I had an ablation a few weeks ago, I'm doing ok, except for the fatigue, shortness of breath and cough. I am in sinus.
I believe the above issues are related to Metoprolol I take 25mg x 2 daily, Flecainaide 50mg 2 daily and 5mg Eliquis 2 daily. I have my follow up appt next week with my EP. I'm really hoping I can get off the Metoprolol and maybe decrease it to once a day. What other beta blockers have minimum side effects, I know everyone is different, and reacts differently to medications.
I'm also nervous if I come off, will I go back into AFIB
Thank you
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Tilos5
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You might want to ask your doctor to try Diltiazem, a calcium channel blocker. Service basically the same function as Metoprolol, but many including myself, tolerate it a lot better.
Sorry to disagree, but ß-blockers exert minimal (if any) rhythm control, and control heart rate and strength of ventricular contraction, both of which can lead to lowering of blood pressure.
Well that's what my 80 plus year Dr said. Together they help rhythm.
I think it is basically the 'result' of controlling BP and CCB controlling H/R.
The improve was good for a year with changed regime of meds but now with H/R 62-69 Day good has changed to great!
Metoprolol showed pauses of 2 seconds during sleep. That's a worry on the 24-hr monitor and ECG showed my heart under stress.
I ran an experiment of my own whilst Dr away. Stopped CCB and H/R went back to 156. Then another time forgot my Bisoprolol whilst on short holiday. BP rose. This time I had kept up CCB.
So there you are. My meds optimum results taking low doses of CCB AM and low dose of bisoprolol PM.
My AF is classed as Rapid and Persistent. The former well controlled and less symptoms of Persistent.
My heart rate is in the low 60's now, but I have not been able to exercise besides walking. One night at the ER, I was given Dilitiazem and my heart rate dropped too low which caused my heart to pause for 5 secs and 7 secs, HR was at 163. In the hospital they did not give me the Metoprolol if my BP was lower than 107 they would skip the PM dose. I'm hoping that the lower dose of Metoprolol will reduce my shortness of breath. I'm amazed that notwithstanding a lot of us here have had burns on their pulmonary veins, some people they can bounce back to normal exercise in two weeks.
I have 60s H/R now because Diltiazem assisted in bringing me down there with 120mg CCB.
If your normal or with a BB is 60s then NO NO don't even go to Diltiazem. In NZ there were low doses such as 30mg and 60mg but these have gone.
I'm not sure what I will do if I do need to look at the dose of Diltiazem.
Heck pauses I had pauses of 2 seconds but on 47 H/R!
Yes it is a balancing act. An individual concoction of meds!
I also take Thyroxin Synthroid 125mg daily because surgically removed thyroid and 12 right lymphs. They got it in time as 2 lymphs infected. 3 x all clear cancer scans and I declined RAI and suppression.
2 years on now it is NOT an automatic have RAI and suppression if low risk.
I might have been one patient used in any research.
I say I will manage my own health after listening to Specialists etc.
We need to in this day and age.
Carry on Tilos5 you know what you need to do. If you manage then you are taking responsibility for your own risks in life. We can't blame others.
Dawn wants to sue in USA but we can't here - we are all trying to get a piece of Billionaire John and Johnson for FALSE research. NZ depended on Canada and Australia. The mesh was far too young being used in operations. It took 10 years to damage me. Last year I had it partially removed under ACC they called it 'an operation which ultimately caused damage" But in 2019 I and the Specialist knew it was going to happen but ACC needed proof of damage.
Worrying a month after I had a stroke with AF but then the thyroid cancer was found in a routine scan of the Carotid arteries. I remember the lass saying 2 for the price of one. OOPS you have a shadow on your thyroid I had better get the boss to look. I was lucky and felt lucky when that was removed.
With the OP, it appears that the Metoprolol is a nodal blocking agent, which is advised when taking Flecainide. Diltiazem serves the same function (nodal blocking) with Flecainide with a better side effect profile for most. That was my comment.
Yes, Diltiazem controls mainly HR, but Metoprolol does as well. That's why they are often used interchangably both in the hospitals and at home to reduce HR during an afib episode. The fact that Metoprolol also can lower bp and has a slight anti-adreneline effect is besides the point in these uses.
I don't know why your BB didnt control your HR, maybe it was too low a dose, or maybe that's your individual reaction, but again, it's used for rate reduction all the time, both in a hospital and home setting. Personally, I prefer Diltiazem for rate reduction, as I tolerate it better.
Metropolol was doubled back in 2009 to 47.95 mg x 2. Split twice a day. I rang to say I couldn't breath properly. I would have been hospitalised if it had not improved.
In 2010 my BP was too low so it was dropped.
I have never been offered Flec... Rhythm is not a concerning factor - it is the BP and rapid H/R that are.
Never had a cardioversion and can't have an ablation. (Enlarged chamber).
Even though I said NO to Metoprolol offered after stroke I was still given 3 x 23.75mg. Side effects breathless, so fatigued, couldn't manage exertion. Couldn't walk up a little elevation or steps and 24-monitor showed pauses of 2 seconds at night when heart rate is always 47 regardless of no meds or meds.
Dr said that metoprolol can interfere with breathing and that is why it should not be given to asthmatics. More than 2 Drs said Bisoprolol better for AFers.
Even when I reduced M.... over year to 1 x 23.75 I was in trouble and my H/R stayed at 186 H/R on monitor.
Finally H Specialist listened and I got changed to Bisoprolol but H/R 156 and left so I went to the recommended private H/Specialist. CCB won the day. So CCB AM and BB PM.
Yeah, I'm happy with my lot but I am terrified for others not being on the right meds.
Why do H/Specialists add Flec..... and not CCB?
105 reduction in H/R within 2 hours is something life changing. I was glad it was only 180mg and not the 360mg the priv specialist offered I could go to! I went down to 120mg and that lasts only 12 hours. Just as well as without any meds my H/R night is 47 minimum.
I get to ask now for my priv H/Specialist at the next Public appointment I have been told in December and 18mths after last one.
What's a Clinician? Apparently I saw one last July as the H/Specialist was off sick.
It appears a lot of folks who have not had COVID jabs are ending up with AF. That's in NZ. Is it the same in UK?
Don't unjabbed folks realise that us jabbed folks help them to have less instances of the virus.
I'm at level jabbed 5 times.
Being a nurse I weighed up the balance of problemobility that I could get very ill and the Government direction that we all should... etc. But I've never had a flu jab. Now retired.
It's strange how meds work. No more breathless after stopping Metoprolol and yet H/Specialist wanted to blame the highh rate on AF and my TSH level.
I find my happy place is between TSH 1.0 - 2.0. T3 3.9-4.0 (the lowest T3 normal).
cheri JOY 74 (NZ)
I have an ongoing leaky roof one place around 4 x 4. Coming up to 10 years and unfortunately the internal sarking is not treated. The latest flashing and blocking has not worked. Raining continuously.
I take the same as you except I take warfarin 5 mg daily, also my metoprolol is ER ( extended release) it is my understanding if you take Flecainde (which I have been on numerous doses) you take a betablocker to help with the side effects from it. I had my third ablation April 28th and am doing very well. It does make me tired, BUT it is such a blissfull trade over having persistent afib. I had to take it plus cardizem, which absolutely gave me such pain in the muscles of my legs( it was horrible) Every single time I stood I had to stretch the muscles and still PAIN. Maybe extended release metoprolol might help, IDK?
although I had a cardioversion I was on same drugs and doses as you. The Metopropol made me really flat the doctor reduced it to 12.5mg twice a day and it made the world of difference. After a couple of months went off the Flecainide and now 7 months post CV am down to about 8mg Met twice a day. I hope to come off that after my next visit in August. I think it’s about easing off and letting your body get used to the adjustments
yes I did, Flecainide. They suggested that if you have it for a few weeks prior it can help revert to sinus or settle rhythm to assist the CV to work and maintain it after CV. I was keen afterwards to get off it so my heart would find its normal rhythm again and not have to rely on Flec.
I thought that the dose of beta blockers needed to be reduced after having an ablation, so maybe this will get sorted out when you have your follow up appointment. Good luck
Yes, I experienced the same afer my AV Ablation, but I did not wait, I contacted my doctor and told him, he took me off the Metroprolo right away , and within 24 hours I felt so much better and my blood pressure and pulse were in the normal limits. I would call you doctor, don't punish yourself if you feel bad, when it might be an easy fix.
I take Metoprolol once a day 25mg, I cut it in half , on half in morning and another half at night! When I took two of them 25mg each , my heart rate was too low , not safe!
I had complained to my doctor about fatigue. He switched my Metoprolol to an extended release version which I take before bed. I tolerate it much better than the dose I was taking during the day.
I think the problem is that the beta-blocker / flecainide is now working on a heart that is, essentially "normal", hence the "side effects". I suspect any other beta-blocker would be much the same as they all slow the heart from doing what it ought to be doing. It seems to be that doctors like to keep the heart extra calm for the blanking period as this seems to increase the chances of it remaining (relatively) AF free. I would phone the cardiac nurse in the team to ask about this.
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