Stopping metoprolol before ablation

It is strongly advised to cease any anti-arrhythmic medicines and beta-adrenergic drugs or calcium channel blockers a day or more prior to an ablation SO THAT the heart will begin to act up and thereby reveal where the re-entrant signalling, or the foci, are when the EP goes in to begin mapping and zapping. A common criticism of your run-of-the-mill EP (bless their hearts, they all have spent zillions of hours learning and being supervised by mentor surgeons to get their qualifications) is that all they really feel comfortable doing is a simple PVI...pulmonary vein isolation. This is because, if a patient is still in the early, 'paroxysmal', stage, which you seem to be....still..., their area of rogue signals is 95% sure to be in the ostia of the pulmonary veins where all four of them empty out into the back wall of the left atrium. But, some cases are a bit more advanced or complex, and this is where a patient done with a PVI will still find themselves fibrillating partway/most of the way through the three month blanking period that follows. The better, more skilled, and more self-assured, EPs will want to see you only the one time (it's surgery, if only day surgery, but it's surgery...after all). So they don't want a shroud of medication put before their eyes when they're trying to find the spots where they need to apply energy to cause the tiny scars....hundreds of them. The ideas is you have to surround each focus with a complete, contiguous, ring of scar tissue out of which the rogue signals cannot escape. If they cannot escape, your heart will only respond to the normal signal bundle, the SA node, or sino-atrial node. This is where you, and your earnest EP, want you to be when you're wheeled out to recovery....fully and comprehensively ablated.

I can sympathize, believe me. I was horribly symptomatic when in AF, and couldn't wait for an ablation. It took two before I was free of AF. Twenty-five percent (25%) of all first ablations fail across hospitals because the EP didn't close that ring completely, or didn't find a second or a third,....spot where he/she ought to have zepped. AF won't kill you. It can make you miserable...did me. But I wanted my heart to be 'as is', and that means stopping the drugs that try to alter your heart's real condition.

Thank you for your comment. I understand why we need to stop taking the meds I was just wondering if anyone had trouble in the 48 hours pre procedure because they quit taking them. I am dealing with very symptomatic PSVT not AFIB.

@anjimlynch I am right there with you! I too am getting an ablation in 72 hours and have to stop my 50 mg metoprolol succinate for 48 hours. Since my PSVT has broken through the metoprolol 4 times in 3 months, at 180-200+ and needed ER adenosine each time, I am really nervous about the upcoming 48 hours. Would love to hear about other SVT patients' pre-ablation experiences.

@anjimlynch Sorry, I have AF on-the-brain. 🙂 But really, alla same, alla same. Neither arrhythmia is dangerous per se, not for weeks and months, but it depends on the rate. If your rate exceeds 100 BPM for 24 hours, then you would be advised to seek help at an ER. In your case, you're only going to go about 24 hours, and believe me, your EP will be most grateful if your heart obliges by being cranky off the drugs.

@osgilian oh I am right there with you too !!!!!!! I am wishing you the very very best and please keep me updated on your progress !!!!!!! Mine has been breaking through my metoprolol also and I had to have adenosine in the ER to stop it. Not the most fun I’ve ever had. 🙁 Please keep me updated and I wish you the best of luck in your upcoming hours !!!!!

@gloaming thank you that does help. It’s just so uncomfortable!!!! I know it’s not life threatening but still I can think of better ways to spend my days 😉