Beta blocker necessary?

[Kgkgkg13]

I am on pradaxa and metaprolol half of 25 MGM twice a day. I have not taken the beta blocker for 3 days because I am out of town and forgot to take it with me and local pharmacy had trouble getting it. Anyhow after missing 3 days worth I think I feel better without it. I have no symptoms with my af and I think the beta blocker slows me down. I hate to not follow doctor orders but I am a nurse and know my own body and doctors don't talk to you enough and are very hard to get hold of. I am not scheduled to see doctor til February. I understand that this drug is taken to reduce heart rate and most always my heart rate is regular and usually around 78 which it is now. Also does anyone else know if norteiptyline 20 MGM which I take for migraines can cause arrhythmia. Wow sorry so long this is. Any comments appreciated. Thanks

[BobD Volunteer]

Most doctors prescribe beta blockers when a patient presents with AF as it helps to maintain a lower heart rate when in AF. The down side of this is lethargy and often an inability to perform meaningful exercise.

There is no real "cure" for AF and any treatment ,( including ablation) is about improving quality of life (QOL). Leaving the heart racing during AF is not a good idea as it can lead to cardiomyopathy or even heart failure but at the same time beta blockers are not good if one has asthma and to some extent if your AF is vagally mediated. You really need to discuss any treatment with a specialist like an electrophysiologist as few GPs are well enough trained where AF is concerned.

[CDreamer]

I cannot take beta-blockers and when I was on Bisoprolol I felt terrible. I had a stand up row with a cardiologist on the acute cardiac ward because I wouldn't, it turned out I was right as I have Myasthenia gravis (undiagnosed at the time) for which Beta Blockers & other rate drugs are contraindicated.

Doctors are trained and experts (or should be) in Diseases &a dysfunctions of the human body and possible therapies but you are the expert on you so my view is - do what you think feels right for you. If they make you feel worse, then dump them, tell GP and see if there are alternatives, the only reason for prescribing is for QOL anyway so if they don't improve that - why take them!

I have a red alert on my hospital files that I must not be given any rate control drug.

[CDreamer]

PS check the norteiptyline with your pharmacist as I know there are a lot of drugs which can trigger your AF - have you noticed a correlation?

[Omniscient1]

I would echo what the others have said, my GP put me on BBs and told me they could cure AF, and he was (is!) the practice's heart specialist. This is nonsense sadly. BBs (Mine was Bisoprolol) do slow you down and can make you feel lethargic etc. If your AF is non-symptomatic (ie you can only tell by checking your pulse) then your quality of life may be better off without them. I saw a AF specialist at a stroke clinic who told me to stop taking them. An alternative would be to lessen the dose, but in my case I went down to almost nothing with no effects either way. Check with your doctor (but not at my practice!).

[Hidden]

Hi, I've been off beta blockers for three days and already can feel an improvement and see my heart reacting more to exertion, e.g. It goes up when a go upstairs. The question, which only time will tell, is how much it was stopping my heart going too fast. Twice when I have done a little more exertion it has raced and then struggled to come back down. I'm hoping that this is just getting use to not taking the drugs.

It sounds like you need to ask the question to your doctors and push the improvements not having them make. There could be other drugs / solutions.

Good luck

[bear5814]

Dangerous to stop anticoagulant; you will not be protected if and when you have another AF episode. metroprolol can cause fatigue; ask your doc to try other drugs. is your BP normal??

[Kgkgkg13 in reply to bear5814]

My bo is very low which is why I only take 1/2 of bb twice daily

[bear5814 in reply to Kgkgkg13]

How low does your blood pressure average? Yet another reason for fatigue.

[PeterWh]

Bisoprolol does not only reduce the heart rate but importantly limits the maximum heart rate under every day situations to help keep the heart in better shape. For those who are asymptomatic that can be even more important because often they may not know if heart is at say 120bpm.

There are other options and these need to be explored and tried.

Also remember once you have had AF once it is almost certain that you will get it again at some time in the future whether that be days or years. Also many who have symptomatic AF incidents also have asymptomatic AF incidents both in the daytime but more often at nighttime when sleeping.