What can be the name of this problem?

[nagylottii]

Thank You for reading my question! I am a 27 years old woman. I had an ablation because of WPW 1,5 years ago. I had episodes because of WPW, but I was able to run (5-10k) without any problem. After the ablation this WPW was gone, but I was weak and I was hardly able to even walk. This weakness remained. I had bradycardia ever since I can remember, my resting heart rate is about 49-55 BPM. After the ablation it elevated to 75 (OK, it is good) during the day, but during sleep it went back to 45-55 as before. During walking, it elevated to 160 BPM and during running, it elevated over 190 BPM immediately. I had some orthostatic problems too, I had severe chest pain continuously and had leg odema. My doctor said, I have exercise intolerance (I had stress test), but there is no arrhythmia or problem in the ecg, as my heart accelerates, it makes perfect synus rythm, so he thought that there is something in the background. He and his colleagues examined everything (hormones, autoimmune diseases, thyroid,... really everything... I had CT, ultrasound everywhere in my body)  but found nothing. At the end of this search for another reason, my doctor said that we can try ivabradine. Beta blockers are not safe for me because of my bradycardia, so this medicine remaines. And it helped so much! My leg odema is gone, my resting heart rate is now 49-55 again (it is ok for me) and I can walk with 120 BMP and even run a 5k around 165-170 BPM with a 175 maximum. My chest pain passed slowly, now it is a very rare symptom. I take only a half of a normal dose, 2x2,5mg and it is enough to have a normal life and not harm my resting heart rate. I never noticed before, that I had so bad short of breath. Now it is like the air would be cleaner and it feels like mountain air (it is funny, but after the first few pills it was so good to breath.)
My question is: my doctor never name my problem. What can it be? It looks like an inappropriate synus tachycardia, but my resting heart rate is too slow for that diagnose. It would not change everything, I take my pills and live the same life, but I am curious, what do you think? I live in a small country in Europe with no dysautonomia center or even a specialist, I have a different diagnose on my paper, because I can only get this medicine if there is written, that I have angina (stupid rules), but I have not.
Thank You for your answer!

[itdood]

It sounds like it fits "dysautonomia".  That's a very broad category.   It takes a lot of work to test and treat it.   I'm not aware of any cures for it.  You have to find the therapy that works, it's an ongoing issue.

[MichelleP_3811]

Well you did mention that you had chest pain so that may be why they diagnosed angina.  I am not really sure you will get an answer unfortunately.  It could be that your heart needs to adjust to a new normal.  I know for me I had a normally high heart rate partly because of have frequent svt episodes.  I had avnrt not wpw.  My heart rate was generally elevated for a good 3 months post ablation but went down after that.  My resting rate went slowly down from there and it took a while to adjust and I would feel mild chest pain as it got use to the new normal.  It is possible some nerve fibers were damaged a bit from the ablation and things will settle down but good to hear that your heart rate is well managed now.  Exercising may help build up its tolerance back up as well. Well hope you continue to feel fine. Take care.