propranolol for SVT

[Jctga]

I had an ablation two years ago for Afib and so far it is holding. I also have SVT, PVC and PAC. I’m on olmesartan and amlodipine for BP control. I was put on 12.5 mg carvedilol twice daily for rate control which made me feel breathless and exhausted . Changed to Metaprolol which was worse, so put back on carvedilol and told to deal with it. Dosage reduced to 6.25 about 8 months ago after my many complaints. Better but not good. Asked to reduce to half that dosage and felt much better and had decent rate control until last couple of weeks. Rate goes to 160’s for 5-10 minutes when I try walking even slowly for exercise. Goes into 120’s just doing mild activities such as showering. Since I had been on propranolol years ago before Afib and SVT I asked EP cardiologist if I could try it instead of carvedilol. He asked ME what dosage I wanted. I had only taken 10 mg once daily in the past before Afib and SVT so that’s what he prescribed. Pharmacist questioned that dosage when prescription filled as it is not a therapeutic dosage. So I have not switched over. My question is this: since I have an incompetent doctor should I suffer through high heart rate for another two months until I can see a new EP cardiologist or try the 10 mg propranolol 3 times daily.? If I switch do I do it by just stopping one and starting the other as I was told to do by current EP? I feel like he makes me try to be my own doctor. I appreciate any advice and realize no one is a doctor. Just looking for experienced opinions. Thanks.

[Rainfern]

Hi Jctga, I’m not a medic but mention of propranolol made me sit up because it has been a bit of a lifelong friend to me - not that I’ve taken it often but when I do it helps. When I was first diagnosed with AF that’s what I asked for - more as a kind of pill in pocket in case my heart beat went out of control while travelling. I was prescribed 10mg and that brought things under control on the rare instance I needed to call an ambulance. I have hung on to a couple of packs even though I’ve since been prescribed the harder stuff (amiodorone before a CV and digoxin while awaiting ablation). My body seems to tolerate old fashioned meds!

I think medics can only build up a picture of our needs over time, and by and large we need to be our own masters. However, you should be able to get a clear and simple answer to your questions - how to switch meds safely, question on dosage etc. If it was me I’d ask my GP or the cardio nurse. EPs are gods as far as medical procedures go, but not necessarily any better at knowing the right dosage - we’re all so different!

I hope you get it sorted soon

[Jctga in reply to Rainfern]

Thanks so much for your reply. I’m hoping a different cardiologist will be better than the one I have.