It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Heart Disorders Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 07-13-2005, 12:26 AM   #1
Senior Member
(female)
 
Join Date: Jun 2003
Location: California
Posts: 117
PA2LA HB User
started the Beta Blockers!!

One week after my husband's visit to the Electrophysiologist/Cardiologist, he recorded enough events to warrant treatment w/Beta Blockers. He's still wearing the monitor but, he took his first dose of Toprol-XL (25mg) this afternoon.

I'm relieved that this has been diagnosed and treated, relatively fast. However, he didn't have a real appt w/the doctor today. They just called him in after an extensive phone conversation, to pick up sample of the bb to try. I wish that all doctors were as great as this group!

Anyway, of course we have more questions than we can remember to ask and we will direct these all to them tomorrow. In the meantime, I just wanted to see what the general consensus is on the effects of the beta blockers, specifically Toprol-if you've had any experience with it.

The big question is: What is the target heart rate while taking this? His heartrate has been ranging from 77-216. By far, his worst recorded event on the Holter was in a sitting position, his H.R. spiked from about 88 up to 216 in a matter of seconds. After this first dose of medication, I have witnessed his hr go as low as 55 bpm. That is quite drastic, so I just want to make sure that there is no need for concern.

He said that the sensation is like someone has their hand around his heart and they are controlling it with gentle pressure. He says that he can feel when an attack is TRYING to happen and it is as though the b.b. pulls his heart back to normal. It is kind of uncomfortable.

He did record an event just awhile ago (ate dinner 30 minutes earlier) that he felt a shock of pain when his heart rate tried to go up (and it did make it up to 190), then it shot right back down. Luckily, he thought enough of it to record that, so I guess we'll see what the doc thinks about it.

I guess that some of this can be chalked up to just starting out on a low dose and it being the first course of intervention. It would be great to hear some experiences of the first few days on the beta-blocker.

BTW, I do not have a condition name, as of yet. I am going to call the doctor tomorrow and ask a few questions of my own. Although, from what I gather, the doctor expects treatment to last around 6 months.

Do you think that it is helpful/necessary to invest in a good Blood Pressure monitor at this point? I know that there are risks of hypotension while taking bb's, so any advice and opinions on whether or not that is needed is certainly welcome.

I understand that not everyone has a favorable response to different Beta-Blockers and I'm not sure that the difference is between them. Anyone who can shed some light on why that is and what the difference is between them, would be very helpful.

One last thing...is it safe to take Xanax while on Toprol? The doc said that he can continue taking it, but I can't find any drug interaction info on that, specifically. I don't want him passing out on me!

Thanks so much for your help, info, and support in the last 10 days. Without your posts, we would've been lost!

 
Sponsors Lightbulb
   
Old 07-13-2005, 05:16 AM   #2
Senior Veteran
(male)
 
Join Date: Nov 2004
Posts: 8,484
Lenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB User
Re: started the Beta Blockers!!

The goal of beta blocker treatment tis to allow the heart to beat as fast as it can get away with WITHOUT going into fibrillation. ALL beta-blockers will lower the heart rate markedly and anything above 50 is no cause for concern. Maybe call the doctor the first time you see anything in the 40's. It's a delicate balance and there are other drugs that are stonger and work better that can be used (like sotalol.)
All beta-blockers will knock the slats out of his energy so I would recommend stopping the xanax until you see what several weeks of the toprol is doing. If he feels he needs the tranquilizer then and has some energy left he can add it back.
There's lots of trial and error ahead of the two of you and I DO think a BP monitor is a very good idea for anyone on a beta-blocker (or ANY BP med for that matter.)
Sounds like he has a good bunch of doctors.

 
Old 07-13-2005, 08:51 AM   #3
Senior Veteran
(male)
 
started04's Avatar
 
Join Date: Jul 2004
Posts: 1,566
started04 HB Userstarted04 HB Userstarted04 HB Userstarted04 HB Userstarted04 HB User
Re: started the Beta Blockers!!

My BB is Coreg and it is prescribed for CHF caused in part by an enlarged heart. My cardiac treatment was to get the HR and BP as low as can be tolerated. After 9 months the lower HR and afterload (dilated arteries) the enlargement has decreased and EF is around 50% up from about 16%.

I haven't had arythmia and fibrillation but to have the heart beat as fast as it can without going into fibrillation is counter intuitive with my experience and condition. It begs the question does the lower HR cause arythmia and fibrillation?...A very fast HR does not give enough time during dystole for the heart to fill, and as a consequence with the lower cardiac output there will be fatique. Also a fast beating heart will enlarge.

 
Old 07-14-2005, 02:26 PM   #4
Inactive
 
Join Date: Apr 2004
Posts: 156
jpos HB User
Re: started the Beta Blockers!!

I take a bb for inappropriate sinus tachycardia and neurocardiogenic syncope. When I started them at 1st it made me more aware of the tachy (before hand I didn't get palps with the tachy and so was unaware of it). By the 2-3 week mark I felt so much better. It actually took away my fatigue and increased my bp to a more favorable level (it happens to be low again, but ok). My ep said this happened, because my heart was pumping more efficiently now.
I have been on atenolol (Tenormin), but couldn't tolerate but 1/2 of the smallest dose, Cardizem, Toprol and am currently on bisoprolol. There wasn't really a problem that caused me to chg. bb's all those times, it was just... well, it's a long story.
I am allowed to take the xanax with my bb's. Oh, and my ep wanted to get my heart rate in the 50's, but said my heart wouldn't cooperate.

 
Old 07-15-2005, 04:01 AM   #5
Member
(female)
 
Join Date: Jun 2005
Posts: 53
Caroliz HB User
Re: started the Beta Blockers!!

Like one other posters stated above it is trial and error with BB. I can only tolerate 25mg of Topol but that is not doing it for me. He wants me on 75mg..Topol causes me to itch but this does not happen with eveyrone. I have a good BP arm monitor here and I record several times during the day and I also note whether BP is taken after a meal. Good Luck.

 
Old 07-15-2005, 05:17 AM   #6
Senior Veteran
(male)
 
Join Date: Nov 2004
Posts: 8,484
Lenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB User
Re: started the Beta Blockers!!

kenkeith,
Many people take beta-blockers SOLELY to prevent atrial fibrillation and flutter. For them the desperately low heart rate and the hypotension is debilitating. My statement that the goal is to use enough blockade to eliminate, or lessen as much as possible, the occurrence of bouts of fibrillation is strictly for them. Using more blockade than necessary with the result of a 40 BPM heart rate and a BP of 90/50 is a huge mistake if fibrillation can be avoided while maintaining something like a 60 or 65 BPM rate.
That's what I meant by keeping the heart rate "as high as possible."

Nothing I said is intended to pertain to anyone in Heart Failure or even a person with serious hypertension, only someone treating fibrillation episodes.

A lower heart rate DOES seem to diminish the rate of fibrillation episodes, the problem is how low does one need to take it to be able to tolerate the condition. Medicating to the point of being bed-ridden being the extreme. Thus I feel that medicating just enough to eliminate the fibreillation episodes "while keeping the HR as high as possible" is the way to go.

I have a dear friend with the condition who has had to be "cardio-inverted" several times and is now getting decent results from sotalol. He can virtually eliminate any fluttering with desperately high doses of the potent beta-blocker or take a middle ground and medicate JUST to the point of good results. He's happier keeping his heart rate "up" a bit.

 
Old 07-15-2005, 11:37 AM   #7
Member
(female)
 
Join Date: Jun 2005
Posts: 53
Caroliz HB User
Re: started the Beta Blockers!!

Quote:
Originally Posted by Lenin
kenkeith,
Many people take beta-blockers SOLELY to prevent atrial fibrillation and flutter. For them the desperately low heart rate and the hypotension is debilitating. My statement that the goal is to use enough blockade to eliminate, or lessen as much as possible, the occurrence of bouts of fibrillation is strictly for them. Using more blockade than necessary with the result of a 40 BPM heart rate and a BP of 90/50 is a huge mistake if fibrillation can be avoided while maintaining something like a 60 or 65 BPM rate.
That's what I meant by keeping the heart rate "as high as possible."

Nothing I said is intended to pertain to anyone in Heart Failure or even a person with serious hypertension, only someone treating fibrillation episodes.

A lower heart rate DOES seem to diminish the rate of fibrillation episodes, the problem is how low does one need to take it to be able to tolerate the condition. Medicating to the point of being bed-ridden being the extreme. Thus I feel that medicating just enough to eliminate the fibreillation episodes "while keeping the HR as high as possible" is the way to go.

I have a dear friend with the condition who has had to be "cardio-inverted" several times and is now getting decent results from sotalol. He can virtually eliminate any fluttering with desperately high doses of the potent beta-blocker or take a middle ground and medicate JUST to the point of good results. He's happier keeping his heart rate "up" a bit.
I am also on NorpaceCR after a month trial of Sotolol. Soto had too many side effects for me. When I had my A-Fib attack I had to be convereted via Corvert. I do not want to ever have another attack of this again. The A-Fib was so severe that the heart enzymes spilled over (this can come with a severe A-Fib attack) I was on TopolXL25mg and Avalide150/12.5 and baby aspirin when A-Fib occured. The EP and Cardiologist are aiming for the HR to be no lower than 65. They do not want the HR any higher than 80. (it is usually around 90-100 every single day for years) A-Fib HR went thru the roof.

They want the BP no lower than 110/65. Aim at 120/70 is great. No higher. Hard task but I have to do this to keep me out of A-Fib. Good Luck To All..

Last edited by Caroliz; 07-15-2005 at 11:38 AM.

 
Old 07-15-2005, 04:56 PM   #8
Senior Veteran
(male)
 
started04's Avatar
 
Join Date: Jul 2004
Posts: 1,566
started04 HB Userstarted04 HB Userstarted04 HB Userstarted04 HB Userstarted04 HB User
Re: started the Beta Blockers!!

Thanks for the clarification. It may be information I can use in the future.

I have read to prevent blood clots a higher HB within a range as opposed to lower is desirable for patients with MV regurgitation.

 
Old 07-16-2005, 03:11 AM   #9
Senior Veteran
(female)
 
Join Date: Jul 2005
Posts: 543
starsofglass HB User
Re: started the Beta Blockers!!

I've been taking a small dose of Inderal (10mg; propranolol) to lower my heart beat, but ever since I've been having MORE ventricular extrasystoles. How is this possible?

 
Closed Thread




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Join Our Newsletter

Stay healthy through tips curated by our health experts.

Whoops,

There was a problem adding your email Try again

Thank You

Your email has been added








TOP THANKED CONTRIBUTORS



Machaon (77), Vyking (50), sjb (25), JJ (22), ladybud (18), started04 (15), rosier (9), Beefsteak (8), cvcman (8), Bob652 (6)

Site Wide Totals

teteri66 (1165), MSJayhawk (1000), Apollo123 (898), Titchou (833), janewhite1 (823), Gabriel (758), ladybud (747), sammy64 (668), midwest1 (665), BlueSkies14 (610)



All times are GMT -7. The time now is 05:24 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!