Beta Blockers

[rebss]

I have had a high resting heart rate (100-130s) since July, and I finally decided to go ahead and try a beta blocker to help lower my heart rate and reduce the chest pain. I have normal-low blood pressure, so I know I'll have to keep an eye on that and any side effects. I don't remember which one my doctor said he was going to call in (I think it's propranolol), but I was just wondering if there is a beta blocker that works best... or do they all pretty much work the same?

[The_beat_goes_on]

If it is in fact something benign (benign = structurally sound heart, it's sinus rhythm and it's not causing shortness of breath, dizziness, etc ...) like an inappropriate sinus tachycardia, you might grow out of it.  I know it sounds silly since you are a 22 year old woman, but, it is very common for young healthy women to have a higher than average heart rate, and it will probably lesson as you get older.  I know taking a pill every day or twice a day *****, but it might not be "forever" ... you might take it for six months and re-evaluate, and find that you don't need it.  Or even in six years.

Has your chest pain continued to be a problem with the metoprolol?

[rebss]

My cardiologist called me back yesterday and switched me to Lopressor (metoprolol). I went in this morning for the EP test and it didn't happen. The doctor didn't feel comfortable doing it since my blood pressure was low and I was a little light-headed because of it. My oxygen levels were 90 which is low too. Better safe than sorry.

Thanks, Jerry. I definitely want to find what is causing it, which is why I kept putting off taking beta blockers. I didn't want to take them without knowing the cause. I've had tachycardia for 6 months now, and other than chest pain I don't have any other symptoms, but I know a high heart rate for so long isn't good. Thanks for mentioning an oximeter, after this low oxygen today, I'll definitely invest in one of those.

[Jerry_NJ]

I suffer from AFib and take a beta blocker to control my heart rate. I have used Toprolol and Generic Metoprolol and Atenolol.  I like the Atenolol best and take 25 mg every 12 hours.  The generics are very low cost.

My long term experience with selective beta blocker is they have some impact on my blood pressure, but only at high levels.  I have taken Metoprolol at as high as 100 mg twice a day.  

Beta blockers have some side effects, but for me 25 mg slows my HR to in the 50s when asleep (or just wake up and check in bed before moving much) and in the 70 most of the time when at rest. Going up stairs I could see 140 I suppose, but I am also an older person and suffer from AFib, so the atrium chambers are not helping.  

It is best that you try to find a cure, taking medications all one's life is not the best solution.

Other:  I purchased an Oximeter for about $25 over the Web.  This device clips on the finger and give a quick (few seconds) readout of heart rate and oxygen saturation (its main purpose).  This may give some "spot check" information that will be helpful.  In my case I got it because of a my concern about my oxygen saturation and the ability to make a quick check on HR.  From this I learned that I may suffer from obstructive sleep apnea, which proved to be the case in a sleep study.. but that's another story and I mention only to point out my success in acquiring data that helped doctors focus on specific health problems.  

[rebss]

It's just an EP study, to see if there is anything wrong with my heart. I assume if they find something they'll fix it, but from all the tests so far I don't have arrhythmias (afib, etc.) or anything that needs to be fixed. I took my BP today since I was feeling a little dizzy this morning and it was 68/45 so propranolol is lowering my BP but not my heart rate at all. I called my cardio and spoke to his nurse, but am going to have my doctor call me later to see if I should lower or stop the beta blocker. I hope this low bp won't affect me getting the EP test tomorrow. I'll let you know how things go.

[The_beat_goes_on]

Is it just an EP study or are they going to modify your sinus node?  Do not be alarmed if they find arrhythmias ... the drugs that they use to stimulate conduction are very strong.  I went into my first study knowing about three and all were inducible with the drugs (they were aggressive with stimulating my heart and both my atrial flutter and vtach degenerated into fibrillation) and they were able to ablate (they couldn't do was modify my sinus node as much as they wanted, because apparently conscious sedation makes me wiggle around like I'm being excised and my phrenic nerve was in danger) ...  if your electrophysiologist is going in with the intent on a sinus node mode, I hope he is as conservative as possible.  What I didn't expect was, after mine was modified, my heart rate continued to plummet over the following weeks and from what I've read, this is not uncommon

Good luck!  And I hope you'll let us know how your EP study turns out!

[rebss]

Thank you so much for the responses. I started propranolol Saturday and there hasn't been a change in my heart rate. My heart rate hasn't gone below 100, and jumps up to the 170s just going up one flight of stairs. I'm looking on Amazon and plan to buy a BP monitor tonight so I can monitor my BP at home and notify my doctor if it gets too low.

My doctors just seem stumped since I have a high heart rate but no arrhythmias. That's good, but it also doesn't help get an answer. I'm scheduled for an EP study this week; it looks like it's for those with arrhythmias, which I don't have... but who knows, maybe the doctor will find something out. I'm hoping for an answer, I know I don't want to be on beta blockers for the rest of my life (I'm only 22). I'm so sorry that you've had to go through this and ended up with a pacemaker, the_beat_goes_on. But thanks for sharing, I'll definitely keep this info in the back of my mind.

[The_beat_goes_on]

It should start working with your first dose ... I did not have any lowering of my heart rate by propranolol (just further lowering of my blood pressure which caused lots of symptoms) ... but your doctor will probably want you to try it for at least a week or two before changing it unless your noticing adverse effects (fatigue, light-headedness, etc...)

My tachycardia that caused the most symptoms for me (verified by monitors) was inappropriate sinus tachycardia (up to 210bpm just sitting in a doctors office, totally calm, and NEVER going under 120-- even sleeping).  No beta blocker worked, so I had my sinus node modified.  Twice.  Plus some other arrhythmias ablated (that did not cause many problems for me) I ended up with a heart rate that kept lowering, never in sinus rhythm.  I went from junctional rhythm in the day time to a REALLY slow (25-30bpm) ventricular rhythm with pauses when I slept.  My heart rate also did not raise appropriately with activity after my ablations so my pacemaker was implanted pretty quickly.

I'm sharing this with you because it sounds like you are almost where I was at the beginning.  I hope you find a beta blocker that can get your symptoms under control.

[DeltaDawn23]

I was first put on Toprol 25 mg. which made me dizzy and dropped my bp.  Next I went on Atenolol which does not pass the blood-brain barrier and I felt much better on it.  I, too, tend to have low bp and my family doctor suggested breaking it in half, or even 1/4's and keeping a check on my bp.  If my heart rate or bp get too low, I delay the dose.  Good luck with this.

[rebss]

Do you know about how long it takes propranolol to start working and I should see my heart rate start to come down?

[rebss]

The monitors didn't show any irregularities, only my high heart rate. The one from last month showed my average HR was 100, lowest was 75, and highest was 179. Glad there weren't any arrhythmias that I should be worried about, but it isn't helping us find an answer.

Thanks, I will. I hope things are going well for you and you have your tachycardia under control. :)

[The_beat_goes_on]

I hope it works for you, I hope you'll keep us updated.  

On the holter monitors, were your symptoms correlated with tachycardias?

[rebss]

Thanks for your response. I just picked up propranolol from the pharmacy, 40mg. I'm not sure what is causing the high heart rate, I went to the hospital for chest pain and found out my heart rate was high. It usually is in the 60s, but increased almost overnight and hasn't come down. I've had numerous tests done - xrays, CT scan, echo, holter monitors - and all of the tests came back normal. After 6 months of dealing with it and no answers I decided to call my cardiologist yesterday and get on a beta blocker.

[The_beat_goes_on]

When I first was treated for my tachycardia, propranolol was the first beta blocker my cardiologist tried.  It is non-selective and crosses the blood brain barrier, so you might experience more symptoms with it (like fatigue) than you would one that is cardioselective, like metoprolol.

What dose is your doctor starting you with?  generally it's pretty low and if you notice symptoms that outweigh the benefits, prescriptions are easy to change.

Why are you experiencing chest pain? I hope you can find a beta blocker that works for you!