Occasional Irregular Heartbeat Post Op?

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lieb2101

I know everyone is going to tell me to contact my Dr. on this one, and I am going to, but I also wanted to see what you all had to say about it:

I'm 2.5 weeks out of surgery. Over the last couple days I've experienced an increase in the frequency of a certain irregular heartbeat. It's very difficult to explain. It feels like there is a brief pause where there should be a beat and then it returns with a heavy thump.

I've felt this before but not so often. Last night it was keeping me up and was happening maybe 2-3 times a minute then it would go away and come back randomly. I checked all my vitals, and nothing is out of place, regular BP, BPM, Temp, and SpO2. There is no pain or discomfort, it's just more annoying than anything. It feels like my heart is trying to assert control over its electrical system. I just hope this isn't a precursor to anything serious.

Anyone else ever have this or know if I should be concerned?

Thanks!
Brian
 
It sounds like extrasystolic beats (PVC's and PAC's) which generally are benign. It's still a good idea to tell your doc.
 
Of course, check with your doctor. You may wind up with a monitor overnight. They (and you) will want to make sure the misrhythm is not a dangerous one (it's probably not).

However, be aware that your heart is recovering from being cut open. It gets to have some rhythm issues for a while. It's also remodelling to a smaller size, so some temporary rhythm issues will go along with that for some months, along with temporary (and potentially wild) swings in blood pressure.

I would avoid trying to get drugs to counter benign palpitations or transient blood pressure changes in the months after heart surgery, as many of these arrhythmias are very temporary, and you can wind up taking long-term medications for a short-term problem. You also cannot know if such drugs may interfere with your body naturally regaining your heart's normal rhythm and blood pressure.

In other words, if your doctor says you need medication, that's one thing. If you ask your doctor for a prescription out of fear or impatience, that's another. Patients do pressure physicians into prescribing, even untintentionally.

Best wishes,
 
YEP, it sure sounds like either Premature Atrial Contractions (PAC's) or Premature Ventricular Contractions (PVC's). They sound and feel the same. I'm told that you can only differentiate between them with an EKG. "Regularly Irregular" is a common description.

PAC's and PVC's are the "common cold" of Cardiology.
You will know it is benign when your Cardiologist nods or yawns.

Beta Blockers can often suppress them. My cardio believes in using the Minimum Dose that gets the job done. Some Doc's like to start at the "minimum theraputic dose" which can cause lethargy and drowsiness.

If you develop a rapid irregular heartbeat, that is probably Atrial Fibrilation and needs to be treated (usually with an anticoagulant i.e. Coumadin / Warfarin) to prevent blood clots from forming.

Any / all of the above are NOT uncommon for several weeks following OHS. They usually resolve once the heart reconditions itself following surgery.

If anyone suggests taking AMIODARONE, tell them "Thanks but NO THANKS". That is the Sledge Hammer of anti-arrhythmics and has a Laundry List of Nasty Side Effects. (Do a SEARCH on VR.com or Google or read the Rx Information Sheet).

Even the manufacturers caution that Amiodarone should only be used as the drug of LAST RESORT. IMHO, too many Doc's hand it out like candy because It Works (but at what cost?). Before it works, it must saturate ALL the Cells in your body so there is a Loading Dose for 2 weeks. It takes FOREVER to eliminate it from your system after you stop (OK, months).


'AL Capshaw'
 
Yup,
They've got me on 25mg of Metoprolol every morning.
My heart rate in the morning is usually in the low 80s and will stay that way until evening. It gets up to about 100-105 when I walk @ 2mph.
However, at night it seems that my heart rate will not drop below 85 and thats when I have trouble sleeping + these premature contractions.
Does anyone take Metoprolol at night instead or in addition to the morning?
I've heard that it can limit your exercise capability so I'm really hesitant to ask for more of it...
 
I take 12½ mg in the morning and 12½ mg in the evening (the 25 mg tablets are cut in half at the pharmacy).
 
Hi Brian - Yes, of course, the disclaimer: Call your doctor.

That said, however, I've had something that I would describe the way you described what is occurring with you, and a few things came to mind including the heavy beats that seem to settle down weeks and months after valve replacement: When my heart is in sluggish shape, I have more goofy beats. So if I try to get regular exercise (and I'm no exercise fiend by any means) then my heart beats better. Also, my heart has more goofy beats if I'm really tired or exhausted; and my heart does maybe exactly what you described if I'm not drinking enough water.

Hope you're fine. Let us know what you find/figure out.
 
Oh yeah...

My heart normally sounds like a dog with a wooden leg chasing after a cat :D

Im on 1/2 a 2.5mg bicor (beta blocker) tablet a day which keeps it ticking fairly normally.

But it still goes tick tick ...... tick ..... tick tick tick .....

There isn't a regular beat in the thing unless i'm exercising then it behaves itself with a tick tick tick tick tick tick tick as expected.

I noticed mine at about 2 1/2 weeks post op also, just suddenly thought it sounded weird.....cardio/surgeon said its probably beat like that all my life but i'm only noticing it cos i have a mech valve now.

I did attempt to reduce the bicor to 1/2 a tablet every other day in preparation for a complete stop but it would get a racy heart beat on the days i didn't take the tablet...so i think i'm at a theraputic minimum dose for me.

But still, ask the doc..;)
 
The regular Metoprolol (not the extended release) is taken twice a day . I find that the evening dose is very important in keeping the heart regular and quiet during sleeping. You could always ask your doc to let you try half a dose (12.5mg) at night to start, I'm sure it would be a big help. My pills just snap in half.
 
I had the EXACT same thing after surgery, and it lasted at least a couple months. Totally benign and very common PVC's in my case. From my understanding, they are often related to the heart reshaping post-op.
 
rckrzy1 said:
This post is EXACTLY why I HIGHLY recomend cardiac rehab as they will watch your heart and most likely catch any problems.
Click to expand...

I also endorse Cardiac Rehab BUT note that most Doc's recommend waiting until 6 weeks post-op (when the sternum is fairly rigid and other early-on issues are hopefully resolved). Note that the original post by Brian was written at 2.5 weeks post-op.

'AL Capshaw'
 
Found this old thread:

Since surgery I have had a normal sinus rhythm of between 80 - 100 bpm. I woke up today and my rhythm has been off all day. It will beat normal for a few beats, then pause and beat four times with pauses between beats, then beat normal for a few, then perhaps beat twice normally, pause, twice normally, pause etc. for a few beats, then return to normal again.

Does any of this sound like anything I should be worried about or is this my heart reshaping itself?
 
brunoandbear said:
Found this old thread:

Since surgery I have had a normal sinus rhythm of between 80 - 100 bpm. I woke up today and my rhythm has been off all day. It will beat normal for a few beats, then pause and beat four times with pauses between beats, then beat normal for a few, then perhaps beat twice normally, pause, twice normally, pause etc. for a few beats, then return to normal again.

Does any of this sound like anything I should be worried about or is this my heart reshaping itself?
Click to expand...

I have had PVC's since a couple weeks after surgery, but they are getting more and more infrequent now. Last week at cardio rehab I had a bunch of them but stopped after about an hour. Now I have them mostly at night when I am laying down. The cardio tells me not to worry about them but I am wearing a heart monitor for a month to check them out. He says they should go away after a while, I am hoping they do!
 
So soon after surgery you want to call your doc just to be sure nothing "out of the ordinary" is going on.

Like the others, I still get them infrequently. Mostly when I lay down at nite.

My wife, a retired RN with no heart problems, also gets them from time to time.
 
I called the doctor on call and they said that it is probably okay, though, if my heart starts racing, I feel dizzy or my blood pressure drops, or it does it more than five times in a row then I should come in to get it checked out. I am seeing my cardiologist tomorrow so I'll see what he says about it.

It has been doing it all day since I woke up, very weird but I'm just going to try and check it tonight every hour or half hour.
 
Your Cardio will probably have you get an EKG before he comes in the exam room. Hopefully it will catch these arrhythmias so that he can identify them 'on the spot'.

The On-Call Doc gave you good guidelines. "TRY" to relax but if you develop any of those more serious symptoms you may want to get someone to take you to the ER for evaluation (and possible medication).

'AL Capshaw'
 
When mine acts ugly, I go excersise and it stops! LOL! It is bored I guess and just wants to bother me. My surgeon told me as long as it is ticking it is working, and it would out last me. But only being 2.5 weeks out of surgery I would be sitting in his office in the am tomorrow. Could just be they need to adjust your meds that is what took the longest with me. I take my topral xl in the morning with my 1/2 cafe and breakfast then drink a bottle of water, and get going. I did try and take it at night but it just did not fit me and my doctor wanted me to take it in the morning! So I minded this time! Good Luck Hang in there!
 
brunoandbear said:
Found this old thread:

Since surgery I have had a normal sinus rhythm of between 80 - 100 bpm. I woke up today and my rhythm has been off all day. It will beat normal for a few beats, then pause and beat four times with pauses between beats, then beat normal for a few, then perhaps beat twice normally, pause, twice normally, pause etc. for a few beats, then return to normal again.

Does any of this sound like anything I should be worried about or is this my heart reshaping itself?
Click to expand...

google bigeminy... http://en.wikipedia.org/wiki/Bigeminy

your particular arrhythmia would probably best be described as trigeminal or quadregiminal, but there's no wiki for that :)



Lieb, congratulations on your successful surgery! Regarding your sleeplessness and higher heart rate at night: I would consider taking the beta blocker at night to give you that extra boost to get you to sleep. It might even be prudent to talk to your doctor about taking 25mg at both AM and PM.

When I was on tenormin I could use it as an alarm clock to wake me up just by taking it exactly 12 hours before I wanted to be awake in the morning. The ternormin's efficacy would be so sharply reduced at the 12 hour mark that my heart would thump/beat fast and wake me up.

Now I take a beta blocker once daily at night that has a significantly longer half life and it generally will be comfortable for an entire 24 hours. It's name if anyone is interested is bystolic. It's very expensive compared to the generics, but the autonomy I gain from reducing the number of pills per day I take is worth it to me.
 
Forgot to mention...

CAFFEINE can be a "trigger" for arrhythmias so limit your intake of Coffee, Tea, Cokes, and CHOCOLATE (my weakness)
 
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