started the Beta Blockers!!

[PA2LA]

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!

[Lenin]

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.

[started04]

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.

[jpos]

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.

[Caroliz]

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.