Although I thought to myself, "It's just me," this update might resonate with someone else. After my initial diagnosis a year and a half ago, I was put on the beta blocker metoprolol --first at a low dosage, then increasing to the max (100 mg / day). It did next to nothing in abating my episodes, and only resulted in my feeling exhausted. Because it was not diminishing the frequency or duration of episodes, I just tapered off of it and left it at that. After a few months of no meds (besides apixaban), my cardio and I tried the calcium channel blocker Cardizem (diltiazem). It has worked MUCH better, reducing the number and frequency of episodes. It does dampen my pulse, but my BP seems to be holding steady.
Everybody's physiology and chemistry is different; this change just happened to work for me, in case anybody else has had no luck with beta blockers and is looking for an alternative.
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malaekahana
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I also tolerate diltiazem better than beta blockers.
The other question is whether a beta blocker or calcium channel blocker is even necessary. Both are very weak anti-arrhythmics. I did fine without either for my first 30 years of afib, with episodes only every 10 years.
Doctors often feel they have to do something for the patient and/or are just too lazy to put in the time to find out what works best. Even if a beta blocker reduces the afib burden by 20% (not saying it would) is that worth walking around like a zombie, as many report? The cure should never be worse than the disease.
Thanks, Jim. In my case, the change to a calcium channel blocker reduced the episodes significantly. And whereas the beta blocker did indeed induce zombie effect (in my case), the cc blocker--not at all. But once again, physiologies and chemistries are all different.
As I keep saying AF is a long journey and finding the combination of life style changes. drugs and or ablation which suits each individual takes personal effort and determination. Sadly some won't make the effort. Well done.
Of course neither beta blockers nor calcium channel blockers are rhythm control drugs , merely reducing rate whilst AF continues. Many people can't take one or the other for various reasons so it does take time.
That's a useful thing to know, thank you. I recently read how these drugs work by affecting the flow of electrolytes into the heart muscle cells, and they are genuinely and essentially different - even individual beta-blockers such as bisoprolol and nebivolol. I think it must be worth trying a different one if the effect isn't doing anything useful.
Beta blockers were a disaster for me. I tried three different ones..... All made me very ill. Calcium channel blockers in my case Verapamil was a real god send. It slowed my heart down (racing at 130 at rest) there by relieving my Afib. It still runs in the 90s which it never did before Afib. Used to be 70s. Both Calcium channel blockers and beta blockers lower the conversion rate of thyroid hormones But calcium chrnnel blockers are heart specific whereas beta blockers are generic. I was told this by a cardiologist. No amount of changing my style of living would stop my Afib as I have cardiotoxicity. ie damage to the heart from aggressive treatments used to treat cancer. My weights in range, I eat healthily, my one vice is the odd glass of wine which makes no difference to my Afib.
I was initially put on bisoprolol but we found I just couldn’t tolerate it. Couldn’t walk across the room without running out of breath, so no good for someone with asthma! Changed to Diltiazem and after a few goes at getting the dose right for me, it’s been fine. Have to be careful about fluid retention though and I do need to take a diuretic now to counteract
Thanks for the info! My cardio did not mention fluid retention as a possible side effect, but I did notice a period about two months ago when that happened. It coincided with a vacation, and I was going to talk to my MD about it upon return, but it subsided on its own.
Similar experience here, but luckily my GP figured it out during the first visit after the ER visit. I was prescribed metoprolol by the ER Cardio doc. It also left me exhausted. I could not walk 500 metres without gasping and my legs felt like rubber. After 3 days I’d had enough, went to see him, and his response was…”they put you on metoprolol? No no that’s not right for you.” And prescribed Diltiazem…which worked great, back to absolute normal.
No episodes or issues since, almost 3 years and counting.
Atrial Fibrillation is when the upper chambers of the heart do not beat properly and are "out of sync". They fibrillate or "quiver" and do not do their job pumping blood. Some people end up with tachycardia when their atria are going bonkers and a drug like metoprolol, which is a beta blocker, will help to slow the heart down. Sometimes this will help the heart stay in a sinus rhythm. There are two different kinds of calcium channel blockers. Cardiazem is a calcium channel blocker that has inhibitory effects on the sinoatrial (SA), and atrioventricular (AV) nodes thereby resulting in a slowing of cardiac conduction and contractility. It also relaxes the blood vessels. There are also sodium channel blockers too. The drugs that work on the "arrhythmia" of Afib are called anti-arrhythmics. They work by helping to control the rhythm and the rate. There are different classes of anti-arrhythmics so I won't get into all the details here. Some have black box warnings, some are very well tolerated for some and others are not so well tolerated. It all depends on the individual and what other issues they may have going on with their heart and health status. A cardiac electrophysiologist is the best person to advise on what drugs will be most effective for an individual as Afib is an electrical conductivity problem within the heart.
My EP put me on a potassium channel blocker, Sotalol which has reduced my afib episodes. I have been getting them around every 4 months but very long episodes of 30 hours. No mention of potassium channel blockers in this thread, is anyone else on them I wonder?
metaprolol exhausted me. Fortunately I had two ablations, one to eliminate my premature ventricular contractions, and the other to take care of the a fib. I’ve been in sinus rhythm for sometime now and it feels great. Just a consideration.
I also reccomend pulmonary vein catheter ablation cause nothing helped me more than that. I had AF episodes every other day and I could not work or function properly anymore. It took me 3 ablations to get my life back to normal but it was worth it. Ablation caused my resting heartrate to go from 38 to 90, and has stayed that way since. Still, I haven't had an episode for months now! 👍
I was put on the lowest dose of metoprolol (23.75mg). Like anything, your body develops tolerance and I found after about 7 years that I was going into a-fib (stair-climbing, alcohol etc.) Everyone is unique.
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inspired by Paul’s post yesterday!
