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How did you wean off Metoprolol?

Heart Rhythm Conditions | Last Active: Sep 19 7:56am | Replies (551)

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@afrobin

You are on Coumadin and a beta blocker? When unmedicated, do you only have occasional skipped beats and an increased heart rate (into the 80s)? If so, you would fall into the unmedicated category with my cardiologist. Years ago, once on the beta blockers, I didn't need a blood thinner because my Afib was well controlled. Currently, my heart rate at total rest (watching TV) can be 110....after eating a sugary food. Otherwise it's a normal 80 beats per minute. My cardiologist told me not to be concerned about the 110 beats. He says that I should only be concerned if my heart rate is up above 160.

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Replies to "You are on Coumadin and a beta blocker? When unmedicated, do you only have occasional skipped..."

Life time of PVCs. On and off. One doctor offered anti arrhythmic drug, I declined because my situation technically wasn't dangerous. He switched me from Atenolol to Acebulolol, the PVC occurrence plummeted. All was well.

Incidentally, it was too much quality chocolate at Easter that started my worse episode of PVCs that lasted months, that was the cause of the PVCs above.

Years went by. The usual stuff, periodic tests, everything's OK. Last November, the afib started. They were going to do a Adenosine Stress Test, that would have been followed by a Heart Cath. My wife worked for a cardiologist that was not infrequently angry at these extra tests, he believed there is a group of doctors that get a cut of the insurance by doing needless tests. I told them no stress test, get rate controlled, anticoagulation in place, and I'll see my own doctors.

My cardiologist is very well known, he saw no reason for the stress test, neither did my family doctor, and, in a way, I had one. They withheld the Metoprolol, most of it, on the day of the stress test I refused. Having been told that I'd have an Echo Cardiogram the following morning after admission, here it is, three days later and still no test. So they sent me for one, prior to discharge, or so I thought. During my echo cardiogram, my heart rate was 160, I didn't even know that, but they refused to discharge. They finally gave me the full Metoprolol, I was discharged the following day, and they bumped it up more. My cardiologist bumped it up more still.

The Echo Cardiogram was normal, the same as one I had last year, except afib was now present. The same doctor, also very well known, interpreted both. But think, it was done with my heart at 160, I'd think I'd have chest pain if there was restriction, and there should have been additional changes in the EKG.

I'd rather have a normal rhythm, but converting, and maintaining it isn't without risk too. The literature on Sotalol says Highly Symptomatic patients should only use it, I'm not, at that point. Younger patient's are similarly given Sotalol, it's a quality of life thing.

I just read an article the other day, urging doctors not to over medicate Afib patients, the article cited 110 as a target heart rate, interesting yours said the same. I was used to mine in the 50s, I'm in the upper 60s at rest now. (Summer will probably be higher).