Going too fast

Days 90 to 91.

For my birthday, my heart decided to gift me the gift of a fast heart rhythm.

From around 7 AM on Saturday 26 August my heart rate went up from it’s regular beat to between 120 and 130 beats per minute.

I decided to have a lie down for about 30 minutes to see if that settled things down, but oi vey - to no avail. So I got on with Saturday things. I plastered a wall. I helped the husband organise the garage. I was fairly busy.

I kept an eye on the Fitbit, but not religiously. The last time I noticed a high heart rate on the watch, it didn’t align with the heart rate monitor in hospital. My thinking was: it is possibly a blip.

By the evening, it had not eased off. I knew my fate was sealed. (And I had noticed a bit of chest tightness and shallow breathing after climbing the stairs.) I made a lovely big dinner - like someone going to jail. Lemon pepper chicken, roast cauliflower with walnuts and mashed potatoes. Yum!

Hospital time

After dinner, the husband dropped me off at hospital at 7 PM. No ambulance this time. It was my first experience being admitted through the ED waiting room. It is slightly different to the ambulance experience.

I was triaged and given an ECG and a blood test for electrolytes. I went back into the waiting room. After a little wait I was admitted into ED. I was hooked up to a heart rate monitor and, well, monitored.

The registrar doctor on duty recommended an extra dose of bisoprolol to try and drop the heart rate. This didn’t seem to have any immediate effect. By 3 AM I was admitted to the cardiac ward.

On the ward

Instead of dropping my heart rate, the bisoprolol dose dropped my blood pressure. Some distressed nurses monitored my blood pressure every 30 minutes until it came back up. I also had a low body temperature.

Most of Sunday I was just monitored to see if my heart rate and blood pressure normalised. I was not given my usual bisoprolol dose with breakfast for obvious reasons.

Normally my ICD would only pace me lower at a heart rate of 170 or over. My heart rate was consistently high at 128. An ICD technician kindly came from her home late Sunday morning to use the ICD equipment to try and manually pace me out of my high heart rate. This made absolutely no difference unfortunately, and my heart stayed stubbornly high.

At around this time a theory formed that it may be an atrial induced high heart rate, instead of a long and slow ventricular rhythm.

Amiodarone

Once the bisoprolol was out of my system I was started on an Amiodarone IV drip. I had 3 IV bags over the course of a day. I finally got back into a normal sinus rhythm at around 7 pm on the Sunday night.

The after-effects of the Amiodarone IV was that my heart rate was at around 40 beats per minute for a few days.

Luckily my ICD also has a pace making capability which means my heart can't go below 40 beats a minute.