A-flutter began in August 2023. I’ve had five cardioversions since then, lasting from three weeks to three days.
I am now in A-flutter awaiting an ablation on February 6. Success rate statistically is around 95%. Fingers crossed.
I take Eliquis like clockwork. I take no other heart medications, and this is the gist of my message: I have stopped taking metoprolol. Reasons?
1) It has never had any effect on my heart rate or rhythm, whether given by IV or taken daily in varying dosages. (Ditto diltiazem. Amiodarone had a hugely negative effect on my heart rate; we stopped it after ten days back in 2022.) My daytime heart rate hovers around 130-135bpm. I’m sometimes in the 60’s while sleeping. I’ve been taking metoprolol off and on for three years. I have never perceived it affects my heart rate.
2) Metoprolol causes me barely tolerable side effects that (a) mimic and only make the effects of A-flutter worse: debilitating fatigue and lightheadedness; and (b) causes the additional unwanted effects of profuse sweating (especially night sweats), bad dreams, insomnia, and breathlessness that I do not experience when not taking metoprolol.
Here is a quote from online. It’s a clear statement of what I’ve read in studies published on the NIH/PubMed sites.
“After analyzing data from 1,679 people with AFib, it was found that heart rate was NOT significantly associated with heart failure hospitalizations, stroke, systemic embolism, or death, suggesting that strict heart rate control might not be necessary for stable outpatients with AFib. This can be reassuring for both people with AFib and healthcare professionals, as it implies that focusing solely on aggressively controlling heart rate might not be required to prevent these reactions in individuals with stable AFib.”
I have been told by my cardiologist and by my electrophysiologist, when I posed the question directly, that my high heart rate is not causing further damage to my heart.
It’s important for me to note that I have, as my cardiologist put it after two MRI’s, “Good news. You have just simply Afib/flutter.” “Just simply??” I had to smile. What she meant was that there are no complicating conditions such as amyloidosis, no valve issues, no stenosis, no scarring, with atria and ventricles of normal size, etc.
in other words, my heart is good to go (at 82) other than miscreant cells misfiring electrical pulses, a situation an ablation can correct. I understand that others are facing more complicated situations.
Since stopping metropolol four days ago, I’m sleeping through the night, profuse sweating has ceased, and I’m not breathless when I reach the top of my stairs. I’m still constantly fatigued and feel fuzzy-headed due to the high HR blood rushing through my system too fast for my cells to grab all the nutrition they need and are used to getting.
To sum up: My high bpm is not harming my heart or statistically making me more prone to heart failure, stroke, embolism, or death.
My solution to Aflutter and its high bpm is an ablation, with fingers crossed hard and realistic optimism. Drugs and cardioversions have provided no solution for me. I informed my doctors of my decision and they are fine with it. They can see as well as I that the metoprolol was doing nothing, but I turned out to have to be the one to say it out loud.
One last caveat: a high heart rate over an extensive period of time can, I understand , definitely cause harm and requires treatment. That is not the case with me. Yet. I have not reached an extensive period of time, and now have just a month to drag through until the ablation.
I’ve read everything I can find and asked every doctor I’ve talked to about post-ablation best practices to make sure I’m doing my part to encourage my recovery.
What a journey all of us are on.
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Thanks for the link. I learned, among other things, how lucky I am that my wayward heart has access to a major medical center that has a groundbreaking heart institute, leading cardiology providers and faculty, and the latest advances in technology and procedures
I guess I should say, however, that my ending up there was not an accident. I set that as my goal and persevered as I navigated my way through a fairly broken medical system. I have done everything I know how to do to get the best care available.
You mentioned my “assertiveness.” It has been crucial, assertive self-advocacy backed up with hours and hours of research on my own—combined with an ability to be congenial while taking medical folks to task or remaining undeterred in getting my needs met.
It’s so easy to fall through the cracks; medical people are overworked, overwhelmed people just like most people in high pressure, high stakes jobs.
Providers and staff can lose track of ever-changing prescriptions (I keep track meticulously);
records can be incorrectly entered in the system (I have them corrected);
the cardiologist and the electrophysiologist can have miscommunications, with the right hand not knowing what the left is doing (I am the communications bridge);
and of course, not every nurse or doctor graduated in the top half of their class—some medical providers are, in my experience, in the wrong business (I stay vigilant and questioning).
I do not subscribe to “The doctor knows best.” I can only work with doctors who will work with me in partnership and mutual respect
Anyway, I try to stay on top of everything. Congenially. It pays off. I have no hesitation in speaking up clearly, directly, and politely when I see something amiss—one of the advantages of being 82 (-:
Now I just want it all over with! (Patience is not one of my virtues.)
My husbandsAF heart rate caused his stroke and left severe left ventricular function apparently on his eco so it sounds like you’ve been lucky . I hope your second ablation goes well. We’re hoping my husband can have a second one this year .
I get you don't tolerate Metoprolol-- I didn't either-- but your story and citation notwithstanding , I don't agree leaving you with a high heart rate prior to ablation, based on what I have been told by doctors and readings., Why don't you at least ask to try the rate med Diltiazem, to at least get you down to 110 while awaiting ablation? Many tolerate it much better than beta blockers like Metoprolol.
Thanks, Jim, but diltiazem is also a no-go. It’s not brought my heart rate down either through IV infusion or tablets. But more importantly, my normal blood pressure is on the low side.
In 2020 I was first diagnosed with Afib at my local ER. The doc said, “Here, take these pills.” I did. I didn’t quite catch the name “diltiazem.” The next evening after watching Masterpiece Theatre on my iPad in bed for two hours, I stood up….and blacked out, falling and breaking my right arm. Syncope (fainting) is one of the principal side effects of diltiazem, which I wish I’d known. I also wish the doc had asked me if I ever had problems with low blood pressure. (Yes.) I wish I’d been more diligent about what drug I was taking. (I am now.) The ER doc who tended my broken arm is the one who diagnosed that the drug had caused the blackout
We did try diltiazem again a few months ago after yet another reversion following a CV, this time with me being forewarned that it could lower my blood pressure too low and cause syncope. It did lower my blood pressure (which did not need lowering), but not my heart rate. So we went back to metoprolol, to no good effect. For some reason, these drugs that work for others for rate control don’t work for me. According to the literature, I’m not alone. People respond differently to identical drug prescriptions. We learn as we go along
I do not see drugs as a solution to my fib-flutter, not even interim. As far as I can tell speaking only for myself, they cause additional problems and fix none.
The only way I see forward is an ablation. It’s only 37 days away now.
Many thanks for your concern
PS
I should have noted that the quote I messaged came from a site called Healthline in case anyone is interested in looking it up.
February 6 can’t come soon enough! Best of luck with the procedure and hope they’re able to totally zap those pesky bits. I don’t do well on metoprolol either. Was knit at the start of my journey, almost 10 years ago and short term as a bridge to clear out old meds before trying a new one. Hang in there!
I'm really curious about this post. I have Atrial Tachycardia, which is related to atrial flutter. I finally stopped Metoprolol for much the same reason as you. Interestingly, my EP was skeptical of my claim that the Metoprolol wasn't doing anything to minimize the arrhythmia so he ordered a shorter Holter while on it. As I suspected, my Atrial Tach burden and PAC burden were exactly the same as they were before the Metoprolol. The only improvement was that the episodes of A Tach were shorter in duration, but the overall burden (11%) was exactly the same. So I stopped the Metoprolol. Unfortunately, I have no future plan for ablation, but he also echoed that I am in no current danger of cardiomyopathy.
I had a similar situation. I do believe if we "test" cautiously we can discover a great deal about our meds and our personal reactions to them. The combination of Flecainide and Metoprolol helped me in the beginning but as time went on less and less... hence my multiple ablations. I did change to Bisoprolol and found it to be less debilitating and sufficiently effective to merit using it at a low dosage. Higher left me unable to go up even stairs --- and I am still working. My situation was Afib RVR, then added Aflutter, Atrial Tachycardia.
It would reduce my rate from 180-230 down to 150-160... the compromise helped me to be more functional in my work - which is physical.
I believe it is worth trying different meds and combinations - clearly with a doctor's advice.
Hope something works better for you - and best wishes for the ablation! I don't regret any of mine, and certainly not the last one - which is still holding!
That was when in Afib.... otherwise, although it became nearly persistent as was every 24 hours. My resting heart rate was around 75 bpm. Slowly increasing over the years and of course post-ablations. With the recent PFA ablation my heart rate did not increase!
Ah ok . My husbands rate has come down from 163 to about 100/120,ecg and pulse about 90 we have an appointment at arrhythmia clinic in Feb he s recently had a failed cardio version and ablation in 2017 so we ll see what happens next . Bisoprolol seems to keep his heart rate better than it was as he s in persistent AF now . Also thinners of course which I think he should have been on after his first ablation . Maybe he would have avoided his stroke in July . Who knows
Oh gosh, well hopefully they'll find a best solution for your husband. None of us have the same triggers, reactions to meds.... you're a great wife. He's lucky to have you online for him! Take care, and best wishes for your February visit!
I had the same symptoms as you with various beta blockers.In fact , they made my heart rate higher because I had low / normal blood pressure when I was put on them which got very low at night on those drugs so my heart rate increased even further to correct it.
I have Atrial Fibrillation linked to Chronic Dysautonomia, my cardiac issues are not just heart based but affected by autonomic nervous system dysfunction and the affect of another condition called Ehlers Danlos Syndrome on my circulation , it causes a loss of pressure in my system when I change position because of the laxity of the blood vessels.
My CD is caused by a combination of Sinus Node Reentrant Tachycardia and POTs.
I finally got my Tachycardia under control with medications which helped to improve the heart rate without changing the blood pressure and strengthen the integrity of the blood flow along with an anticoagulant. I have a PIP for AF events and do need to take statins because I have Familial HyperCholesteroleimia.
Because of my EDS and the link to micro electrical and neuro issues they aren't happy to use Cardioversion or Ablation on me except as an Emergency because they cannot guarantee that it would not make the underlying problem worse or cause damage.
It took years of persistence to get my Dysautonomia and EDS properly diagnosed but it was worth it to finally get on medications that can give some help in my situation.
I think part of the issue when they prescribe our drugs is they often don't look at the full medical history when making the decisions and just follow the same game plan using the most commonly helpful drugs first , but I know many patients whom have a similar reaction to us with beta blockers because they don't suffer from common blood pressure issues with their AF and their AF may be caused by a combination of autonomic as well as cardiac causes so other medications which assist both problems are more suitable .
Unfortunately, most specialists have little experience of treating and diagnosing Chronic Dysautonomia subtypes and so it is often missed and treatments can be less successful for some people because of this. The lack of knowledge about less common cardiac issues also leads them to treat the patient with scepticism when they say a drug causes side effects or makes things worse. It wasn't until I did a lot of research on my symptoms and conditions and learnt how to politely but confidently question my doctor's or speak about my options that things improved.
Wow. A person after my own heart. Yes, patients are often treated based on boilerplate protocols, are often treated as bodies on a production line conveyer belt. Too often the whole person isn’t seen, just a body part here, a body part there.
That’s why self-advocacy and in-depth research by the patient are crucial to getting the best health care possible. Patients simply have to be proactive, knowledgeable, and determined.
It doesn’t hurt to remember that a leading cause of injury and death is medical errors, especially those made in hospitals, and misdiagnoses. The statistics are staggering. I don’t have the statistics on iatrogenic injury and death at hand, and the medical establishment does not advertise them, but they are mind-blowing. Patients do have to look out for themselves as best they can, but it’s not easy once you’re caught in the medical maw.
Right now I’m in the middle of another situation requiring proactivity, research, and self-protection. I have a TMJ disorder that means my mouth has an unusually narrow opening due to my jaw structure, something I was born with. After my first ablation (and first ever general anesthesia), I woke with my face, jaw, neck feeling as though my head had been run over by a truck, The pain was excruciating.
It occurred because the anesthesiologist paid no attention to my health record showing TMJ, so followed usual protocol for an adult with a normal-sized mouth opening, forcing my jaw and facial muscles into stress positions they had never been in before, resulting in extraordinary pain post-anesthesia.
So this time, in preparation for my second ablation, I have brought this issue to the attention of the EP team and, at my request, have a pre-procedure anesthesia clinic appointment tomorrow with an NP, to whom I have congenially sent four links regarding anesthesia practices in patients with TMJ. In addition, I have made clear that I need to speak directly in person to the attending anesthesiologist the day of the procedure—this last request based on the advice of two anesthesiologists I queried during two of my CV episodes. Both told me not to count on the anesthesiologist reading records and notes—but not to tell anyone that they told me that. Each stressed I had to speak to the anesthesiologist on the very day of the procedure and make sure he or she knows of my TMJ situation so that the necessary adjustments to protocol can be made. Without my proactivity, I could end up in the same excruciatingly painful boat.
Is this kind of proactivity the patient’s job? YES! Blind trust in the medical system is ill-advised and dangerous.
But is trust in your doctor needed? Absolutely yes! A trusting bond between a doctor and a patient is essential to optimal healing outcomes. Getting to that place of trust depends a lot on the patient not giving up until finding the right doctor. I went through three cardiologists before finding the exact right one for me. Time, patience, persistence—and listening to your gut.
Congratulations to you and your perseverance in getting the right diagnosis and medications. It’s not an easy road to navigate. Thumbs up to you, and I hope all the best for you.
Well done, I had to do the same thing. I have a damaged vocal cord due to cervical spine fusion. If the anesthesiologist isn't careful with the intubation, it gets damaged AGAIN. I voiced this prior to the ablation and on the day of the ablation and he told me he could use a smaller and more flexible tube! Worked like a charm, no issues post ablation. Best wishes for your recovery. PS, if you can find an excellent osteopath or fascial therapist they can help with TMJ! Also, if there is anyone who uses FSM (Frequency Specific Microcurrent) in your area it is also very helpful, but in the hands of a manual therapist is even more effective. Take care!
Thanks for the TMJ treatment advice. I’ll follow up. What’s helped me most is acupuncture, but a lot depends on who the acupuncturist is. My now retired acupuncturist worked magic. Others I’ve seen since have had varied success.
And thanks for relaying your experience that talking directly with the anesthesiologist can be effective in getting proper treatment given our particular conditions. Very encouraging!
I had very high cholesterol and triglycerides in two tests despite eating a healthy low fat diet because I have no gall bladder.I chose to continue on the diet but to try using non prescribed statin options ( plant sterols etc.) for a further six months , as at the time I did not have AF and Arrhythmias just the Dysautonomia.
My three month test remained high , my second test was higher still especially the HDL.
This was enough to give a clinic diagnosis confirmation of my Familial Cholesterolemia , and I was required to be on statins to bring down , and keep down my cholesterol.
As , it turned out , not long after my diagnosis , my Mother was checked when she went into hospital with advanced Non Alcohol Fatty Liver Disease which had caused her Hepatic Encephalopathy, she was akso diagnosed with FCh which had never been picked up on , they just gave her statins and left it there , and assumed they would be enough.
COVID had meant she wasn't checked with regular blood tests for two years so the NAFLD was missed and left untreated.
She had specific blood and genetic tests to confirm her FCh.
She eventually passed away from the condition a month later.
FCh is actually very common but because it is symptom free in most cases , or statins are prescribed without further testing so help manage the problem , you may not get a formal diagnosis or realise it's written in your medical notes.
Unfortunately, FCh is one of those silent conditions that doctors don't look out for as they should , it doesn't cause a problem on its own but eventually can be the cause for cardiac problems , plaques and blockages, PAD, stroke , neurological issues and liver conditions.
It is why I think it's worth thinking seriously and getting more consistent testing before making a decision about taking Statins or not, as diet and lifestyle changes or natural statin alternatives do not manage FCh or the problems it can cause in later life.
Thank you so much for your reply. I asked for a Coronary Calcium Scan and doctor gave me the order. Are you saying your mom's non alcoholic liver disease was caused by high cholesterol?
My Mum's NAFLD was caused by the vicious circle between her unmanaged high cholesterol and the reducing function in her liver from accumulation of fat and cholesterol.She also had blockages in the heart which post mortem determined was partially attributed to FCh and it's affect over many years but because she also had Ehlers Danlos like myself surgeons could not fit stents , they tried three times.
She had been given Statins early on when she initially began with CAD and had very high cholesterol levels but no one tested her for FCh at the time so she didn't realise that taking cholesterol lowering medications was important in her case and chose not to take them ( or only took them on very irregular occasions). She continued to use diet and dietary products instead which was insufficient for her medical history. They also found that she probably should have received gall bladder surgery. She had been a professional dancer and was a dance teacher and choreographer all her life so it wasn't as though exercise was an issue either. She never drank, took illicit drugs, or smoked in her life.
My own gall bladder had to be removed at age 39 , despite me being on a healthy diet and exercising regularly. At first , because I was very underweight (7st 10 and 5 ft 8) and losing weight the consultants weren't ready to accept I could have gall stones or fatty blockages they were convinced that I was just malnourished from an eating disorder even though I was eating a healthy diet and actually trying to gain weight. After five emergency admittances with pancreatitis they took my gall bladder out and it was full of stones and my bile ducts were blocked with fat deposits. My pancreatic consultant now says that part of the reason for the gall bladder problem was that I have FCh and was not removing cholesterol from my bloodstream.
a very interesting post. I’ve recently been told to reduce my dose of amiodarone and have started to get heart flutter since. I’m suffering from terrible night sweats and disturbed sleep and am on waiting list for ablation so will follow your progress with interest. I’m 79.
I’d suggest to keep reading up on amiodarone. For many practitioners, it is to be used only as a drug of last resort. It is a powerful drug. It was clearly the wrong drug for me—I fell into the 20% for whom amiodarone can CAUSE arrhythmia. And it was prescribed for me as a drug of first resort. That was a medical error in my estimation.
My educating myself on amiodarone combined with the alarming readings on my Apple Watch and Kardia is what led to my cardiologist agreeing I needed to get off the drug after only ten days on it. The arrhythmia it caused, sending my bpm into the 120’s-140’s, lasted the entire five months as I waited in queue for an ablation. Beta-blockers and calcium channel blockers did nothing to lower my rate. I do wish you well in dealing with amiodarone. I am understandably wary of it.
Night sweats, ugh! The nights sweats I was experiencing on metoprolol found me up at two in the morning using my hair dryer to dry a sopping wet cold head of hair. Night after night. It was awful. My pillow was wet, as though I’d been swimming.
I knew the sweats came from the metoprolol. Finally I said to myself that my body must hate this invading chemical so much that it is going to extreme ends to get it out of my system. I needed to listen to my body. And I did. Since I quit metoprolol, no night sweats, no day sweats from minimal exertion, no anxiety-causing bad, weird dreams. I’m sleeping through the night except for maybe one short awake period.
If I believed my life or my future heart health depended on metoprolol, I would take it. Ditto amiodarone. But that is not the case. Metoprolol is supposed to make me feel better by reducing my rate. It does neither. It makes me feel worse and has no effect on my heart rate. And amiodarone caused me harm. That doesn’t mean it’s not the right drug for you. I’m talking only about myself. Amiodarone has saved lives.
I keep a log of medications I take and side effects I experience, along with relevant readings from my Watch and Kardia. That gives me information to take to my doctor so that we can work in partnership in determining the best treatment plan. I am fortunate to have found doctors who will hear me and respect my insights into my own health situations. Are you keeping a log that you and your doctor can study? I recommend it.
I’m sorry about your night sweats. They are horrible!
But I see a problem with rapid H/R Anaesthetists will not operate.
The last 2 operations I was done publically (although one was under ACC private) and had 2 Anaesthetists in the room.
Not controlled with the 1st a Thyroidectomy. I was on 47.75 Metoprolol.
I was controlled by last 2 with Diltiazem 120mg AM.
BP controlled by 2.5mg Bisoprolol PM.
So if you are not needing an operation it will be your symptoms.
My rapid AF H/R for 2 years 3 months has done damage to my heart. A severe dilation of left atrium and RVentricle moderately regurgitation as a result. Pressure is good and Systollc function good although I showed a soft systollic heart murmur.
At your age and mine my symptoms would be sweating, breathless, fatigue on Metoprolol. Cardiologist changed me to Bisoprolol in the first instance.
Really well thought out and sensible approach you’ve detailed there - very best of luck with the ablation for the flutter - like you say not long to go now - it’s a battle at times but I really do believe in the power of positivity
Me too! My positivity is what is going to see me through. My positivity makes my proactivity possible. My positivity is what allows me to trust my EP, whom I’ve gotten to know. My positivity leads me to educate myself, and that gives me confidence in myself and my decision-making. My positivity spurs me on to best health practices to support my recovery: food, exercise, social connection, joy and gratitude. Optimism is a potent healing force, as studies have shown. I’m with you there!
As is often the case with the studies, the devil is in the details.
First it's unclear from the study data,how many, if any, were actually in continuous afib. The word prevalent is used, but never persistent or permanent.
But what struck me the most was that this was an essentially asymptomatic atrial fibrillation population.
For those with symptomatic afib with a higher heart rate -- like many of us, including myself-- the study has an opposite conclusion.
"...in symptomatic patients with uncontrolled AF, rate or rhythm control are important to improve haemodynamic stability and AF-related symptoms and to prevent or reverse systolic dysfunction."
In other words rate control is very important if not in normal rhythm.
You could well be right. Each of us needs to find what is right for us. Afib in one person is different from Afib in another in so many ways both big and small. There are no simple answers, one size fits all. Afib is an extremely complicated condition. The heart is extremely complicated! Where do all those electrical impulses come from in the first place? I’m in awe of the heart.
It would help if the literature did not contain conflicting information from different studies, but historically that’s just part of the process in the unending search for scientific truths. Right now it seems to me medical attitudes toward afib rate control are evolving as new information becomes available. I also see that practitioners and researchers are not in complete agreement on many Afib issues. There’s room for judgment calls based on the best available information we can find, and not only we patients, but our doctors, who are bombarded with studies that do not conclusively agree on best treatment protocols. That’s what I see, anyway. I got caught between two cardiologists who disagreed on the best treatment program for me, basically lifelong drugs vs ablation. Neither had a lock on The Truth. Neither of us do, either….
I wish both of us the best!! This is not easy, this thing we’re going through.
I’m pretty close with you except I chose to try one last drug, sotolol, rather than have a sixth ablation. My heart is pretty scared up from the previous ones.
Sotolol is working so far for me (4 months) but we’ll see. If/when it fails, we will take a pace and ablate approach or whatever my EP team recommends.
Consider a PFA ablation... less collateral damage! I have SLAS as well so it was a difficult call to choose to have yet another ablation, but fortunately it was successful.
I love success stories! I am full of hope that my ablation will be successful, which I might define as 5 years afib free. That would get me to 87, which would be fine. Five years afib free sounds heavenly. Even one full year sounds terrific! I feel totally positive going into the ablation and Watchman implant in a couple of weeks. I understand there are no guarantees (in life, ever), but I remain realistically optimistic. Stories like yours cheer me on. Thanks!
Lucky you! Your story goes to show us all that each person is unique and has different outcomes with meds and other treatments. In my case Metoprolol seems to help put a stop to high BP and HR along with Perindopril. Also I've suffered with ectoprics for 15 years and now have partial occlusion of coronary arteries. I will be going for an angiogram this spring.
I only wish metoprolol had done for me what it did for you and does for so many others statistically. I’m glad you found a good combination of drugs that help. That good news.
I had a similar situation. I do believe if we "test" cautiously we can discover a great deal about our meds and our personal reactions to them. The combination of Flecainide and Metoprolol helped me in the beginning but as time went on less and less... hence my multiple ablations. I did change to Bisoprolol and found it to be less debilitating and sufficiently effective to merit using it at a low dosage. Higher left me unable to go up even stairs --- and I am still working. My situation was Afib RVR, then added Aflutter, Atrial Tachycardia.
It would reduce my rate from 180-230 down to 150-160... the compromise helped me to be more functional in my work - which is physical.
I believe it is worth trying different meds and combinations - clearly with a doctor's advice.
Hope something works better for you - and best wishes for the ablation! I don't regret any of mine, and certainly not the last one - which is still holding! Pure delight. Courage!
Wow! You hit the nail on the head. I have an appt tomorrow with my cardiologist to discuss just what you have written about.
I too don’t think that the Metopropolil does anything and I also wonder about the Eliquis. I’ve been on them both for about 1 year.
I have been experiencing what I now call “heart” flashes (thought they were hot flashes or from my Raynaud’s disease) 4-6 times a night. Sleep has become elusive.
An ablation is always an option…have had one for SVT (lasted aprox 6 years). I will probably go that route again but dislike the idea that it will have to be done again in the future (they do not correct the problem forever). And, while the doctors tell us that it’s no big deal, I can’t help but wonder what they will say 10 years down the road (I am 65 years old now).
I hate the idea of another ablation but hate taking meds even more.
Thanks for your post and good luck with your ablation!
I’m in sync with you on meds. All of them have side effects. They can fix one problem and cause six others. But if that one problem is a big one, the side effects have to be tolerated. It’s a Catch-22.
Thanks for your good wishes. If my ablation could last six years, I’d be thrilled. I’m 82 and very much hope for a vigorous life for someone in their 80’s. I’m so tired of being fatigued. After a cardioversion, I feel great for however long it lasts, but then my heart reverts. I just hope the ablation gives me more time of feeling good and full of life as my remaining time grows shorter.
Hello, I have no doubt that the ablation will help you. It’s a rather easy procedure and you should fair well. Keep us all in the loop. Anxious to know how you feel afterwards.
This sounds like me exactly. I have always been hesitant about the meds, and sure enough, many of them made the problem worse, although after two failed ablations, I am back at the med route. It is a really tough spot to be in. I think the meds are/can be worse than the fix. It is a fine line to walk and it takes a really conscientious doc to listen to the patient and understand that we do not all have the same responses to the meds. there is no one size fits all...
Thank you for sharing your story!!! Before my ablation I was put on metoprolol. I was greatly fatigued and it lowered my pulse rate drastically. After a couple of weeks the doctor agreed it was not for me and took me off of it.
What a wonderful post and explanation to read this morning. As each of us is more than likely to know, Atral Fibrillation is not a "one size fits all" condition. It can be frightening as a new diagnosis and many times the providers and their team are not very transparent when prescribing medications and in general, less transparent in offering a full explanation of lifestyle and dietary changes we need to make going forward.
Fortunately, for those of us who research the condition, Dr. Percy Morales, MD and Dr. John Day, MD both have websites and publications that offer a wealth of information to help us understand, manage and possibly reverse Afib.
As my EP has said, "there are generally only two things that cause Afib and they are age and triggers. You can't do anything about age, but you can certainly identify the triggers and take action to live a long and enjoyable life".
Thanks for posting your story and best wishes in this new year.
I really never thought about toprul causing these sweats or difficulty climbing steps.Thought were helping.Now wonder if any decisions I made from ablation to pacemaker been right.no going back on some but wondering about toprul..fatigued often.
Each case is unique, metropolol has worked well for me for years controlling episodes of HR over 100 with no life altering side effects. I have paroxysmal Afib since 2009, (age 52 then), normal BP, heart not enlarged, normal HR 68-76. When I do have episodes of Afib, metropolol rapidly controls the pulse rate usually in less than 1 hour. Metropolol and Rhythmol therapy usually leads to cardioversion in less than 12 hours. I've required 3 medical cardioversions over the years, the last one in Sept 2023 when I had my first Afib/Aflutter episode. Aflutter definitely seemed more resistant to the metropolol in my situation, HR stayed higher and lasted longer (12-18 hrs). I have been influenced by comments on this forum and am currently "experimenting" with Diltiazem in place of the metropolol, WITH EP APPROVAL OF COURSE! In my personal situation I would never allow my heart rate to stay long term above 100, if at all possible. I have an Aflutter ablation planned for Feb 2024. Best advice I have gotten from my EP "The longer you are in Afib, the more likely it is to return". With an otherwise healthy heart ablation therapy is what I, and my EP, believe works best in my situation. I wish you a very successful ablation and many years ahead without Afib/Aflutter!
Best wishes for your ablation! I concur, our physical response to meds can change over the years AND they work so differently for us all. I had tried all the meds out there and the only ones which helped initially were Flecainide and Metoprolol.... with time they were less and less effective -but still better than not taking them (which I also tried)! I finally settled with Flecainide and Bisoprolol. On occasion one can find solutions which improve one's situation if not even eliminating for some!
I was unable to tolerate Rythmol, sent my Afib places I'd never been before in terms of ECGs and Diltiazem exhausted me. I am fairly sensitive to meds so the EPs always start low and increase if needed, but these two drugs were not only not helpful but MORE debilitating! Hence, I always agree, with an EP's help - do experiment! We are not a one size fits all group!
I know. It’s strange—but well reported in research. Some percentage is affected this way, another percentage a different way. There’s still so much, so hugely much, we humans don’t know about the workings of the human body.
I sure wish metoprolol worked for me as supposed to without side effects. I’m happy for you!
Why do I notice that appointment’s and surgery dates are always so far out? Is this a European/UK thing? The USA system is far from perfect, but with having a PPO, I’ve never had to wait longer than a few days to see a specialist ie. Cardiologist, Orthopedist , or Electrophysiologist.
TY for the post. It's more evidence for me that my beta-blocker, atenolol, may not be essential in the control of rate. Rather, my rate, being stable now for years in the 70-80 bpm range and with an excellent heart muscle similar to yours, I probably don't need it. However, I am also taking it for borderline high BP (130/90 range) and it seems helpful as 120/85 are my now long standing numbers. My cardiologist and I agreed to halve the dose to supposedly clinically insignificant levels to see. So far, so good. Next step may be eliminating it completely. But with minimal side effects, I'm left asking myself whether it matters.
I like your slow, careful approach in partnership with your doctor. Each of us has to find our own way, and it’s likely different in ways big and small from most everybody else. When I can taper a drug then get rid of it, I do. It’s done its work and I’m grateful. I’m being especially careful at 82 to not get pulled into being overmedicated. It happens. Too often. I’d love to be totally drug free, not be taking any drug that fixes one thing but disrupts another thing that’s going on in my body. It’s a balancing act.
I can only address the HR issue: After taking Atenolol for years, I was switched to extended release Metoprolol recently. While I have not experienced the side effects you have mentioned, I have found the rate control is not nearly as effective as was with Atenolol-while no overt tachy, HR jumps around from 60-100 numerous times during the day, whereas things were much more stable with the Atenolol. The side effects with the Atenolol were noticeable, however, so maybe this is the price we have to pay for effective HR control.
You appear to be going really well, and very wisely in yourself investigating your symptoms, available treatments and all the rest. To me it's tragic and wrong that we today need to ourselves research everything relating to our health - I loved "I do not subscribe to “The doctor knows best. I can only work with doctors who will work with me in partnership and mutual respect". Exactly how I feel, and it's distressing and upsetting to realise many doctors seem to prefer not to bother. I remember very happy days with my mother having a 'family doctor' she trusted and could confide in about almost anything. Now I feel like I'm just another item on a moneymaking conveyor belt, shown the door after a strict 15 minute appointment time in order to ensure the doctor gets his daily fee tally met. No wonder so many today are searching for medics such as Dr Sanjay Gupta of York Cardiology on YouTube to have their anxieties and fears eased and obtain adequate information! However, you seem to have ensured all the blocks are in place for a successful ablation - praying for absolute best results!
Finding the right doctors is a really difficult part of navigating the medical system. I don’t hesitate to keep looking if the provider I’m seeing does not meet my needs and expectations, if I’m just on the patient conveyer belt, unheard and unseen as a whole person and not cared about as an individual. It can take time, persistence. It can lead to dead ends and wasted energy. It’s a hassle, but in the end worth it when you find the right one. Then I just have to cross my fingers they don’t retire! That’s happened twice in the last ten years, sending me off on new searches for a PCP, running into a couple of clunkers before finding again a good one for me. The days of your mother’s “family doctor” who sticks with you for decades seem definitely over, a loss for all of us, doctor and patient alike.
Thanks for your good wishes and prayers. I feel the quality of my life in my remaining years rests on the upcoming ablation. At 82, I’m going to “age out” of the ablation business in not too long. This one has a lot riding on it for me. I remain positive. The odds for a successful outcome are on my side. I’ll take ‘em!
Good girl! If you're Christian, as I am, cling to Jesus and prayer - you've done the best you can - try to now rest and let Him take you through it all. He has promised to be with us whatever we need to go through - and as you know, He doesn't lie. 😄 He cares for you!
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Experiences with Metoprolol 
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afib episode after decrease in metoprolol
