I have only ever tried metoprolol, and was on it for five years continuously until the end of the blanking period after a second (touch-up) ablation. Some report that they don't do well on metoprolol. I found that it stunted my aerobic exercise capacity by about 25%, although my cardiologist refuted my assumption and insisted that it should have no effect on my cardiac output like that. However, it is a calcium-channel blocker and a beta-adrenergic, so it would not be a prescribed medicine if it did nothing like keep a lid on my heart rate.

If you have an arrhythmia, it is a progressive disorder. What works right now won't work inside of four-seven years. You'll need something else. If you have AF, and would like as little effect on your daily routine as possible, you want to get a catheter ablation before the disease progresses to the point where you have permanent/persistent AF, which is much more difficult to treat. A successful ablation will keep you free of arrhythmia for many months, often up to about 7-9 years. Eventually, though, you'll need another intervention...happens to pretty much everyone. There are literally tens of thousands around the globe who have had four, five, even six ablations over their lives, sometimes inside of three or four years until they get an electrophysiologist who is highly skilled and who can fix them...not cure them...fix them...for now. My point is that the mechanical fix, which is what catheter ablation is, has a much better record over time of keeping you off meds (who doesn't want that?!?), and free from the anxiety and palpitations that can ruin sleep and invite all the other problems that that condition invites.

As for which calcium-channel blocker, I'm afraid only you will be the final determinant of how well it works. Try metoprolol first, since it is by far the most commonly prescribed blocker, and well tolerated by millions, literally. If it's a bust, try diltiazem or cardevilol, and hopefully one of them works.

Jump to this post