hi,
in a situation where there is a low heart rate between 55 to 60 bpm when in afib, does it make sense to take metaprolol drug, designed to reduce the ventricular heart rate, amongst other things?
my allopathic md prescribed this and i cannot help but feel a bit uncomfortable. i don't wish the heart rate to go even lower then 55 bpm. but perhaps there is some logic to it all. all other parameters are fine, such as blood pressure etc.
crazy
I was on Metoprolol 25mg and my blood pressure dropped and my heart rate was low 50s.. My Paces is set to Sinus Rhythm at 60 so my Main ( Muscle ) Cardiologist told me to cut it in half 12.5 and my Ep Cardiologist agreed.. It resumed back to 60..
I would love for my heart rate to be 60 right now…currently I am back in Afib with high heart rate.. I am currently pacing at 120 going to high 160’s.. I will be undergoing my 4th ablation on Tuesday..With that being said for me Metoprolol worked great.. I am not a Dr and would not suggest doing anything changing of meds but you might want to call your Cardiologist.. Hope this helps.
4th ablation? Have you considered PFA or mini-maze? PFA is not necessarily more effective but I understand that it causes less scarring in the heart. Been hearing a lot of positive things here about the MM recently. Might be worth checking out if you haven't already. Best wishes.
Thank you so much for this..I will definitely ask about this..
Is your heart naturally 50-60bpm, or is that what Metoprolol brings it down to?
I take Metoprolol 25mg morning and night. I wouldn't want to take that dose if my heart rate was naturally low.
I would suggest either speaking to your GP or pharmacist about this matter.
Hope they can re-assure you one way or the other.
Jean
thx for the reply. my heart is naturally running between 55 and 60 bpm in both, sinus and afib episode, that's why I'm concerned with taking metoprolol as I don't wish the heart rate to go below 50 or lower... that's where this dilemma stems from,crazy
I would be concerned as well. I also have low 50’s to low 60’ resting pulse rate. Blood pressure is usually low side of normal.
When I had A-Fib (1or 2 confirmed cases, only, but a number of tachycardia events, over many years) my pulse was 150’s and bp was 160/105 . Tachycardia events, highest recorded pulse was 173 bpm. I am not sure if I ever had a-fib with any of the previous tachycardia events because I only got my Kardia Mobile 6L device a few months ago. I have worn heart monitors for 20-30 days at a time, twice, nothing was picked-up.
My Cardiologist’s nurse has ordered 25 mg Metoprolol for me, I asked if it would lower my BP and pulse a bit too much..
she said to take half of the pill )ie. 12,5mg) and see how it goes. Filled script for regular dose and I must break pill in half.
I haven’t started on them, yet.
I am going to get another opinion… with an EP before I start on them.
Have you looked into/discussed possibly trying Vagal maneuvers when in A-Fib? Or discussed going up and down stairs, to tru re-set heart rate, when in A-Fib? I am not promoting this, please research and discuss with your doctor…
I stopped my 8 hour a-fib event by doing two types of the vagal maneuvers (found them on mayo Clinic website and York cardiology, UK on youtube.. Dr. Gupta, I believe, a well respected cardiologist in the UK)
I told my cardiologist’s nurse that I came out of a-fib by doing these… immediately worked when I decided to try some… saved me a trip to the emergency room (and lots of $$$$’s)
She was ok with me trying them again in the future, if needed.
that they have found that people who have lower pulse rates when in A-Fib, often have been able to re-set their heart back to normal, by doing some exercises like stairs.
However, if one has a faster heart rate , they recommend not doing the exercises during a-fib. Will look for that website and send link.
I think your concern is justified. My normal resting HR is on the low side and although my HR goes up to maybe 130 at the onset of AFib it comes down pretty quickly and even 1.25 of Bisoprolol absolutely prostrates me with low HR and blood pressure and also stays in my system for hours after NSR has resumed, so I politely declined it.
It doesn't make much sense to me why you would have been prescribed this medication based on what you've told us.
A rate below 50 that is not symptomatic is, I was told, not a problem. Presumably the figures you give are for resting heart rate, but doesn't this increase with demand, from exercise, say? Also, when in both AF and NSR, are you saying that your resting rate remains at 55-60bpm?
Steve
yes, the numbers of 55 to 60 bpm heart rate are for resting, for both sinus and afib rate and without metoprolol. in fact I never took any drugs, including metoprolol. naturally, when exercising and in afib, ie walking fast, the heart rate goes up but not above 80 or so, and I feel its arrhythmic beat quite a bit more. I guess I'll give the allopath (who prescribed metoprolol) another call and perhaps he can shed some light on this...thx to all for your replies, much appreciated
my allopathic md
Your choice of a medical provider is an individual choice and deserves respect. That said, most people with afib prefer to be treated by a cardiologist or EP. Best to You !
Hi
Metropolol for me is banned.
The 24 hr heart monitored no control on h/rate @ 186 avge Day, 47 avge Night but caused 2 second pauses through the night.
Changed finally to Bisoprolol. Controls BP only. Still uncontrolled @ 156 avge Day. 47 avge Night.
A private cardiologist brilliant. Interested. Introduced CCB Diltiazem 180mg but lowered 120mg AM with Bisoprolol 2.5mg PM.
2 years 3months my H/Rate Day nw 60s Day. BP 130/69.
The first time I had Metroprolol for hypertension within a year I went too low so I was withdrawn from it. At doses over 47mg I was breathless then without AF in the background.
cheers JOY. 75. (NZ)
I also have a low HR in AF maybe 75-85 when in sinus 60-65. Post cardioversion I was given 12.5mg metoprolol and 50mg Flecainide to help the heart settle in. My HR dropped to 40-45 at rest so doctor adjusted the Flecainide to 25mg and now my HR at rest is around 55-60
"My HR dropped to 40-45 at rest so doctor adjusted the Flecainide to 25mg"
Are you sure it was the Flecainide he adjusted?
I have Metoprolol (25mg BD) for rate and Flecainide (150mg BD) for rhythm. When still getting AF episodes too frequently, daily Flecainide dose was increased and then increased again. I had low HR before starting AF meds and doubling and tripling my Flecainide dose had no noticeable impact on my resting HR.
According to paper "Twenty-five years in the making: flecainide is safe and effective for the management of atrial fibrillation".....
"Flecainide does not affect sinus rate, although bradycardia and tachycardia have been occasionally reported."
YMMV but it differs from my experience/understanding. If the above paper is correct, even though it might work that way for you it may not work like that for most AF sufferers.
Interesting and I noted in the report that bradycardia was noted which is a slower HR I guess I’m one of those that Flecainide contribute to that.
my natural resting heart rate is about 58-62, was put on metoprolol 25mg morning and night along with flecainide 50 mg, morning and night. Resting HR was down to about mid to high 40s -and was feeling quite fatigued. After consulting with PCP and cardiologist agreed to drop morning dose of Metoprolol and HR now around 48-52, and feeling less tired. The flecainide stayed the same dosage and as of today (happy anniversary Me!) I am one year without any afib episodes though was having them almost daily. Still more tired than before drugs but it’s more manageable and I’m thrilled that afib epeisodes are no longer with me. Also started on B12 on recommendation of PCP as it was a bit low. Bottom line—I think it’s always worth a discussion about tweaking the meds because it’s different for everyone. Good luck!
Daily use of metoprolol?
Bisoprolol and low heart rate 
Metoprolol
Irratic heart rate resting
Low Heart rate, should I be worried? 
