Metoprolol as rate reducer with no affect on rhythm....

[MeganMN]

So after my last Holter showed 8500 episodes of SVT (Atrial Tachycardia) in 14 days, with a 19% burden of Atrial Ectopy and 11% burden of tachycardia, my EP recommended an echo (which was normal, thankfully), starting Metoprolol, and Eliquis, while I wait for another ablation. I have tried, and failed, about six different antiarrhythmics, and he seemed to indicate that he would prefer just using the metoprolol because the others seemed to make my SVT worse.

The question I have, though, is that the Metoprolol doesn't actually STOP any of the episodes, and he knew that , so what would be the purpose? I am guessing it is simply to slow the rate down, so that even if I am in SVT, it is slower, so I can minimize any potential risk of Cardiomyopathy? Does that make sense? I plan to ask him tomorrow, but thought I would run it by my online experts too!! 😀.

[etheral]

Hi, makes total sense to me. If the metoporol works to slow the Ventricular Rate it will benefit the heart by easing the strain on the left ventricle. Curious what type of SVT ( afib,

flutter etc) you've been diagnosed with and what antiarrythmics you've tried. I'm

assuming underlying disorders such as hyperthyroidism or hyperadrenalism have been ruled out. Best etheral

[MeganMN in reply to etheral]

Thanks Etheral. My EP echoed what others have said, he wants to help me minimize symptoms and strain on my heart until the ablation. Seems reasonable. To answer your other questions, I was diagnosed with severe Atrial Tachycardia (19% burden) and he is suspecting some intermittent, infrequent flutter and/or afib as well. I tried Metoprolol, then Cardizem, then Flecainide, then Norpace, then Rythmol. They have found no reason for the SVT.

[BobD Volunteer]

Yes. Bottom line is that provided rate is well controlled the end result remains the same regardless of rhythm.

[JOY2THEWORLD49]

Hi

Metoprolol is banned for me. The 24 H/Monitor gave average Day 187! No energy and breathless. Night 47 average with 2 sec pauses.

Not suitable for AFers.

Changed to Bisoprolol no breathlessness, no pauses and ENERGY up a little but still @ 156 average Day. Night stays 47 average.

Private H/Specialist introduced CCB Diltiazem 180mg too much. Reduced to 120mg Day S.C HCl.

H/Rate Day now 60s.

Reduced Bisoprolol 2.5mg PM controls BP.

Energy returning. Can't have Cardioversion, Ablations, or anti arrhymnic drugs eg Flecainide.

My heart is structurally abnormal. The Echo shows evidence.

Together with CONTROLS my AF is CONTROLLED. Still there but much improvement.

cheri JOY

[Ppiman]

Your assessment of the use of the metoprolol sounds likely to be right. I believe that a slower rate is thought to be beneficial, as you say, and can also lead to an overall calming of arrhythmia activity. It seems to have done so with me, having started on daily bisoprolol (1,25mg) last March, even though "breakthrough" effects occur regularly enough. I was also given losartan, an antihypertensive, even though I have normal BP, as I was told it was a useful "cardioprotective" in the long term although this might have been as I have a bundle block, too.

Steve

[Vicmeister]

Metoprolol is to bring the heart rate down. Probably a good idea in your case to ease the strain on your heart. You're right it won't stop the episodes. I use metoprolol when I have an AF attack to control my rate. Keep well.

[Lenaropes]

I would agree. When the heart beats too fast it losses it's effectiveness as a pump to perfuse the tissue.

[MeganMN]

Thanks for the replies! The EP echoed what others have said. I have certainly noticed that I feel significantly less tired now that my heart is not racing away for most of the night. I'm apprehensive about the ablation because the last time I had an attempted ablation, they were unable to induce the rhythm. I hope this time is different and they can induce and fix it. I have gone to a different EP and he has some different ideas than the last one did.

[MeganMN]

So now I am a week in to the Metoprolol and found out that the ablation can't be done for at least three months. The tachycardia has completely broken through the Metoprolol as if I were not even taking it. Ugh..