appears to be using, and that just wasn't getting me where I needed to go.

I would continue to work with both doctors to understand the reasons for the differences in approach. Try to act rationally as you work through it.

I would also find an alternate local doctor for a second opinion.  This doc needs to be able to assess your situation and independently appraise you of your condition. The doc needs to listen to you and be someone that you can trust. I look for credentials and upon meeting them assess their sense of ethics, concern for people, and attention to detail. You may have other criteria.

If the doc can clear you to make a road trip of flight, you could also consider traveling to seek your medical care from someone regarded as highly qualified (if such a person is not available locally).  The cleveland clinic for instance used to offer appointments to people within one week.  If not, you might be able to get a second opinion online (the clinic also used to offer this), or plan a trip after you are fully recovered.

Don't let yourself get discouraged.  Lots of technology to fight your condition is available to you.  You are fortunate to be able to use the internet as a major source of research. Knowledge is power.  US news offers its best hosptials issue. Starting with a selection, you can go to the hospital web site and do research on the doctors affiliated. Medscape has a heart rythmn section. emedicine has a lot of info. You can search for medical books and research papers. Or just get basic information if that's all you want.  I  have also used my state's interlibrary loan program to obtain medical books normally available only in university libraries.  If you can exploit all of this, it is to your advantage, and is good practice.

regards,
bromley