With your forum for years. My first AF hit in 2012. I am on medication since then. Presently I am on Metoprolol 25 mg XL for last 7 months. I was on Cordarone initially for 4 years. Switched on to Bisoprolol 5 mg for another 3 years, later on Ivabradine for about 4 years. Have hypothyroidism on mediaction. After covid 19 in 2020 I also developed respiratory illness for which I have to take inhalers. But recently for few days I am experiencing 'skipped beat' sensation although the HR is lying between 70 to 85. Cardiology doctor is saying that these are ectopics and extra beats. This is felt particularly while I am sitting or lying down. One night these were so frequent that made me sleepless. I also had these symptoms when I was on Bisoprolol. But this time this is really bothering. Doctor has increased my dose of Metoprolol by 12.5 mg. I don't know whether this is the side effects of any medicine like Methylprednisolone which was prescribed by Pulmonologist. Do you have this sort of experience?
Ectopics : With your forum for years... - Atrial Fibrillati...
Ectopics
I have ectopics, thousands per day according to my 24h ECGs. Beta blockers don’t cause or treat ectopics. Some people find them helpful, some find them useless. I doubt they are a side effect of beta blockers. I had increasing ectopics following a severe viral illness in 2012. They became increasingly worse. I had my first AF episode at the end of 2021. I’ve never found an effective treatment for ectopics. They flare up and settle down of their own accord, it seems. No cardiologist has ever been concerned about them.
I also suffered from Viral fever one month ago.
There’s definitely a connection between viral illnesses and developing arrhythmias, or causing a flare up of an existing one.
Just an fyi, I have found adding Magnesium Chloride very helpful in calming the ectopics. I use what is called SlowMg for heart & muscle.
I haven’t had much success with magnesium supplements in any form.
I didn't have much success by adding foods that were higher in magnesium. But my EP cardio advised the magnesium chloride he said because it is more readily absorbed. That said ectopics are sneaky little devils & in most cases cardio has not been concerned. The discomfort & unpredictability just became a burden and using the beta blocker became a greater burden. So between adding the magnesium chloride, using relaxation skills, getting better sleep & reassuring my self I wasn't going to go into Afib constantly, it helped.
In many cases ectopics (and AF) are caused by valve regurgitation and the compensatory remodelling of the heart. In those cases, breathing exercises, eliminating caffeine and dietary supplements etc will fail to have an impact.
It’s probably the viral infection that has upset the apple cart for you. I was told that ectopics are harmless and that sometimes they can stop an episode of AF by keeping the heart in sinus rhythm. Perhaps when your body has recuperated they will settle down. I can understand your concern, as l don’t find them pleasant myself. The anxiety, of course, makes everything fire up, so try and relax - if you can. Wishing you well.
ectopic beats typically occur at rest for most people (me included). This being when HR slowest when the time period between two beats is longest. Ie more time for the ectopic to jump in between 2 normal beats. BBs slow the HR even more at rest giving a longer period between beats for the ectopic to do it’s thing.
I have ectopics which do vary widely from 0 to 5 per hour, to 20 or 30 which does make me feel bad. I find that the same strategies that people recommend on here bring them down a bit. There were more after my last AF episode, fewer and calmed down after my holiday. I take magnesium which seems to help. I have done all the usual things and would say that good sleep is what helps most, along with leaving 3 hours between my last meal and going to bed.
Yes.I have developed ectopics in the last year.
I get on average 100 PVCs per hour and it's stopping the pacemaker from working properly. Instead of maintaining a minimum pulse rate of 70 BPM, I'm dropping to less than 40 BPM.
It's causing blackouts and falls and at times you feel that you are going to die.
Mainly affects me when inactive.
I'm due to see the consultant (pacing) in three weeks, and In the meantime, been waiting 9 months, I'm on a dose of Bisoprolol 10-mg daily to try to reduce the ectopics. Sometimes it works sometimes it doesn't.
I'm surprised you say you are on 12.5-mg as my PIL (leaflet) says 10-mg is the maximum.
Mind you, I have accidentally taken 20-mg without ill effects.
For many, ectopics go unnoticed and do no harm, but if other complications are present like heart block, things can get serious.
After 18 years with complete heart block, ectopics have been an unwelcome complication.
I have thousands of ectopics a day which doesn't affect my pacemaker. Maybe your pacemaker needs checking. Before l had my pacemaker l was getting pauses of 10 seconds and blackouts everyday. The pacemaker has stopped that. It is set at 60 b.p.m.
Well, it certainly affects mine.
The pacemaker has been checked.
The ectopics started in January 2023 after 18-years of no trouble with the pacemaker.
How else do you explain that a pacemaker with a minimum rate set to 70-BPM, suddenly starts allowing pulse rates below 40?
My blackouts and falls started in January with the pacemaker working.
What I think is happening and I will be finding out in 3-weeks time, is that the pacemaker is detecting the ectopics and does not differentiate between ectopics and "normal" beats.
The pacemaker maintains a base rate by timing between normal beats. The ectopic beats reset the timing which starts all over again, thus introducing a pause where there shouldn't be one.
The high dose of Bisoprolol is an attempt to suppress the ectopics to the point that the pacemaker can distinguish the normal beats.
My pacemaker is fairly old and due to be replaced in 15-months. I'm hoping that I will get a replacement that can cope with ectopics.
Yes, maybe it is because it is old. They are improving them all the time and making them smaller. Saying that, mine is being replaced after only a couple of years; the reason being that mine was in a batch that could be faulty , although mine has been O.K up until now. Hope you find that your new pacemaker works better.
Hi 1234
I couldn't write any more.
Try again. Metopolol makes me breathless with n energy and fatigued. It is banned for me.
If you have AF Bisoprolol is better says my H/Specialist. But she left me still uncontrolled with H/R Day avg 156. Over 120 on rest.
CCB Diltiazem resolved and controlled my Day H/R ..60s now.
cheri JOY. 74. (NZ)
So sorry to hear this, I've had some ectopic episodes in the 2000's+ and it's worse than AF. This may sound simplistic, but BobD and others have shared this breathing technique, which really does work. Long, slow inhale, then VERY slow exhale with pursed lips (as if breathing through a straw). Do this for a few minutes. See if they stop. (This is even stranger, but--I have also stopped AF and ectopics by playing a didgeridoo, which is all about breath control.) Maybe breathing really is the key to all this. Some recommend the book, "Breath" by James Nestor. The other thing that has worked when in the worst ectopics was straightening my spine and leaning slightly forward, as if sitting at a computer. I experimented with leaning forward at slightly different angles. Weirdly, they will suddenly stop and my dr. says it's all about the vagus nerve "touching" certain spots. All best wishes for getting rid of the pesky ectopics. Diane S.
Ablation for ectopics?
Experiences with Metoprolol 
2 weeks after ablation - ectopics going a bit crazy!
PVCs, PAF and ablation 
