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What causes persistent heart palpitations with dizziness?

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Posted on Sat, 11 Nov 2017
Question: had a heart ablation 4 weeks ago. Still have daily palpitations, sitting pulse 69 standing 110 or higher depending if i move around alot. feeling dizzy. is something wrond?
doctor
Answered by Dr. Ilir Sharka (56 minutes later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome back on HCM!

Regarding your concern, I would like to explain that having palpitations and dizziness after an invasive procedure like cardiac ablation, needs a comprehensive investigation.

First it is necessary to explore your heart rhythm while on palpitations.

Not rarely palpitations are an expression of arrhythmic episodes and this could sometimes be detected by performing a resting ECG, but more frequently through ambulatory ECG monitoring (24 to 48 hours Holter).

Sometimes palpitations may be an expression of any cardiac structural abnormalities. Coming to this point a cardiac ultrasound (echo) is necessary to confirm possible previous structural abnormalities or after cardiac ablation. Sometimes cardiac ablation is associated with damages of nerve (vagus nerve), heart valves or fluid around the heart.

Palpitations and dizziness may happen also in the presence of hypovolemia (decreased blood volume like in case of dehydration) or orthostatic hypotension (excessive blood pressure value decrease when standing up from the supine of sitting position).

In addition, several other conditions may be responsible for this clinical symptomatology, like anemia, thyroid gland dysfunction or an electrolytes imbalance.

It is necessary performing:

- a complete blood count,
- thyroid hormones level,
- blood electrolytes level

Also, beta-blocker therapy when interrupted abruptly or applied intermittently even for a few days may lead to tachycardia and palpitations.

You should discuss with your doctor on the above issues!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (1 hour later)
Thank for the info. i have also just read about pots which can happen after ablation.. i know that i should be getting better but i do not feel that i am. i have dr appointment thursday with the surgeon so maybe he can help.
doctor
Answered by Dr. Ilir Sharka (18 hours later)
Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again!

I recommend discussing with your doctor on the previously mentioned options.

It is very important to clarify the exact nature of your palpitations, whether it is due to arrhythmic episodes, as that way it may be concluded with certainty about the success of ablation.

In case of any further questions, feel free to ask me again.

Wishing you good health!

Regards,

Dr. Iliri

In ca
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (1 hour later)
I have one more question. I seem to be worse than before the ablation which i know was only a month ago. When i wake up i seem to be ok for a bit but just getting out of bed and taking a shower makes my heart skip every three or four beats, It seems the more i move around the worse i am. I thought ablation was suppose to stop it from doing this. Makes me regret ever having it done. How can i trust the doctor now if this is how i will end up?
doctor
Answered by Dr. Ilir Sharka (15 hours later)
Brief Answer:
I would explain:

Detailed Answer:
Hello again, dear Victoria!

I understand it may sound discouraging feeling the same as prior to ablation.

But, you should know that depending on the reason why it was performed cardiac ablation success rate may differ from 50% to 90%.

Not rarely a second ablation would resolve the problem. But, other causes may be involved and should be sought as well (as I explained at the beginning of our thread).

So, it is necessary to conclude on the possible persistence of the same arrhythmic phenomenon in order to decide the most appropriate therapeutic strategy.

In addition, a careful discussion about medications options should be considered as it could control your palpitations and make you feel at rest.

You should ask your attending cardiologist for a new Holter (24 to 48 hours) monitoring, a cardiac ultrasound and on the above mentioned lab tests.

I remain at your disposal in case you have available medical reports of the above mentioned tests.

I would be glad to give you a second professional opinion.

Best regards,

Dr. Iliri





Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka (18 hours later)
I understand. Thank you for the info. and your time.
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

If you have any other uncertainties in the future, please feel free to ask me directly at any time!

I would be happy to answer to all of your questions!

Wishing all the best,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Ilir Sharka

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What causes persistent heart palpitations with dizziness?

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Welcome back on HCM! Regarding your concern, I would like to explain that having palpitations and dizziness after an invasive procedure like cardiac ablation, needs a comprehensive investigation. First it is necessary to explore your heart rhythm while on palpitations. Not rarely palpitations are an expression of arrhythmic episodes and this could sometimes be detected by performing a resting ECG, but more frequently through ambulatory ECG monitoring (24 to 48 hours Holter). Sometimes palpitations may be an expression of any cardiac structural abnormalities. Coming to this point a cardiac ultrasound (echo) is necessary to confirm possible previous structural abnormalities or after cardiac ablation. Sometimes cardiac ablation is associated with damages of nerve (vagus nerve), heart valves or fluid around the heart. Palpitations and dizziness may happen also in the presence of hypovolemia (decreased blood volume like in case of dehydration) or orthostatic hypotension (excessive blood pressure value decrease when standing up from the supine of sitting position). In addition, several other conditions may be responsible for this clinical symptomatology, like anemia, thyroid gland dysfunction or an electrolytes imbalance. It is necessary performing: - a complete blood count, - thyroid hormones level, - blood electrolytes level Also, beta-blocker therapy when interrupted abruptly or applied intermittently even for a few days may lead to tachycardia and palpitations. You should discuss with your doctor on the above issues! Kind regards, Dr. Iliri