Pacemakers and beta blockers

Sorry to see you are experiencing this. Must be very worrying.

When you say 'racing', what exactly is the rate, and is it steady or does it rise and fall, say with exertion, standing, or when you worry about it?

A pacemaker, depending on the type and for what purpose, should not allow your heart to race if it is of the type that can help to slow the heart. A pacemaker is meant to do what its name suggests....to pace the natural heart rhythm for the current demand or need. Some of them need to be set with a pacing process, and then they are to be monitored. If your HR exceeds 110 BPM or so, say 120-130, that is abnormal and you should seek help at the local ER. Certainly don't let a high rate go unchecked for more than 24 hours because that high a rate suggests that your ventricles are contracting that quickly.

@gloaming I agree. Be your advocate high bp numbers need answers.
I am now on my 4th Medtronic pacemaker beginning in 1998-99, now in 95th year of life,
And pacemaker was placed for bradycardia and beta blocker for tachycardia. Overtime dosage has changed. To keep my heart from racing I keep my bp around 105/55 approximately and daily check bp and weight. Beginning in 2000, dosage atenolol 100 mg, then reassed to 50 mg then 25 mg. So docs listen.
Today, older years I am now at
1/2 pill of 25 mg.
We are individuals with different set of medical needs.
Good luck.
Prayers and blessings. In Jesus name.

@verdine if I could recommend a most important tool for you is keeping your own daily log.
Date, weight. Blood pressure and oxygen.
With heart failure, I keep sodium intake records. For me, phosphates are a no no so no no soft drinks. I am required to drink 62 oz water daily and have done all of this for 20 years. We are all different with different needs. Talk to your cardy and internist.

I experienced some tachycardia and Atrial Fib soon after my pacemaker insertion 5 years ago. I learned this is not usual but also not that uncommon and learned that when I changed electrophysiologists. The AFIB resolved after a brief period of time and it has not recurred. I would encourage you to seek input from other medical experts if it doesn’t “feel right” to you and/or you are not feeling well.

HI I AM ON BETA BLOCKERS NOW TOO!! BUT WAS JUST CHANGED TO CARVEDILOL
my BP has been so nice, I've never seen my BP run so currently the same almost all day 2x daily.
I am happy but have to wait for my eliquist to be restarted because I had a 100 % plural effusion
in my right lung after the surgery I got pneumonia day 3, and the effusion was started right after
the second placement 7 days after the first one, they said i coughed the lead out

Before surgery I was on metoprolol, and the cardiologist switched me to nebivolol thinking it might make me less fatigued. Both worked fine to control BP, but I felt very fatigued after minimal activity. Both of these are selective B-1 blockers. Other BP meds caused all sorts of nasty side effects, from dizziness to swollen feet. I have several bottles of pills I learned NOT to take.

Two weeks ago I had 2nd-3rd degree AV block (pulse=30), a short helicopter ride to an Orlando hospital, and now have a pacemaker.

Leaving the hospital, the hospital cardiologist switched me to carvedilol - a non-selective beta-blocker. In a few days I was feeling dizzy and every day it got worse. My original cardiologist told me to switch back to the prior meds, which I did immediately. Dizziness quickly cleared up. The difference is selective B1-only vs non-selective B-1, B-2, and ARB.

BUT... the same dosage Nebivolol (10mg) is now reducing my BP to something under 110/70 and I feel like a dishrag. I cut last night's pill in half, and my BP is still below 110. I'm not sure what the answer is, but my research (as an engineer, not a doctor) suggests the BP meds might now be TOO efficient. The pacemaker will maintain a lower limit, but the beta blocker is keeping the strength of the heartbeats from getting too strong.... or perhaps strong enough.

It will take me some time to figure out a proper dose. Until then, I monitor my own BP frequently. You might check the details of each BP med, note their action and target, and potential side effects. From that, you might be able to figure out which ones work well for you, and which ones don't.

@jimgrupe It's a bit of an aside, and I don't know anything about you, certainly not your age....the cardiology field is moving rather quickly, generally, to raising the range of systolic and diastolic pressures for those over the age of about 70. What brought this on was a population average higher rate of falls and injuries in the aged, and it was soon realized that we are over-medicating people whom we felt were in incipient hypertension or in full-blown hypertension. Older people, it turns out, do much better on raised blood pressure. It's natural. Who knew!?

I don't know where this will settle, but many cardiologists insist now that BP in the 130/80 range is nothing to worry about for those over 65. In fact, the building wisdom is now that you SHOULD be concerned when it runs much below that lower limit in some cases, keeping in mind the patient's reported symptoms and events.

I turned 79 yesterday. My PCP is a bit of a fanatic when it comes to BP, insisting that I keep it well below 130/70. I am past the point of trusting any doctors completely. The heart block that brought me to the ER two weeks ago was dismissed by the cardiologist as a error in the stress test that he ordered - despite previous tests that ALSO suggested a possible AV heart block. Looking back, I can think of other symptoms going back years that might be attributable to a growing AV heart block problem, Which is why I am now intent on adjusting my own mediations. This morning, my readings were a consistent 131/74 P75 after HALVING the Nebivolol pills for the last 2 days to 5mg/day vs the prescribed 10mg with a side of Losartan as needed. I'm sure my PCP would argue that it's still too high. I am shocked that people here are reporting keeping their systolic BP under 110. Anything less that 130 makes me feel like a dishrag, and under 110 I can barely stand up.

@jimgrupe Welcome to Connect! I see you recently joined our discussion and are presently focused on BP (blood pressure) and various BP medications. We do not give medical advice on Connect but do share our experiences. Your cardiologist and electrophysiologist should be in the loop concerning your BP. While our PCP (primary care providers) are certainly excellent doctors, these other specialty doctors have more current knowledge and experience in their specific fields. My cardiologist oversees my blood pressure meds. @gloaming noted an important debate concerning blood pressure. There does not seem to be any definitive answer at this point, but I did see this by AI (scientific verification needed - it seems that studies at the UVA-University of Virginia are investigating):

"Why Targets Can Vary

Blood pressure management is highly personalized. Your doctor may adjust your "perfect" range based on specific factors: Underlying Conditions: If you have diabetes, chronic kidney disease, or a history of heart disease, your doctor will likely aim for a tighter control. UVA Health+4

Frailty & Medications: For some older individuals, aiming too low can cause dizziness or increase the risk of falls. In these cases, a slightly higher target may be chosen to balance safety and cardiovascular benefits.
IntraCare Health Center+3"

We highly recommend not changing any medications without consulting your doctor. A discussion and questions about age and BP readings may result in a more comfortable outcome for you.

....and.....unfortunately......it sometimes behooves a body to change physicians on top of one's medication. It is disconcerting for a needy patient to learn this regrettable fact, but oftentimes a patient must advocate for themselves forcefully and it happens that their physicians will tell them coolly that they can no longer help them. So, time to seek new help, one who will pay attention to what you tell them when you say your medications are making you as ill as the condition for which they were prescribed.