ventricular eptopics and EF 47%

[Ba1414]

hey recently being told I have ventricular eptopics and EF at 47% I’m on 2.5mg bisoprolol and 1.25mg ramipril. Dr said they want to get to me 10mg of bisoprolol however I’m worried as HR drops to 42-44 already.

Anyone had the same or any advise

[Chinkoflight]

Hi, I have ectopics but more significantly left ventricular tachycardia and Afib. I have an ICD fitted. I have long known and lived with bradycardia ,typically resting HR of 40. The Drs started me on bisoprolol of 1.25 with an intent to increase up to 10 such was there concern to prevent the peak tachycardia. However, before the ICD was fitted whilst in hospital CCU when the bisoprolol was started my HR dropped to 36/37. The normal monitor alarms were switched off. During one night the desk alarm went off because HR dropped below 30. I was woken by a nurse shaking me....!When they fitted the ICD it also had a pacing wire which they set at 60. By the time I got home I was experiencing extreme discomfort. This took two forms, occasional shocks lying down in bed but during the day I could feel the pacing which was leaving me feeling debilitated. I hadn't felt ill with the heart problems but now I felt ill.

The hospital said a lead had detached. They also switched off the pacing lead pending a refit of the ICD. I immediately felt better, it was dramatic.

The upshot was not to increase my bisoprolol dose but to leave me on it. To set the ICD intervention should my HR fall below 33.

I wish I was better protected against the likelihood of another LVT, ie had a higher dose bisoprolol but recognise it's a balancing act. If they asked me to increase I would try it. A year on after the refit everything has settled down.

One thing I can say with certainty I don't want another sudden cardiac arrest and will defer to the Drs advice.

[CuriousCat9]

I have ventricular ectopics (high burden of 50%) and take the same medications. My ef is 36%. It was the low heart rate that got the Dr's concerned and they referred me. When the consultant gave me the meds, I panicked because obviously the meds lower heart rate and I thought I'd hit the deck, but you don't! I'm up to 5 bisopralol and 7.5 ramparil. Once they get settled in, it's not too bad for me.

Also, the machines don't pick up my ectopics properly. Just the big beats. So pop a machine on my finger or feel my pulse at the wrist and it's 45 ish. Listen to my heart and it's about 70/80. The samsung watch can pick it up but not the hospital finger machine lol. I keep telling different nurses not to put it on but they never listen and panic.

Trust the medication, they really know what they're doing and ask loads of questions, they'll explain it all for you.

Hope you're feeling better soon.

[Gambalunga]

I'm a 66yo SCA survivor (2021) & am on 1.25 bisoprolol, ramipril and the others. I also get ectopics which recently have been very intrusive. I had an ECG a while ago, the ectopic performed but the underlying pattern was good which was reassuring. My bisoprolol was initially set at 2.5 and I suspect they forgot to ramp it up. I did ask the GP if I could come off it, we settled on a reduction to 1.25 which felt loads better.

As has been mentioned, a lot of digital readouts get confused by ectopics. I cycle a lot and wear a Polar H10. On occasions it's shown my walking around heartbeat to be 37 which I know is nonsense. However with the higher bisoprolol dose my resting beat was towards 40.

Finding a suitable regime has helped me cycle with confidence, which I do 3 or 4 times a week. And generally I aim to cycle in the Zone2 range which doesn't elevate the heart rate too much.

Of course working out heart metrics for those of us on beta-blockers is a whole area of under-researched uncertainty!

[Eeee13 in reply to Gambalunga]

my heart rate always drops after exercise and when stressed. Can go as low as 23Bpm

Max to want your heart to go to is 220 less your age.

I have ectopic beats all the time.

Beta blockers will lower your blood pressure. They affected me so bad I had to come off them. Currently on Degoxin. I feel normal again and does not lower my Bp

[Chinkoflight in reply to Gambalunga]

So true on the guidance for heart range during exercise. I can't get any advice so am also self limiting to max of 140 while running. It means I have to walk/run which is a tad frustrating.

[Eeee13 in reply to Chinkoflight]

Wish I could offer some help

I’m in similar situation. You’re not alone

Take care keep speaking to your healthcare professionals. Go to A&E if you nee to.

I was told after my last Ablation in Jan my heart must not go above 120 during exercise for 3 months . Well it’s been banging away 150 all day every day since when sitting on my back side.

I burn 7000 calories a day doing nothing.

It’s like being on a treadmill for 8 hours . It’s physically exhausting

Last December decided to get fit as nothing was happening. Cross trainer for an hour 5 evenings aweek for the month then had to go back on blood thinners 2 weeks for next surgery 18/1 and have had to stay on ready for next surgery imminently expedited. Can’t even go up stairs without being breathless. Let alone go for a walk.

Just living from one day to the next at the moment.

[Chinkoflight in reply to Eeee13]

I was given the advice to always exercise at a conversational pace which I stick to. But the exercise I had done I'm sure prevented the SCA being worse and aided recovery.

[Eeee13 in reply to Chinkoflight]

I was told to take regular exercise after my last surgery after 2 weeks rest and gently in crease and to keep my heart rate below 120bpm for first 3 months

Well 2 1/2 days after surgery in Jan heart rate races up to 150 while I’m awake all day. If I exercise it goes even higher. So I’m in a catch 22 at the moment. Awaiting further surgery.

Yes exercise does work not only curb your health but mental health too.

Good luck

[Eeee13]

Do you by any chance have low blood pressure ?