“Ventricular Tachycardia After Aortic 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”

Ventricular Tachycardia After Heart Valve Surgery

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. (To learn more about AVR, please click here.)

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 below.

Keep on tickin!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

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  • jerry

    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.

  • Cliff

    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.

  • Rita

    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.

  • Lisa

    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.

  • Rita

    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.

  • Sandra

    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!

  • BarbaraS

    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.

  • Katie

    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!!

  • Andrew

    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)

  • Rita

    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

  • Katie

    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!

  • Amy C

    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.

  • emily

    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

  • Joseph

    Im a 64 yr old male and It’s been a month since my aortic valve replacement surgery. I’ve experienced a higher than normal pulse rate (above 100 – varies between 102 and 115). Compared to some of you who have added comments to this blog my pulse rate is low. I was put on a beta blocker but the lowest my pulse has come down is to 93. This is fast for me. I have no symptoms. My worry is that this will continue. I do drink caffeine in the morning. Will stopping caffeine altogether eliminate this symptom? My doctors noted on my discharge that this is something common with heart surgeries – “the heart doesn’t like being messed with”.

    Joe

  • Chrs

    Hi
    I had SVT last month after my mitral valve replacement surgery this past December. I strolled into my first cardio rehab session , they put the wireless EKG on me an noticed my heart beat at 165. Next thing I know, back to the cardiology group same day. They tried to get it down with meds for 2 days with no luck. Finally had a electric shock conversion on the 3rd day. I was in excellent shape prior to surgery so it was a very humbling experience as I thought I would breeze thru recovery. In hindsight, I should have had the shock treament on the day it was discovered. It is a most miserable experience to have SVT for three days. Hopefully it is all in the past.

  • Susan

    Hi, I had my aortic valve replacement in March, 2010. I also had an aortic aneurysm repaired at the same time. Two days later my heart rate jumped to over 200. They controlled it with amiodorone and lopressor at first. When it started again the meds didn’t help and I ended up with a pacemaker and the meds. I seem to be doing better now although it seems I have a fast heart rate when I wake in the mornings. I do feel better than before the surgery, but sometimes I just wonder if it is going to make a difference in the long run.

  • JACKIE

    LOOKING FOR SOMEONE WHO MIGHT HAVE EXPERIENCED A BLOCKED CIRCUMFLEX ARTERY AFTER A MITRAL VALVE REPAIR. APPARENTLY MY BROTHERS CIRCUMFLEXED ARTERY WAS CINCHED WHEN THEY WERE SEWING IN THE RING. THEY STICHED THE CIRCUMFLEX ARTERY IN 3 DIFFERENT PLACES..MY BROTHER WENT INTO V TACH IN THE OR AFTER THEY SEWED HIM UP AND AGAIN 5 DAYS LATER IN ICU…THEY THEN DID A BYPASS ON THE CIRCUMFLEX ARTERY..HIS HEART NOW IS DAMAGED. WE ARE HOPING IT REPAIRS ITSELF OVER TIME. MY BROTHER DOES NOT WANT A ICD AND HOPES NOW THAT THE CIRCUMFLEX IS REPAIRED HE WONT HAVE ANYMORE V TACH.
    WOULD LOVE ANY FEEDBACK…WE ARE PERPLEXED OVER THE WHOLE SITUATION

  • greg

    jackie my name is greg. i also had my circumflex sewed by misyake i was in recovery from mitral valve surgery. they told my wife surgery was a sucess and while in recovery i went code blue and arrested. i was taken back into surgery, chest reopened and an emergency bypass was performed bacause of the occluded circumflex. since my surgery my condition has worsened due to the damage done to heart. i was 47 at time of surgery and my life has been forever changed. and p.s. my ejection fraction is worse now than before surgery. i have a malpractice suit pending.

  • Terry Bell

    I am eleven months post mitral valve repair. Heart rate is faster than prior to surgery but has improved recently. Yesterday while walking the dogs, heart rate went to 186 and had several episodes throughout the evening. Today heart rate i high just when going from sitting to standing. Have had heart monitor study post surgery and EKGs and all are normal. My heart rate can stay over 100 bpm routinely when standing/walking/with activity as simple as standing up. I am not on any medication and do not want to take any unless docs can find something definitive. They seem to want to prescribe meds even when they do not see any abnormalities except the tachycardia. Anxiety is making things worse.

  • Michael S.

    I had MV repair on 10/6/11. All went very welll. Then 5 weeks later on 11/14/11 I experienced a VT with heart rate of 180. Went to ER and was cardo-shocked, as the drugs didnt work. My heart rate remains between 85 at rest to 105 walking etc. Was put on beta blocker, didnt help much. Fuuny thing, neither the surgen or the cardio doctors ever mentioned heart rate or VT as possible post surgery isssue. Ya think that would be something that we all would have liked to know.

  • Terry

    Hi Michael,
    I had mitral valve repair in July 2010. My hearbeat has been faster ever since. I have not been diagnosed with any VT but had episodes frequently where my heart beats between 120-140 beats just doing normal, everyday activities. It appears to be better now, and I don’t pay attention to it as much any more. I wonder if I had a rate that high before surgery and just didn’t pay attention to it. My heart rate does come down if I stop and sit for a while. I agree…it would be nice if they better prepared you for what you might expect after surgery, even as long as a year.

  • Linda Harris

    Hi,This is my question. My brother, age 72 living in Germany had his 2. heart valve replacement (cow valve). Even so that there was a tremendous amount of scar tissue stemming from a infection two years ago and blocking the valve almost completely, the surgery was quite successful other than Tachycardia with a rate of 135 and above. What should be the treatment? Should it include Oxygen continually and what kind of heart medications? Is it to early for cardioversion?

  • Michael S.

    Hi Linda. See my post above dated 11/20/11. Tomorrow I am having an EP conducted. However, since the 11/14/11 VT I have not experienced any other problems. I hope the docs find nothing tomorrow. I will post as soon as I can about the results. Anyway, you might want to ask your doc about beta blockers, they are known to help control heart rhythm issues.

  • Michael S.

    Well, I had the EP study and the ablation. Very interesting procedure. Went well and the docs found and zapped the problem area. Feel great that all is well and no need to return to the hospital. Still have an elevated heart rate, 80s to 90s most of the time. Hoping that will resolve in the near future. :)

  • Bethany

    My name is Bethany, I am 35 years old and I am a heart patient. I was born with congenital heart disease and have had three open heart surgeries, the last one at 25, a Mitral Vavle replacement. It is now 10 years later and I have been having tachycardia. The reason I am writing is because these episodes are happening any time my heart rate increases. I have been to my cardiologist twice, after going to the ER twice with a bpm of 210 & 212! I had been put on verapamil after the first time, and after the second he told me that I need to have an ablation. I was referred to see the EP the following week. He confirms that I need the procedure, however, because of my pre-existing condition, my new insurance will now pay for anything pre-existing for the first 12 months of coverage! The EP gave me a medication called Propranolol to bring down my heart rate when these episodes occur, (a band-aid for the problem). The EP will not do the surgery due to the insurance… At this point I am so frustrated, he even goes as far to tell me that the tachycardia I am having is fine and will not damage my heart! I feel this is inaccurate and I am afraid for my life! I have read that the tachycardia overtime will make me more susceptible to having a heart attack… I am married and a mother of two, I need to be here to raise my children, I don’t want them to loose me because the doctors won’t do this procedure due to money! I have been thinking of trying to get a job to help pay for some medical bills, but I cannot work! I was just outside pulling a few weeds (VERY low intensity activity) and experienced another episode. Anyway, just needed to get this off my mind and into words to someone that might understand what I am going through! Thank you

  • Matt

    Hi Everyone,

    I had a Mitral Valve repair at the end February 2012. Before surgery, my normal BP was 120/70 and my resting heart rate was 70. I am 49 and in great physical/athletic shape.

    Now, four weeks after surgery my BP is 90/50 and my heart rate is 115! My cardiologist now tells me this is common in about 50% of patients and is most likely a temporary issue. I sure hope he is right. They had me on Metoprolol (12.5mg 2 x day) for 3 weeks after surgery, but took me off last week because my BP was too low and I was having bad side effects (insomnia at night, totally wiped out during the day, no sex drive, dizzy and lightheaded, fell down a couple of times, etc.).

    Anyway, they wouldn’t let me start cardiac therapy until my HR is below 100. So, now my cardiologist is having me start 5mg of Bystolic at night to get my HR down and allow me to start cardiac therapy.

    Here’s my question: Does anyone else have experience with this? Is this really a temporary (less than a year) situation until my heart settles down? Or, is it permanent condition I am now stuck with for life? I don’t want to think that my doctors fixed one problem and then created another, which would require beta blockers for the remainder of my life. Living with those kind of side effects is not what I call quality of life.

    Thanks for any support and guidance,

    Matt

  • Chad

    I had an Aortic Valve replacement in January 12. The surgery went great and I completed 3 months of cardiac rehab. Just as life began to return to normal, I had an incident of VTACH while exercising on a treadmill at my local gym in May 12. I was in cardiac arrest and received a shock from an AED. I also Had to be cardioverted in the ambulance because my heart was beating at 280bpm. I spent a week in the ICU and now have an implanted AED. The EP study determined this was from scar tissue as a result of the surgery. It was explained to me that although this is not common, it can happen. I am 36.

  • Missy Masters

    I am 54 and had AVR on May 10th, 2 months ago. I was in the hospital for 5 days. On the 4th day, I started having A-flutter and was treated with medication – Amiodorone and Metoprolol and had to take Lovenox shots which I continued when I went home. About 2 weeks after I got home, I started paying more attention to my BP monitor which showed my heart rate as being between 125 and130 bpm and one time at 160. (I have kept track of my BP/HR since I left the hospital and I recommend this to everyone because I’m the one who caught this, not the doctor). I went to our local hospital because my surgeon had said if anything the nurses gave me on discharge papers occurred, to get to the hospital. Two weeks to the day of my AVR I was put on Coumadin Therapy and had a cardioaversion performed. This wasn’t scary at all, even though they shock your heart, you are out and there were no side effects. Unfortunately, this only lasted until June 22nd and I have had heart beats between 100 and 120. I was in my 2nd week of cardio rehab and they sent me from their gym to my cardiologist. He told me to stop rehab and referred me to an electrophysiologist who I see on Mon. July 15th. He believes I will need an EP with cardio ablation or an implant to slow the heart rate. Like another person above wrote, I don’t want to go through another procedure that’s invasive and this does sound scary. I’m going to ask about trying that other medication first Cartia XT. Maybe then I won’t need the ablation. The only other problem I’ve been having since this past Mon. is my diastolic number on my BP had been over 100 for a few days and my cardio. took me off Metoprolol and put me on Coreg. I was so hopeful the AVR would be a success and I wouldn’t have to be on Coumadin since I chose the bovine valve just for that reason and now it seems like the problems are never ending. I just want to feel better again. Will i?

  • Chad Schulman

    Dear Missy,
    I am glad that you decided to search for answers in this forum. First of all, let me give you a little background about my story. My name is Chad, and at 36 it was decided I needed a new aortic valve. I had surgery at the Mayo Clinic in January 2012. Everything went well, and by February I began cardio pt. Soon thereafter, I began to jog again and in fact hit a milestone of post surgery 5 miles in rehab. By May, I had begun to feel more comfortable with my recovery. May 7th, my wife and I were exercising at our local gym. we started with a mile jog warm-up. As I began to slow down on the treadmill, I felt a flutter in my heart. I became lightheaded and my field of vision narrowed. I try to hit stop on the treadmill but I couldn’t see it anymore. I knew I was in trouble. .. when I came too I was on my back and my wife was kneeling over me. My shirt was off and I learned quickly I had a external defib attached to my chest. Rescue got there quick and took over. I recieved a shock from the portable defib, but my heart rate was still 280. I took another to cardio vert me in the ambulance. Once in the hospital, I underwent a serires of tests including iblation. the consensus was scar tissue due to the surgery. Even through the iblation procedure, there was no guarantee. I’ve had an implantable device ever since. I’ve have to have it downloaded every six months. I have never felt it work, but it’s designed to slower my heart when it begins to beat too fast and set to deliver a shock if a dangerous rhythm is detected. I’ve had a few instances where my heart needed to be slowed but never knew it. If you are experiencing VT, you may need the implant. It will take some time to feel normal again, but you have a valuable safeguard with you at all times.

    Greg, I would like to talk to you more about your sewed circumflex. Please email me at cha7360@yahoo.com
    Thank you.

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