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Hi, @motiger. Glad you could join us here on Mayo Connect, and I hope you'll enjoy and benefit from conversations with the members that @kanaazpereira has poked for you. I wrote a fairly long comment in response to your opening message, then lost it when my computer window closed without warning. It was too wordy anyway, so I'll reconstruct from memory only the main points that I'd have bothered you with.

Like you, I have A-fib, but neither diabetes nor infarction. My main medication is Carvedilol, a newer version of the drug class that includes Metoprolol. My dosage matches yours -- 25mg AM and PM. But my dosage is that large as much for its effect on my blood pressure as on regulation of my heart rate. Does your diagnosis also involve hypertension?

Because A-fib sometimes results in small blood clots being formed in the heart and sprayed around in the arteries, I'm also on an anti-coagulant -- Coumadin. That has meant regular blood tests to be sure of a safe coagulant index and avoiding a lot of leafy vegetables which contain Vitamin K, a Coumadin antidote. Have you taken an anti-coagulant?

Are you pushing too hard with your exercise regimen? Not that I can see, and if your cardiologist is OK with your daily walk of a mile -- with a heart rate of 150 at the end -- you should keep right on trucking. My heart rate used to be 50bpm (from running, biking, and hiking); A-fib pushed it up above 90, but it's now regularly 75-85 as a result of the Carvedilol.

Incidentally, a number of patients on Carvedilol have troublesome side-effects, often because they (or their doctor) abruptly cut their dosage in half or less. It should always be phased down with the doctor's close oversight.

Let us know how you're doing . . . what you're thinking . . . as a result of these discussions. Oh, forgot to mention that I'm originally from Iowa, so I'm assuming that "motiger" reflects a relationship with the University of Missouri Tigers. Right? Martin

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Replies to "Hi, @motiger. Glad you could join us here on Mayo Connect, and I hope you'll enjoy..."

To my last epistle I want to add that I think my stated pulse rate is probably bogus. As a finger insert gadget it creates the stated pulse by measuring the time between heart beats and multiplying. So this morning I was already at 135 by the time I had taken maybe 15 steps. Despite the fast start I never went beyond 152 and it dropped quickly to 14?. Just a random experience. It also tests Oxygen and it is ALWAYS at least 92+. I wonder what others might be using. Mine comes from Walgreens. My Afib requires that I take warfarin 5mgs daily and be tested monthly. I don't have any trouble with this being normal. I'm just getting started with metoprolol and can't discern any slow down in the heart rate. Perhaps Cavedilol would slow me down perhaps not. Wish I knew.
My MI was discovered during a checkup in 2011 and I don't recall anything in the way of symptoms but I have an EKG that Is definetely abnormal. My diabetes was discovered on a check up too. A1C then was 6.6 and has always been less than that since. My ejection fraction is 35% and I have never suffered any angina as best I can discern. So as you can see I am kinda borderline in several ways but I want to keep in decent shape withour pushing too hard. A hundred years ago in high school football I picked up the nickname tiger and I live in Missouri but am not connected with the University except to be a fan. I'm a transplant from a small town in Illinois by origin. We lost our profootball team here(Rams) when a greedy walmart co-owner wanted either more money or notoriety who knows which. He has a gods plenty of both already. Thanks to one and all... I do appreciate the sharing of your experiences and would love to hear more about how you determine your pulse rate.

Hi, Tiger (@motiger). Glad to get your message just now. Glad also that you're taking Coumadin/Warfarin and don't mind the inconvenience. I think it's the best of the anti-coagulants (despite TV ads in dispute). One reason for my choice was the death of a friend who was on Coumadin and fell off a step ladder and struck his head. I was the first to find him, called the EMT, and sent him off to the emergency room. Sadly, the ER had no Warfarin antidote -- CAN YOU BELIEVE THAT? So they called in a helicopter to ferry him to a more competent hospital -- but the half-hour wait was too much, and he died shortly after he arrived at the other hospital. Sounds perverse, doesn't it -- he died from lack of treatment for an anti-coagulant. Not perverse, however. For Warfarin there is the Vitamin K solution that can stop the effects of the anti-coagulant in 15-20 minutes, while the other anti-coagulant drugs still do not have antidotes available, although drug companies are working to develop them.

My other point is whether you might be too concerned about your 150bpm heart rate. After a brisk mile walk, that doesn't seem threatening, but you -- and your cardiologist -- would know better than I. I caution you about hankering to change to Carvedilol, which might work for you, but also might cause some uncomfortable side effects. Like with politics, it looks like the two (or three or four) sides of the issue need to get together and agree on a compromise that meets your personal preferences as the patient (the PPP).

For my heart rate, I rely on my BP meter at home, which reports heart rate along with blood pressure. Like you, I sometimes worry about a rate measured during a brief time, then multiplied to its per-minute equivalent. So I just take my heart rate the old fashioned way, counting the beats per minute and using that as a check on the meter. Bottom line, though, I rarely have any syncope symptoms (feelings of fainting) from accelerated heart rate during or after exercise, although it sometimes shows up when I stand up fast from lying or sitting positions.

Hi Tiger......I'm told to only take the pressure and pulse rate twice a day. Once in the morning before any meds and once at night. I have been on 40 Mg a day of Lisinopril a day for many years and after much stress the family doctor added 10 mg of valium to help bring the pulse rate down. I felt great until I saw a cardiologist that added 25mg a day of metoprolol . My pressure and pulse rate decreased to a very low level. Mostly readings in the 80's over 50's for the pressure but it did help the pulse rate to drop in the 70's. I saw another cardio surgeon that cut the dosage of the metoprolol to 12.5. Vitals were still all too low and he removed me from that completely. Like most meds they work great for some people and for others they are horrible. I am still suffering the many side effects from the metoprolol that included some rare side effects like vision problems, bloating and a constant weird humming in my head. I am told that surgery for me will be a definite in the future to replace the heart valve due to the calcification but I wish that I never had never taken that metoprolol. Please read all the possible side effects and discuss with your doctor if you experience any of them. If you shop on line you can find a cheap and accurate blood pressure monitor that includes the pulse rate on Ebay. If you purchase a monitor bring it to your doc's office and check the accuracy with your doctor's readings. If you plan to take K2 make sure you get your doc's approval on that too. I am waiting for the doctor to respond to my request to use K2. Good luck and enjoy the Holidays.


Just a few PS's. My meds are the aforementioned metoprolol 25mg 1AM &1PM, lisinopril 20mg once daily, atorvastatin 20mg once daily, Asprin83mg daily , Furosemide 20mg once daily,Metformin500mg 1.5 daily. Oh there are others but not relevant. I am a good friend of the local pharmacist. I do have a BP gadget that also does pulse but I can't drag it along with me when I walk. I am beginning to thing maybe you are right...I fret too much over this pulse rate as I haven't had any serious pain and my blood thinner should keep the lumps from forming into a clot. My blood pressure has always been normal. Thanks and merry Christmas to all.

Glad to hear your warm spirit as Christmas approaches, @motiger. Your meds and mine are similar with two exceptions: I don't take Metformin or another diabetes treatment, and I don't take Furosemide (Lasix) any more. Low potassium (hypokalemia) is one of my problems, thanks to a genetic problem with my kidneys, so I stay away from Lasix or see my potassium drop below a safe level. That happened a few years ago and sent me to the ER for rehydration. My diuretic is Amiloride (10mg AM and the same PM). Generally, our medications combine to keep blood pressure down, along with their other benefits for the heart.

I should have realized that my BP meter is no solution for someone who needs (or wants) to track their heart rate while walking briskly. My wife solves that with a Fitbit wrist watch that I bought her last Spring. She's a diabetic and a workout nut, like yourself! She rarely feels faint, as do I. Best wishes for Christmas and the holidays! Martin


Well I never have thought of myself as a workout nut but I live in a retirement community that is focused on keeping us fit and I think it does keep me moving. Sorry to learn that Lasix isn't your cup of tea but it sounds like you have made a successful adjustment. I don't know how your fitbit watch works but hopefully you don't have the same multiplier approach. If it gives you an accurate reading I might be interested in one. My wife and kids are always wishing I would give them a wish list but like most of us we usually just go out and get want we fancy. By the way I have had 76 birthdays...not really that many when compared to my friends around here. Go Tigers!

Hi, @motiger. Hope your weekend is rewarding! We're in a "retirement community" as well. Eligibility limited to age "55 and better." A golf course I don't use (I knew I could quit smoking 20 years ago, because I was able to quite golfing before that!). My wife tells me her Fitbit gives results for a whole minute after making a legitimate count for 60 seconds. Her resting rate is 58-62 bpm and runs up to 125-135 when she's biking or speed-walking. I got the Fitbit Charge 2 for her last Spring for $79 (half price). Birthdays? I've had 82 and when I get up in the morning, try to remember to answer the question, "What shall I do today that can occupy me 20 years from now?"