Cardevilol vs meterplol

Posted by debra54 @debra54, May 8, 2023

Would like to get opinion or experiences with these beta blockers.

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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.

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@gloaming

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.

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I was on metetplol for 10 yrs. Only negative was it made me super hungry so I gained weight. I only have a fast heart rate. But 6mos ago I went for a stress test ,which was good,and heart dr switched me right away to cardevilol, only to say it's better for the heart. Which I'm not AS hunger and it's only 12.5 mg x a day now instead of 50 mg x a day with the meterplol.

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Debra, I would give the new medication a solid trial for several months, say four-six months. If it works, then you're further ahead.
I have just had a second ablation and have been off everything but a statin and apixaban due to my CHADS-VAsc score being over 1.5. The blanking period for the ablation expired four weeks ago, and that's when I stopped the metoprolol. So far, so good!

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Ablation is for irregular heartbeat? Yeah, I'm going to give it a year, which will be August...guess I was on the metetplol for so long that I trusted it. Thank you for input.

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Yes, you should read up on catheter ablation. It is mechanically scarring the tissue lining the left atrium, and the idea is to leave scars around the pulmonary veins where they exit into the rear wall of the atrium. That is where 90% of all AF comes from...incursions of atrial endothelial tissue into the mouths of the four veins (two from each lung). That tissue helps to transmit electrical signals that get into the veins and the result is more beats than there should be. The ablation procedure is done through the femoral vein, near your groin, and they run the catheter up into the right atrium. They pierce the septum between the two atria, and run a small needle at the end of the catheter up against the mouths of those veins and begin to make many spot burns using radio frequency. Those burns will heal over several weeks of what is called the 'blanking period', but what remains is scarred tissue. The electrical impulsed can't run over or through the scarred tissue, so they become dammed, or blocked. End of atrial fibrillation!

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@gloaming

Yes, you should read up on catheter ablation. It is mechanically scarring the tissue lining the left atrium, and the idea is to leave scars around the pulmonary veins where they exit into the rear wall of the atrium. That is where 90% of all AF comes from...incursions of atrial endothelial tissue into the mouths of the four veins (two from each lung). That tissue helps to transmit electrical signals that get into the veins and the result is more beats than there should be. The ablation procedure is done through the femoral vein, near your groin, and they run the catheter up into the right atrium. They pierce the septum between the two atria, and run a small needle at the end of the catheter up against the mouths of those veins and begin to make many spot burns using radio frequency. Those burns will heal over several weeks of what is called the 'blanking period', but what remains is scarred tissue. The electrical impulsed can't run over or through the scarred tissue, so they become dammed, or blocked. End of atrial fibrillation!

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Oh ok...I had a cardiac mri and I have no scar tissue ...thank you

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There are two separate issues with abnormal tissue in the heart. There is scarring (from myocyte death due to an infarct (heart attack), and there is fibrosis. Fibrosis is scarring, yes, but it's a different onset. Fibrosis comes from damage to the endothelium from intractable and long-term arrhythmias. As you go on into long bouts of AF, your atrium will enlarge, and this causes fibrosis during the enlargement. It is best to avoid this because it detracts from proper atrial function, and can even cause damage to the mitral valve between the two left chambers.
Fibrosis is also generated during the scarifying procedure that is catheter ablation. You should hope, as does your electrophysiologist, that a one-shot ablation is all you'll need for many years because subsequent ablations, even a quick touch-up, leaves yet more scarred tissue.

This might make your eyes glaze over (:-D) but it's worth a solid stab at understanding it:
https://www.ahajournals.org/doi/full/10.1161/circresaha.115.306565

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I have no scar tissue or afib

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@gloaming

Debra, I would give the new medication a solid trial for several months, say four-six months. If it works, then you're further ahead.
I have just had a second ablation and have been off everything but a statin and apixaban due to my CHADS-VAsc score being over 1.5. The blanking period for the ablation expired four weeks ago, and that's when I stopped the metoprolol. So far, so good!

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Metoprolol works for me, I've had covid twice I hand syncopy before covid as well as 2 heart attacks, I got off Metoprolol about 1 year before I caught covid ,in 2020 then got 2 Moderna vaccines then Aug 2022 got infected with omnicron then in about 6 months started long covid ,nerological and gi symptoms, stomach pain with gas,constipation lost 27 lbs blood pressure started bouncing all over the place put me in the hospital twice my syncope was out of control I put myself back on my metoprolol just 25 mg is all it took to calm me down again beta blockers really help me with my covid symptoms it really helps against my hyperthyroidism also. take lots of probioticts lots of yogurt do not miss a day I also take a plant based protein powder I mix it with a supplement drink like atkins or equivalent, I found a good mineral supplement works great take that with your protein drink covid seems to have lnflamed my organs my eyes ,stomach, thyroid ,my gi system is a mess I have got alot better since I have figured out what to do don't take vitamin pills it worsen's my inflammation well good luck these are trying times.

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