Hi Dr.
I am sorry to disagree with you, but metoprolol is known to have a "membrane stabilizing effect" (that is, it increases the refractory period of atrial tissue) and because of this bears some similarity to the class 1 antiarrhythmics, which are rhythm-control medications. Metoprolol was even recently studied for its ability to control sinus rhythm in the context of atrial fibrillation - see, for instance, here: http://eurheartj.oxfordjournals.org/content/28/11/1351.full.pdf
Thank you for answering my question. Your observation that my disease is lprogressing is likely accurate and the metoprolol I am taking is insufficient to either control my rhythm or my rate. Since my post I have had a flutter ablation and am pursuing a more aggressive medical approach to deal with the afib. (Not confident about the efficacy of afib ablations yet.) Hopefully I can find something that will adequately keep me in sinus, because life at 150 bpm is for the birds!
Thanks for the comment. I did have a flutter ablation last week, but still have lone paroxysmal afib to worry about - so it is important to get the meds right. unfortunately, when these episodes occur 100 mg of metoprolol will only knock my HR down from 150 to 120, and that still doesn't feel very good, nor is it good for me probably. So I guess I need a real antiarrhythmic, despite the risks. Happy to hear that the ablation worked for you. Do you know what the SVT was? (e.g., Atrial Flutter, Atrial Fibrillation, single focus atrial tachycardia?)
I was on a daily dose of the beta blocker (Metoprolol) for near lifetime SVT. My GP doc said to carry a small supply, and chew an extra 50mg when my SVT occurred (generally 4 to 5 times per month) as it MIGHT help. When I saw my cardiologist I mentioned this to him. His comment was (with a slight roll of the eyes) "It doesn't work that way". I still take it today (75mg per day) following a successful electrophysiology three years ago as it does a good, cheap job of controlling my borderline hypertension.
hi pvc/pac are skips . flutters, paps of the heart
What is PVC? I have AF and have had it since I was 19. My boughts usually land me in the hospital because my heart rate is so hight. the only way out is meds in the IV until I convert , or once, was cardioverted. also, what is Paroxysmal AF?
What is PVC? I have AF and have had it since I was 19. My boughts usually land me in the hospital because my heart rate is so high. The only way out is meds in the IV until I convert, or once, cardioverted. Also, what is Paroxysmal AF?
You say that paroxysmal afib becomes progressive over time. What type of time frame are you referring to?
The reason I ask this, is I was diagnosed with Paroxysmal Afib five years ago, and put on a regimen of 12.5 mg of Metoprolol once daily along with 5Omg of Flecainide twice daily. I have only had one episode of PVC's not afib in all this time. Am I to expect that this will not last?
Hello. Thank you for your question.
Neither calcium channel blockers or beta-blockers are rhythm control agents. They are strictly rate control agents. Your observation that you remain in atrial fibrillation for a shorter period of time may be a coincidence.
In general, paroxysmal atrial fibrillation becomes progressive over time. It sounds as if your "afib burden" is becoming greater. That is, your stay in afib longer and it is becoming more difficult to control heart rate and symptoms. At this point I would recommend you see your cardiologist for a new evaluation to include a history, physical exam, resting ECG, holter monitor (EKG monitor that measures rhythm for a prolonged period), and possibly an echocardiogram (ultrasound of the heart). You should also ask your physician about antiarrhythmic therapy (drugs that help maintain normal sinus rhythm). If drug therapy fails, there are invasive procedures that you may benefit from to decrease atrial fibrillation burden or to eliminate arrhythmia (in certain case of atrial flutter).
Very Respectfully,
Dr. S