“Ventricular Tachycardia After Heart Valve Replacement Surgery?” Asks Rita
Together, as patients and caregivers, we’ve learned that the human heart can do some odd things after valve repair and valve replacement surgery. In particular, the heart can pound a little louder, the heart can beat a little faster and, if you received a mechanical valve replacement, the heart might make a clicking noise.
That said, I just received an interesting question from Rita specific to very fast heart rates after heart valve surgery.
She writes, “Hi Adam - I have a question. Has anyone had ventricular tachycardia after mitral valve replacement. For ten months, I’ve been telling the doctors about the episodes I’m having. Finally, an episode was caught on EKG while I was on treadmill. They are now going to do an EP study and possible ablation. The doctors are looking for scarring among other things. Plus, the doctors may also look to see if anything is genetic. The VTAC episodes are really scary to say the least. Have any patients on your awesome blog experienced this? I would love to hear the outcome. I had atrial fibrillation after surgery. Now, I am wondering if it was VTAC the whole time? Thanks, Rita”
For those of you who are unfamiliar with the term, ventricular tachycardia is a fast heart rate (usually over 100 beats per minute) caused most often by disease or injury, according to the American Heart Association. It can also be part of a normal response to increased activity or oxygen demands. The average heart beats between 60 and 100 times per minute. When the tachycardia is due to disease or injury, it usually requires treatment. Tachycardias may begin in the upper chambers of the heart (the atria) or the lower chambers of the heart (the ventricles). Some are harmless, but others are life threatening.
So you know, I did not experience any form of ventricular tachycardia (also known as VTAC) during my recovery from aortic valve replacement.
As for research about VTAC and mitral valve replacement, I just spent some time looking through online medical journals. Unfortunately, I found very few studies which correlated ventricular tachycardia directly to heart valve replacement surgery.
However, in New Onset Of Sustained Ventricular Tachycardia After Cardiac Surgery, a study which reviewed VTAC and coronary artery bypass graft surgery (CABG), the medical team concluded, “The first presentation of sustained monomorphic VT in the recovery period after CABG is uncommon, but the incidence is high in specific clinical subsets.” So, it appears there is some connection to heart surgery - but, nothing specific to mitral valve replacement.
With that… I will turn it over to the former heart valve surgery patients regularly visit this blog. Can you help Rita? Did you experience any form of VTAC after surgery? If so, please leave a comment by clicking here.
Keep on tickin!
About The Author: Adam Pick is a double, heart valve surgery patient and author of The Patient’s Guide To Heart Valve Surgery. This unique book integrates the clinical facts of heart valve surgery with the personal experiences of 78 former valve surgery patients to help patients and caregivers better understand the problems, the opportunities and the realities of heart valve surgery. To learn more about Adam and his heart valve surgery book, click here.
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August 27th, 2009 at 8:59 am
VT? Hmmmm.
I had an SVT - supraventricular tachycardia. It may have been caffeine related.
I had the Ross procedure done, and then about 5 months later, I was working out on a treadmill one morning, got off, had probably a bit more coffee than usual, and drove to work.
Went to a local store to pickup some lunch, left the store, sat in my car, and suddenly I realized my heart was trying to leap out of my chest. I have a strapless heart monitor watch, and it was reading 200bpm. Rather scary.
I waited a few minutes and my heart rate wouldn’t drop. So I called 911. Also told the folks in the store about what was going on and asked a manager to stay with me in case I passed out.
Eventually in the ER, my heart was rebooted with adenosine, and since then, I have tried to keep the caffeine levels a bit lower.
Overall, really scary.
August 27th, 2009 at 10:10 am
Dear Rita, I had VT develop 2 days after discharge, which was 9 days after mitral valve repair surgery. Rate was 120 to 108 bpm. Whent down after about 3 weeks on beta blocker meds. Seemed to appear after most of the excess fluid had drained from my body. Surgeon did not know why it happened, and he was not concerned.
August 27th, 2009 at 2:24 pm
Well I’ve recently had my EP study and spent 8 days in hospital to try anti arthymic drugs. The EP study was not successful for an ablation since my VTAC is NOT sustainable. I go into VTAC within 4 mins on a treadmill stress test every time. When in hospital they tried 3 different drugs and I had allergic reaction to all so now just waiting to see allergist but they have me on Bystolic which cuts the adrenaline in my body which lowers the pulse and B/P. My VTAC is only set off on exertion like climbing a hill/incline or stairs or like the stress test.
August 27th, 2009 at 4:26 pm
I just finished with a 48 hour holter monitior today, so I do not yet know if or what arrhythmias are present. But, I have had problems with high heart rates and palpations since my mitral valve repair surgery in Dec 2008. My cardiologists said that atrial arrhythmias are the most common after mitral valve surgery because of the scar tissue that is formed where surgeons enter the heart to perform the fix. The scar tissue can then interfere with the electrical pathway in the heart. I am due to see an EP in the next couple of weeks.
I would guess Rita was not treated for A fib when V tach was involved, they look very different on an EKG, sometimes one arrhythmia can cover up another though. They are likely separate issues. ( I am an RN so I see EKG strips on a regular basis). This is just a guess on my part, please consult your cardiologists with treatment questions.
I will update as I know more and will be interested in following this story as I am hearing more now about heart surgery patients encountering these problems post op. All of this is scary to go through, and I do not think we are adequately prepared that these things can happen after surgery.
August 28th, 2009 at 8:06 am
Hi Lisa
Thanks for the info. Yes I was treated after surgery for the Afib - 3 months on amiodarone which they now say is why my thyroid is so out of balance after 29 years of being okay on synthroid. The amiodaraone has a very high levelof iodine in it.
I know what you mean about they look very different - my EKG looks like a child scribbled on a piece of paper.
I will be interested to see your results. When I wore my monitor nothing showed because I had not done an incline that day nor the treadmill. I rode my bike for 8 miles and that does not set off my vtac - go figure.
August 28th, 2009 at 12:07 pm
Rita,
I had mitral valve repair and atrial/septal aneurysm repair in July 2008. I was in hospital for one week after the surgery and the day after I was home I experienced a very rapid heart rate (180 bpm) as I was sitting in a chair. I went back to the hospital and was given adenosine via intravenous as the heart rate would not come down. When it did, I went back home and had to return later that night because it happened again and would not stop. I was told it was ventricular tachycardia. This time I was re-admitted and experienced atrial fibrillation along with the ventricular tachycardia and was put on anti-arrhythmia medication and coumadin. It took them a couple of days to figure out which type of arrhythmia it was and I was told not to move around too much and pretty much sat around. Things seemed to settle after a month or so and I would experience the odd episode maybe once per week. I finally opted to have a cardiac ablation in January 2009 and have not had any problems since. I found this scarier than the actual surgery because you finally feel better and think everything is okay and wham. I was told that this is not uncommon after heart surgery but I only wish I would have known that this was a possibility. All I could think while it was happening is all that work my surgeon did is all for naught because you feel like your heart is pounding right out of your chest and it must be damaging your heart. I opted for the ablation as I am not crazy about being on drugs and I was able to come off everything except for 25mg of Ramipril. I hope things settle for you. Good Luck!
August 29th, 2009 at 2:26 pm
I experienced ventricular tachycardia five days after a mitral valve repair(Thank God I was still in the hospital). The doctors stated that sometimes this occurs because the heart was tampered with. They were able to slow in down thru an injection. Upon reaching home I experienced another attack possibley 15 days after surgery, rushed to the hospital and again the heart was slowed down by injection. This was 8 1/2 years ago. Meanwhile I’ve had no more attacks until 2 years ago when I was on the treadmill at the doctors office, he gave me oral medication to slow it down at that time. So all in all in 8 1/2 years I had three attacks.
Prior to surgery I’ve had many attacks. However, I believe it is because I’m a highly nervous person which irritates the heart and produces a fast heart beat.
However, I thank God for life and I definitely feel much better and more energetic.
August 30th, 2009 at 2:40 pm
Hi Rita,
I was very interested to read your blog. I had a Mitral valve repair 2 and a half years ago and so far this year I have had two EP studies and ablations and I am due another. I wasn’t aware that this could be a result of the open heart surgery and at my 6 months check I mentioned that I get a few palpitations- my cardiologist wasn’t concerned as he though it was the heart settling down. A year later I mentioned it to the nurse at the GPs surgery and she told me to contact him again, that was a year ago. Since then I have been on a variety of drugs and worn various monitors all resulting in the ablations. They struggled to identify the VT and they thought that it could possibly be AF due to the speed my heart goes during the palpitations. The most recent monitor identified a different type of VT which is what I now need treating. The first VT that they identified was the same as what you are describing- exercise related particularly where inclines were involved. This is one that my cardiologist thinks he has dealt with and I am now free to exercise relatively normally! I am hoping that this will be my last hospital visit and all will be sorted this time so I can get on with life!
Good luck!!
August 30th, 2009 at 4:31 pm
Dear Rita
I had an aortic valve replacement in July 08 and my heart fibrillated for a week after. In fact I was a couple of hours away from a cardioversion when the heart went back to normal rhythm.
This May when I visited the gym after a mild viral infection my heart rate went straight up to 160 whilst I was walking (warming up) on the treadmill, apparently it is quite common after an infection. Up until then I had been able to jog at 8.5 Km/hr for 5 - 10 min and the rate would plateau at around 130 -135. However, I have had 3 further instances since, the last one today on the treadmill at the end of a gym session (incline 10% and 5.5 Km/hr so not particilarly strenuous).
The heart always goes back to normal fairly quickly although it is quite sensitive for a short time (15-30 min) and can go into tachycardia again quite easily even if I am only walking.
Tachycardia always occurs on the treadmill and I have not experienced it on the rower or bike (maybe they are less strenuous).
After the first two events the cardiologist was not concerned and suggested not wearing the monitor, but I find it very disconcerting when it happens so I am considering asking my GP for another referral.
Good luck Rita!
(Many thanks for the blog Adam, it has been an excellent source of information for me whilst I have been recovering)
August 30th, 2009 at 9:00 pm
Hi Andrew
I agree on another cardiologist. Sounds like me - only on treadmill or incline and then it stops quickly as well which I know I am grateful for.
Also Katie - you mention a different type of VT - what type would that be?
Thank you all for all these responses. It’s always nice to know you aren’t alone in this.
Adam I would be lost without this site the last 6 months or so. Thank you for all you do
August 31st, 2009 at 2:01 pm
Hi Rita
I have had to look at my cardiologists letters so that I can get the terms correct. The first ablation I had treated was CTI-dependent, having had the ablation the palpitations continued and it was found during a second EP a gap had been left in the circuit which he then dealt with. Now they have identified AVRNT which is what I now need treated. I am unsure of the difference between the two however if you google these terms some information is there. I hope that this helps and that your palpitations get dealt with quickly!!
Good Luck!
September 1st, 2009 at 8:36 pm
Hi. I have had episodes of SVT for 25 years (I’m 41), and it was what got me referred to the cardiologist last fall. The cardiologist did an echocardiogram, and I was discovered to have a 9.2 cm thoracic aortic aneurysm. Three days later I had AVR (mechanical) and aortic root repair. I had episodes of SVT (200 bpm) twice in three weeks following my surgery. After trying metoprolol and amiodarone — both made me super-fatigued — my electro-physiologist prescribed Cartia XT, a calcium channel blocker. I have had been SVT-free for nine months, save for one short episode this summer. I would recommend finding a curious electro-physiologist, and seeing if it can be managed with medication. I just wasn’t up to another invasive procedure following OHS. Hope this information is helpful.
September 7th, 2009 at 5:55 pm
hi there, my dad is an 80 year old aortic valve replacement patient. He had his op at the beginning of June this year, and although the operation went really well he suffered an episode of atrial fibrillation a week after his surgery. This resulted in him having a pacemaker fitted (and his sutures repaired after the cpr), and slowed his recovery. He has made really good progress but his heart rate is running a little too high, and he suffers morning episodes of faintness often followed by a higher heart rate (122 + bpm).
The medical exploration centres round his medication - additional beta blockers,balanced with Warfarin, although I am concerned about his blood pressue lowering - and possibly a procedure to try and reset the tachycardia.
Again, I wondered if anyone else had had experience of overcoming this rapid heart rate. I’m sure it is worse as he suffers anxiety with the raised rate, and he is working on controlling it. For now he has been readmitted to hospital for a couple of days observation. Thoughts welcome.
Emily