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Low bp and resting heart rate after catheter ablation
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Buckeyemichael posted:
I am a 45 year old male with a pacemaker due to syncope caused by sudden heart rate and bp drops. I also have a right bundle branch block and slight right side enlargement. Recently I had 2 catheter ablations due to frequent pvc's and nonsustained v-tach. Before the 2nd ablation, my resting heart rate was 95 to 105 bpm and my bp was too high. Now, my resting heart is 70 to 75 bpm and my bp is averaging 95 over 65. I am not on any beta blockers or heart medications. Are these lower readings due to the ablations? I noticed the pvc's have returned, but they are not as frequent. Thanks.
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cardiostarusa1 responded:
Hi:

"Are these lower readings due to the ablations?"

It's possible (in fact, anything medical seemingly is today), mainly dependent on the area(s) that were ablated. Also, enlargement (dilation) of the heart (right or left side, any degree) as well as any chambers, and/or an electrical conduction abnormality may/can factor in as well.

Bradycardia (slow heartbeat) is defined as being under 60 beats per minute and hypotension (low blood pressure) is defined as being under 90/60.

Bradycardia and/or hypotension are ok, that is, unless it causes concerning symptoms such as lightheadedness or dizziness, confusion, weakness and syncope (a temporary loss of consciousness, which includes fainting and passing out). For some, having both can be a "double-whammy" so-to-speak.

Sometimes, changes in lifestyle, health, side effects from prescription drugs, or changes in metabolism can cause the blood pressure (BP) to become consistently higher or lower than normal, or spike up and then drop down.

Compensatory mechanisms that control BP involves changing the diameter of veins and small arteries (arterioles), the amount of blood pumped out from the heart per minute (cardiac output), and the volume of blood in the vessels.

"I noticed the pvcs have returned, but they are not as frequent."

The heart really doesn't like being poked, prodded, or touched in any way, shape, or form at all, and can obviously be somewhat irritated after an ablation procedure (first time or redo) and can let the patient know by way of palpitations (such as premature ventricular contractions, PVCs), which typically resolve in a reasonable period of time.

Especially with improving older standard radiofrequency energy (heat-based) technology, as well as newer technology cryoenergy/freezing, and high-intensity focused ultrasound, if/when performed by a highly-skilled doctor (IC/EP), via standard endocardial or transthoracic epidcardial, and done correctly (no culprit areas, pathways are missed, no normal areas are damaged or disrupted, the culprit tissue is ablated deep enough), a catheter ablation procedure should completely (100%) eliminate one's particular arrhythmia for good.

Noteworthy though, according to medical literature, approximately under 10% of the time, an arrhythmia may recur (at any time) even after what was thought as being an initially successful (single site or multiple sites mapped and treated accordingly) catheter ablation.

This occurs because the abnormal heart cells or electrical pathway responsible for the arrhythmia was damaged, but not 100% therapeutically destroyed by the procedure. As this area heals, the original arrhythmia may reccur. Also, an ablation procedure may/can lead to the occurrence of a totally different type of arrhythmia, sometimes making pacemaker implantation (which you mentioned you already have) necessary.

Best of luck down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)

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