AF and Heart Parameters

[das1234]

I experienced AF first in 2012. It was recorded in Holter Monitoring. On medication since then. Holter Monitoring done once in a year. No episode recorded. Actually my episodes occur suddenly last for few seconds. ECG sometimes show tachycardia, Echocardiography is normal, TMT recent time is negative. Once the TMT was positive, Angiography done which is also normal. I am 61 years age, recent echo shows Sclerosed Aortic Valve. Doctor told me that I have PAF, I am now on Metoprolol XL 25 mg once daily. In my older posts I have written about my Amiodarone prescription for 4 years. Skin pigmentation and Hypothyroidism were developed then. Still I am taking medicines for thyroid.

My question is that can a person has normal heart parameters in spite of irregular rhythym. Do you have this experience?

Moreover I would also like to know about the use Metoprolol, does it cause weakness, slow movement, dizziness. Before Metoprolol I was on Ivabradine 5 twice daily.

[BobD Volunteer]

AF is an electrical problem within the heart and quite independent of any physical (mechanical) problems. In fact in most cases people with AF have normal physiology.

[das1234 in reply to BobD]

Thank you so much for your reply.

[mav7]

Like BobD says above, af can be independent of normal heart parameters.

I have persistent/permanent afib and a recent echo showed no issues. But like you, I also have aortic stenosis. Like so many other issues, there is not conclusive evidence that aortic stenosis affects afib. Opinions vary, it certainly doesn't help and must be considered when prescribing medications.

I am also on Metoprolol, .50g. .25g that you are on is considered a low dose. When I first began Metoprolol I did notice dizziness (very slight) especially when lying and still notice fatigue. But those symptoms lessen with time.

Regardless, the key is to control your heart rate and blood pressure (blood pressure important with aortic stenosis). May want to discuss with your doctor the proper medication. Best to You !

[das1234 in reply to mav7]

Thank you so much for your replyI am also on Telmisartan 40 mg in the night for my bp control. Also take Atorvastatin 10.

[Sixtyslidogirl in reply to mav7]

Just to be clear, there is a difference between sclerosis of the aortic valve (thickened but functioning normally) and the more serious stenosis where it is also restricting blood flow. My understanding is that sclerosis doesn’t always lead to stenosis but can.

[Cliff_G]

Any beta blocker like Metoprolol can cause weakness, slow movement and dizziness. People often describe being on them as it feeling like they are wading through treacle when they walk. Some betablockers are more targeted at the heart and should minimise this, for example when I switched from Metoprolol to Bisoprolol I found my legs weakness improved.

Statins can also cause muscle weakness, but again, it is different for everyone. I found 20 mg Atorvastatin was not good but I have now settled on 10 mg Atorvastation and 10mg Ezetimibe, and my cholesterol figures are good and leg heaviness improved.

Worth doing (in conjunction with your doctors' advice) a trial period off each medication to see.

Also get your potassium levels checked. The normal range is 3.5 to 5.3 and if you're in that range most doctors will disregard potassium as an influence on arrhythmias. But there is good evidence that being in the upper half of that range - "high normal" - helps to minimise arrhythmias. I found my Furosemide was dragging my potassium down to 3.8 or so. By stopping that and getting my potassium to 4.6 or so (Losartan and Epleronone tend to increase your potassium - important not to go too high as that can be even worse - don't try this without having your potassium levels checked), I have been able to stop Amiodarone whilst being more or less still in NSR. (Thankfully before it did me any long lasting harm, I believe).