Information re: beta blockers: Hello... - AF Association

AF Association

20,275 members24,815 posts

Information re: beta blockers


Hello everybody.

I'm looking for some advice today. I have paroxysmal atrial fib, and am taking 1/4 tab of 25 mg Metoprolol 2x/day (6.25 mg). If I increase the dosage, I get severe brain fog, so much that I can't even operate the TV remote. My heart rate and B/P are both fairly low, heart rate usually 50 - 70 bpm. B/P can be as low as 100/50. I've started having episodes of afib 2-3x/week, usually lasting 2-4 hrs. Stopped by 100 mgs of flecainide PIP. I've tried dietary adjustments, supplements, lifestyle changes, etc., and I'm not sure where to go next.

My physician thinks the frequency of my AF episodes would be reduced if I take more Metoprolol, but I'm not sure about that. Besides, I can't tolerate a higher dosage. I really don't want to take Flecainide on a daily basis, I seem to be very susceptible to any and all drugs. Because of other health conditions, I also do not want to go for an ablation.

Does anyone here have personal experience similar to mine, and how do you manage your AF? I guess I'd like an easy answer, but I don't think there is one...

26 Replies

You are right. There isn’t one. I am completely intolerant to all rate and rhythm drugs so now have a red flag on my medical file - because of other health conditions.

I did the drugs, then the ablation and now the Pacemaker. Flec worked for a year or so, Ablation for 3 years and PM inserted last September and although I still feel AF, my pulse stays regular so I feel SO much better. The AF is still there but I’m just not as symptomatic a I once was but I can cope with that - the brain fog was FAR more debilitating. The PM was the best solution for me.

My view is that as treatment is totally for symptom relief - if the treatment is worse than the disease - WHY?

Horse57 in reply to CDreamer

What is the reason for your pacemaker. I was told by my EP that unless I have bradycardia he would not look at having a pacemaker. I was scheduled for an ablation on May 22 and I canceled. I felt like I wanted to try and manage the a fib longer but I do find that it rears its ugly head over stupid things like if I take fish oil or too much vitamin D or drink a cold drink or whatever. My electrophysiologist is now saying that he wants me to have an ablation in June because he doesn’t want me to have a bad outcome obviously like a stroke. I’m just wondering how you came around to having a pacemaker

Geonome in reply to Horse57

I find it very interesting that fish oil and Vit D triggers your afib. As I take a lot of both. Perhaps I'll cut back a bit to see if that makes a difference.

Horse57 in reply to Geonome

I was told that Fish Oil and Coconut Oil collect in the atrium and irritate the nerves.

CDreamer in reply to Horse57

Having run the gamut of treatments I was going for AV ablation. EP said he wanted me to have a bi ventricular PM which was fitted Sept. Unfortunately the LV lead came detached & I am STILL awaiting a date for reattachment. Since I have seen such an improvement anyway since PM was implanted with only 2 AF episodes that I have felt, no way now of knowing as Kardia won’t show if I’m in AF as my pulse still stays even, I’m reconsidering having the AV node ablation. I had a little Bradycardia as my Har would dip under 50 occasionally & that would trigger AF as much as Tachycardia.

Know you still have AF & can feel it but hardly any symptoms.

I too used to suffer with the effects of medication. I took 12.5mg of Metoprolol and 100mg Flecainide twice daily. Like you, that small dose of Metoprolol would take my BP and pulse down to the low side. I was also getting awful dreams from the Flecainide and had brain fog and lethargy. My decision was to stop the pills and I feel I now have my life back. Fortunately after a cardioversion in January my heart has remained in sinus rhythm for almost 4 months. I have to say that I have little faith in the pills that doctors hand out and at times feel they can do more damage than help.

I also made lifestyle changes and as retired from working I'm fortunate to be in a position where I can lead a very peaceful and calm life. I must admit at times I tend to shut out the world and am now more selective in the friends I have and what I watch on t.v. I do voluntary work as a room guide for the National Trust in a most beautiful and peaceful location, which I absolutely love. When driving locally (don't do long distance any more) I take routes that give me the least stress, no matter if they take a bit longer. I have a mostly plant based diet and avoid any food with artificial additives. Oh yes and my latest idea to keep AF free, is wearing looser fitting clothing. It all appears to be working so far.

I have to admit that I also live in an idyllic, small fishing town with the most beautiful harbour and coastline.

Hope you can come up with some solutions to help yourself feel better.


Can we all move beside you please? Sounds just so peaceful and lovely...….:-)

Sounds like a dream life lol. I live in a horrible town, full of unemployed layabouts, pregnant girls, lots of homelessness and in a not great area. I have a stressful job and 2 dogs. I agree it's about your quality of life, for sure!

Sorry to hear that, would it be possible for you to move somewhere else? I had a friend who would say to me, just do it!

I did have a stressful job before retiring 6 years ago, it was no fun chasing families for money when they'd lost a much loved elderly relative!

I think I've got my life right now and realise I'm extremely lucky and am so thankful for all I have and where I live. Fortunately, good luck has always been on my side, I come from a large family who were poor in wealth, but rich in love and kindness.

Hi. I moved from a lovely place so I could be mortgage free and for work. But I miss my old place. I will be moving back in a few years as it is depressing here.

That will do you good to go back to where it was lovely. Hope that time comes sooner rather than later.

Did you stop everything?It sounds like you live in a lovely place and I really believe that lifestyle in those types of changes make all the difference in the world.

I stopped Metoprolol and Flecainide, still take Warfarin and also Levothyroxine to right my thyroid which was damaged by my taking Amiodarone. Have lived where I am now for over 45 years and there's nowhere else I'd rather be.


Hi Geonome,

My experience was almost exactly like yours, even the dosages. I was taking a low dose of Toprol for years. It wasn’t till I learned from Dr. Gupta’s video about beta blockers & vagally-mediated AF that I wanted to go off it. Soooo glad I did. It was like having a straight jacket removed.

Then EP & cardio wanted me to take it daily, but I refused after the dreadful hallucinations. I only take it now as PIP and tolerate it better now that I’m taking a Kidney Detox Chinese Medicine herbal formula that I’m convinced lessens the impact of the toxicity.

What’s helped me the most in the past few months is discovering Metabolic Cardiology and nourishing the depleted heart cells (and all cells) with the micronutrients they sorely need after experiencing so much AF. You can look up my past posts for the details. I wrote about my discoveries as I was living them, with resources, etc.

The impact of the micronutrients is increased energy, better mood in general, clear thinking, stronger heart, less easily triggered into AF.

Balancing my hormones, which were seriously out of whack has also improved my health overall.

I asked my EPs blessing to ditch Toprol & he was fine with it. Really detached guy. Doesn’t actively support holistic approaches (think he only really cares about procedures); best thing I’ve done is discover these other resources that are backed by studies, etc, legit. It’s what I’ve needed to do and even then I listen to my body to figure out dosage.

It is wisdom to accept that the one-size-fits-all approach with the powerful drugs they prescribe can be downright dangerous for some people. That’s been my experience and it was a rather painful eye-opener for me, but I’m grateful to have taken back the power I’d given to those particular docs.

It’s very common that cardios & EPs don’t take a more integrative approach because of their training. I understand this now & am glad I sought out a cardio who does.

Hope that helps.

Auriculaire in reply to Hidden

Absolutely. Both times I have been prescribed Bisoprolol by a hospital cardiologist (the first time after being blue lighted with a heart rate of 160 bpm and the second nearly 3 years later when in hospial after going into afib recovering from bowel surgery) it was the standard 5mg dose. Within a week the first time I felt absolutely awful and told my GP that if I had to live the rest of my life feeling like this I was not sure I wanted to go on living. He said straight away to reduce the dose and within 6 months I had weaned off completely. I had only one very mild attack of afib in the time between that and the bowel surgery. Again the hospital cardiologist prescribed 5mg. This time I was forewarned. I went back into NSR after about 9 hrs and that day I reduced the dose by half and the next by half again so it never had a chance to zombify me. At the moment I am only taking a tiny dose and hope to stop that soon. I personally think regular 3 times a day magnesium supplements are doing more to keep my afib at bay than the betablockers. That said they can be useful as PIP to lower the rate during an attack especially if you go back into NSR spontaneously after only a few hours in afib.

My experience mirrors Nella’s. I follow Dr Sinatra’s advice on

I follow Lifestyle Medicine advice - stress, sleep, Nutrition & exercise. Eat organic & drink unclorinated water. I ferment so have some fermented foods - kefir, kumboocha, jun, sour dough, fermented veg every day.

Saturday we just had a Fermentation Workshop making Sauerkraut - such fun.

Do things you enjoy & avoid things that stress. Feed your soul & energetic body.

I’m happier, healthier, feel well despite AF & Myasthenia, CFS, POTS, Hypotension, Colitis & a few others! But I have had to adapt & work at it.

Best wishes CD

Geonome in reply to CDreamer

Thank you, CDreamer, Jeanjeannie and Nella.

Your replies are very helpful. It's amazing how much better a person feels when you find out that you're not the only one. I think I was ready to give up and follow the doctor's advice. After all, they're the experts, right???

I am also retired, live on an acreage, have the ability to live a fairly peaceful life. I think one of my next steps will be to reduce my stress. This is one area that I haven't paid too much attention to, but it is something that definitely has triggered AF.

Thanks for giving me back my motivation to find the right solution for optimal health for me!!


Hidden in reply to Geonome

Sounds like you have a very supportive environment in which to take the next steps of researching what works best for you.

I've shared elsewhere, but will say again here that continuing to seek answers and really fine tune my ability to discern what my body needs at any given time has been key.

Looking back on phases of great anxiety I've gone through, at the time I attributed it to AF. It's so easy to do that! But once I decided to really dig into these medication issues and even switch docs, guess what? Loads of the anxiety disappeared! I am certain that much of it was my intuition informing me that that particular doc was not a good fit for me. Even the nicest of EPs is likely to have the very particular and narrowly focused mindset that the training develops, with so much more focus on drugs & procedures rather than balance.

There have been feelings of stress that definitely were my body talking to me, telling me to make changes. So I listened. I've had docs tell me AF is completely random, nothing at all you can do to control it, avoid it, etc., which is hogwash. When you calmly focus on what the possible trigger could be, my experience has been that the solutions come.

The other aspect of stress has been the component that is absolutely physical in nature. This is what my experience has been with the supplements. Saved me from so much mental stress related to "How do I deal with this anxiety??" Balance the hormones! Get enough micronutrients! Those solutions have helped tremendously - and very quickly, too.

Best wishes to you!

Geonome in reply to Hidden

Thank you.

As always, I appreciate your informative replies and perspective on health.


Hi CDreamer, I've just looked at your Dr Sinatra link and found it fascinating and full of helpful advice. Thank you for sharing this.


Hope I haven’t missed something here, but Is there a reason that the cardiologist hasn’t tried you on a regular twice daily dose of Flecainide instead of relying on it as a PIP? Many of us on here are kept in NSR by this, some with, and some without additional beta blocker. I can’t take beta blocker for the same reasons as you?

Pat x

Geonome in reply to Hidden

I don't like the side effects of the Flecainide, so take it only when I have to. I do realize that it is an option to take it on a regular basis, but haven't wanted to go there yet.

Thank you.

You should seriously explore ablation option with your cardiologist. Flecainide would not be a solution in long term. I have developed adverse results at one point. Eventually I opted for ablation. The earlier you go for ablation the better before more complications developed.

Eyup ! I am from Otley, Yorks a but have lived in the US for 11 years and seen both systems.. Got my first official flutter 3 weeks ago... Took 2.5 days to covert (in hospital)..They gave me a drip of cardizem PLUS beta blocker metoprolol at the same time ! and the gits stopped my heart. I was watching the EKG flat-lining for 5 seconds times 5 !!.. Scared the bejayzus out of me for a week... Moral of the story is this stuff is careful. Tried to get off it last week and didn't realize its a 4 to 8 week process, stepping down and staying on each ledge for a week each time... and I tried to do it in 3 days... Ended up with rebound blood pressure of 170...then 2 hours later, a flutter with pulse at 150.... I converted in 10 hours by popping a 50 mtg Meto followed by a 25mg 6 hours later. Success ! I learned a valuable lesson and Meto needs a lot of respect and a very slow ramp down...6 weeks not 3 days... even at the 25mg level that I had been doing for 3 weeks...

Beta blockers only gave me brain fog and had deleterious sexual effects. I use ace inhibitors and calcium channel blockers. And I'm symptom free.

My doctor changed me from metoprolol 12 1/2 mg to carvedilol 3.125 mg. The difference was immediate as I felt 100% better. Heart rate and BP stayed the same. As for afib I don't know as I am asymptomatic.

You may also like...