Atenolol efficacy vs PVCs

[stlcard1521]

Hi, I'm a healthy 21 y/o male who was recently prescribed atenolol for PVCs. I've been taking half a 12.5mg tablet for 3 days now; I think the tablets are making them worse. I'm getting about 10 or so a minute since I've been on the atenolol. I have some minor regurgitation in my pulmonary and tricuspid valves. I took atenolol for 1 day last month when my doctor first prescribed it (took a 25mg dose) and my PVCs were really bad that day so I quit taking it. I went back for a 30 day follow up, told him it made them worse and he said I just needed to take it for 4 or 5 days atleast to get a steady state blood level (He told me to maybe try going to 12.5mg when I restart, which is what I'm now doing). I restarted taking it again this week, it's been 3 days now and my PVCs have been more frequent than normal. Just wondering if the medication should be working, or if I need to take it longer. Otherwise excercise and good nights sleep seem to minimize them, I'll just drop the atenolol and go back to dealing with them. Thanks

[Cleveland Clinic]

Cardsfan,

Nice name.

Unfortunately, the old adage "Theres no cure for the common cold" applies to PVCs as well.  There are a lot of mechanisms for PVCs, some people have them at slower heart rates while others have them at higher. If you are the former, then the addition of a beta blocker will increase the frequency of your symptoms. If the latter, then watching 95 mph fastballs whiz past Edmonds at the plate will probably increase them.

If youve had a normal cardiac evaluation then the presence of PVCs carries no significant bad prognosis other then their bothersome nature.  Honestly, your pretty young to commit yourself to starting a daily medication, so I would look to see if there are better ways of dealing with the symptoms other than the medication.  Look to this forum to see how others have dealt with their symptoms.

good luck

[Bromley]

Hi. That seems like a lot of discomfort.  I have that trouble from time to time too, although I use a different beta blocker.

Dont forget to take the obvious steps of cutting back on caffeine and alcohol, and keeping stress under control.  I also find that regular aerobic exercise helps alot.

Good luck.

[Abeybaby]

Hi I too suffer from PVC's and have been taking small doeses of atenenol to combat the arrythmia which I must add is not working at least for me. I take 12,5 mg because anything higher reduces my heart rate at night to high 30's and I become very susceptible to more PVC's on a low heart rate.  I also notice that taking atenenol gives me runs of them 2 sometimes 3 or even 4 PVC's in a row-string of them. My cardiac workup is normal- ie: normal stress, echos, holters etc ...40 yr old male pretty fit.

I cant explain them but i know that the atenenol is not really working well. If i get off the atenenol i notice that I get tachycardia with the extra beats and then I dont know what is worse- the tachycardia or the runs? I did get runs of them without atenenol too.  My cardio just says ignore them you are in good company they wont kill you.  I want some relief so bad but i am not getting it ... I am thinking about changing the drug to something else but again afraid of the change in beta blockers. I really dont know anymore to be honest with you.

Tired very tired of them they are crippling my life and happiness and its not fair to my family nor myself.

Any other suggestions??? Thanks

[tickertock]

You might want to ask your doctor about another beta blocker, acebutolol(sectral) a beta blocker within the last few years approved for the treatment of PVCs and it doesn't slow your heartrate too much, just a thought, apparently many have had success with it and it's not proarrhythmic.

[upbeat63]

A little background on me, which might help you out too.

Had PVCs since age 18. When I was 30 the PVCs were driving me nuts so I went to the MD and a cardiologist. I was diagnosed with unifocal benign PVCs just happened to be 450/hr. The cardiologist said the only treatment recommended for PVCs was beta-blockers, but that in a young person he didn't recommend them because I would have to be on them for the rest of my life and that the BB might actually make them worse. I decided to live with the PVCs. But it definetly was not easy.

Now at age 42 the PVCs have increased to 1220/hr and the only thing the MD suggested was a beta-blocker. Well I was reluctant given the previous information. But when the PVCs went into constant bigeminy I had to try something. Toperol at 12.5mg for three days stopped the bigeminy, but made me feel like a zombie. So I stopped the BB and the bigeminy has not come back. Yippee. I've just become accustomed to the high frequency, I really don't know how, but I know the BB are there just in case. So you might want to try a different BB before you give up them.

Just to add, to everyone who knows my situation because I've written many times, I actually went to sleep the other night and the PVCs were pounding in my chest and shoulder blade, and as I was falling off to sleep I had this thought about how reassuring it was that my heart was doing "it's thing" at a pretty constant-arrythmia--it became kind of like a familiar lullaby. How's that for strange.

[stlcard1521]

alright thanks a lot... yes I have cut caffeine out of my diet and I dont drink that often. They do occur most frequently when I lay down and/or when my heart rate is slow; I told my cardiologist that... I counted them, im getting 5-10/min at times when im on the atenolol, and i usually dont have more than 5 a minute off medication. And usually when im getting the bumps, i can usually stop them for atleast few hours by swimming or jogging. Thanks for the second oppinion.

[stlcard1521]

note- i meant 5/min when theyre at their worst off of medication, its usually less and theres days i only feel maybe 10 the whole day.

[Abeybaby]

Do you have an email I can contact you direct? I am 40 yrs old male and they are driving me insane. My cousin is a cardiac surgeon here in Toronto, Canada- noted as one of the best and he says live with them. Easy for him to do when you are not the one suffering with this condition. What other beta blocker did you change to? What were you on and what dosage? I am on 12,5 mg of atenenol and its plainly not working out. I cant tolerate higher dosages because my heart goes too slow around 38 at night. I would prefer no BB but my heart goes fast without them especally when the PVC's come. DO you ever get runs of them? What did your doc ever say to that? Let me guess ignore them?

Thanks Very much

[Abeybaby]

Did you say you get 1220 per hr????? Holy **** thats alot that would be more than 25% of your total beats per day? Did they not tell you to ablate them? Isnt that very unfortable? I get max 2000 per day and most days 700-1000 and I am going nuts i couldnt imagine your circumstances.

[madgeOwens]

I was getting them aprox every 4th or 6th beat...with no let up when I had holter monitor.......thats quite alot I believe.
Yesterday I started 80 mg time release Inderol and I was not having many at all today............is that coincidence or the inderol???? holy **** I do hope Indrol is doing it.

[tickertock]

When I took inderal for PVCs and sinus tach, even at doses as low as 10mg 3 times daily it practically eliminated them completely within a day or 2 , sometime just in hours they were gone for months to years , if its the inderal you may have found the magic bullet, keep your fingers crossed and good luck with the continued relief.

[madgeOwens]

Thank you.  I feel wonderful for the first time in e quite awhile. I do hope it continues. I can hardly believe it.
Thanks for all of your good advice and pep talks. Your very kind.
Madge

[fearfactor]

Hey guys - I take 12.5 mg a day of Toprol XL and it really doesn't help my PVCs all that much.  It does lower my BP and heart rate, however - that is why I can't take a higher dose.  I already have low BP anyway.  I am wondering if Inderal might be better for me since I hear so many have had good success with it.  I never tried Inderal because I heard it causes weight gain more than Toprol.  No one here has had weight gain with it?  I just want to make sure because I'm a former anorexic and weight gain would be catastrophic for me even if my palps were better.  Has anyone been on Toprol and switched to Inderal?  Did it work better?
Thanks!

[upbeat63]

Yep, you read right, my 48hr holter showed on average 1220 PVCs/hr and it is over 20% of my heart beat. But I'm still told the same thing. Mostly unifocal, and benign. Stress echo was "normal".

I think ablation is recommended if the PVCs are debiliating. I don't think mine are, yet. I mean, from time to time I get into a real tail-spin and think oh no, this is it, I can't take it anymore, but I have also become a master at distracting myself from thinking of them exclusively, and if I'm good at that, for the most part I don't notice the PVCs. They are still there, but I try not to let them rule my life.

Ablation comes with risks. But I do know some people have benefited greatly, especially for other types of arrhythmias. Some people continue to get PVCs even with an ablation. So I guess it's an option if I truly can't stand it anymore. Even 10 an hour would be better than 1200. But I've come to realize high frequency is not the end of the world. Unless I give in.

All that being said, when I finally "broke down" and tried the toperol XL at 12.5mg/day it stopped a constant bigeminy that my heart had gone into (and a few short runs of non-sustained VT). Mostly it lessened the sensation of the PVCs without reducing them. So I take it "as needed" my choice not doctors, because it slows my heart rate too much and that feels uncomfortable. I haven't tried any other BB. But I also have xanax on hand (also as needed)for any anxiety.

If you'd like to talk more, because as you can see, I can go on and on, my email is ***@**** and just put something heart related in the subject so I know it's from this forum.
Hope you all are having a great day.

[madgeOwens]

You have that many pvc per hour and you are asymptomatic?
Every single pvc I get I get a wave of light headedness....
Someone told me they didnt gain weight with inderol.....I hope not.
So far they are helping me....I am down to a pvc here and there....yahoo................

[Gary-Fisher]

hello.

i too am on atenolol. i take 25mg once a day. i first started out on toprol xl then got this cause it was cheaper.

i was given them to control my heart palpitations. i never..EVER had a pvc until i started taking beta blockers.

so, my question, could my pvcs be a side effect of the medication im on? as i have no history of them..and i didnt get them until i started beta blockers about 3 years ago.

[Momto3]

Why were you prescribed a beta blocker in the first place?  They are often prescribed to reduce the number/frequency of ectopics (ie: pvcs, pacs).  Were you having pacs?  

[tickertock]

I was given beta blockers first years ago when I was 18, in a couple weeks I'll be 41 , I was first presribed beta blockers because of a sinus tachycardia 90-110 at rest, 120-150 bpm when anxious, even though I have always had the occasional PVC , i did notice a slight increase PVCs when my sinus tach and pounding got under control but only a very slight increase frequency. The beta blocker made the living easier.

Most persons that have a fast heartrate and pounding heart in their younger years I am told that as they age they tend to develop adult onset episodes of PVCs, I was told this just recently by my cardiologist, usually it has to do with minor changes in our heart , body and hormones as we age, usually from the ages of 20-45 this happens or so I've been told. Too bad only some are aware of them, though most people have them in the same pattern , they just don't notice them. You were probably going to develop them anyhow, that's not to say the slower rate from the beta blocker didn't help trigger them, to be honest I prefer the occasional PVCs to the constant fast heartrate and pounding heart.Take care.

[upbeat63]

I do have symptoms occassionally. Sometimes SOB, dizziness, sense of having the flu, being fatigued, lots of anxiety. It's those times that I try to slow down a bit, but not for long.

Since I have PVCs all day, and only symptoms on occassion, I'm not sure whether it's the PVCs or related to high anxiety. I've opted to believe it's high anxiety and try to do whatever I can to stop that, being active helps the most. And being active helps to distract me from, and may even decrease the PVCs.

It's the catch 22 with taking beta-blockers. I seem to get pretty fatigued on only 12.5mg of toperol xl, but it did help stop my bigeminy. I'm glad you've had some pretty fast relief of your PVCs with starting the inderal. Who cares if you get a little weight gain (which I haven't read to be true) if you get relief of the PVCs. Really, which is worse!  I will hope that your relief lasts and lasts, and for anybody whose beta-blocker isn't working, I would suggest trying another. Tickertock had mentioned a newer one higher in this post. It's worth talking to your doctor about.

[madgeOwens]

I agree, the most important thing is that the drug works, and as far as weight gain I figure if you eat to much well you gain weight.  That is if you do not burn it off and at my age thats a bit difficult but I do my best. Take care!

[c123]

I have been on Atenolol 12.5mg for 3 months now and it's made me tired, probably since it disrupts my sleep. I awake after only 5-5.5 hours of sleep. I went back to my internist today and we are going to switch to Coreg which has less effect on the melatonin and hopefully will be able to sleep at night. Has anyone tried this beta blocker?
By the way, 7 years ago I tried Sectral for 3 weeks. The problem with that beta blocker for me was that I had joint pain, pain down my thighs, and increased urination along with severe fatigue. I also would wake up at 5am on a full capsule and 7am on a half capsule...i.e. it also disrupted my sleep. It only comes in the U.S. in capsule form so it's hard to break in half like you can with the atenolol.

[madgeOwens]

Inderol is working great for me so far.  It is a blessing!
Of course now I hurt my back hahaha......badabing

[Epicwave17]

Hi fellow PVC'ers.  I just wanted to thank everyone for posting on this site about there own personal stories dealing with PVC's.  It really helps me knowing other people out there are going through the same thing i'm going through. here's my story...

My name is Kenny, I'm 24 and i was recently diagnosed with PVC about 5 months ago.  Around then, one morning i had a bout with a rapid rise in heart rate, for no apparent reason, which subsided in about 2 minutes.  Of course that freaked me out, but what happened afterwards i will never forget, i started taking my pulse and noted it was skipping every 7-10 beats.  I thought i was gonna die.  It was absolutely terrible.  Worse of it..i had just gotten marriend 2 weeks ago...i couldn't believe God was gonna kill me now.  So i went to the ER and the doctor told me it was just PVC's and they were nothing to worry about.  I still wasn't satisfied, so i went to a cardiologist and he said the same thing and gave me an echo that was normal, and a holter monitor that reported 7,000 PVC's a day!!.  He told me i just have to live with them, and that they weren't life threatening....however, despite all this assurance i still felt the grip of death around me everytime my heart skipped a beat.  When i told my family and friends, they didn't seem to care that much, that i should just ignore them.  I would think "of course you think its easy to ignore, your not the one who feels their heart 'stop' 7,000 times a day". It was really frustrating not having someone understand. It wasn't until i found this forum, a few months ago that i have finally been able to "control" my PVC's. Reading inspirational stories about other people PVC's made me feel part of a community, and better about myself.  Thanks to everyone here that has posted, i'm now able to ignore the majority of my PVC's.  Of course i still have bad nights (like tonite), but when i do, i go over to my computer and read the PVC message boards and feel so much better. So basically this post is just a big thank you to everyone that as posted their story.  Thanks

[madgeOwens]

Hi Ken,
As long as they checked you out and you have a strong healthy heart the pvc's will not harm you. However, having said that, if you get symptoms ie shortness of breath, lightheaded or chest pains from the pvc's they can treat the symptoms.  Your heart is not stopping when you take your pulse, thats the premature ventricular contraction (arrythmia) or (irregular heartbeat).
Stop taking your pulse so much.  Try not to worry , that makes more pvc's. Stay away from caffeine  in chocolate, soda tea etc.alcohol also.....these will bring them on. Enjoy your new bride and stop worrying.  If you cannot stop wprrying, then talk to your doctor. If he'she won't listen. Find one who will.
Take care.

[madgeOwens]

Hi Ken,
As long as they checked you out and you have a strong healthy heart the pvc's will not harm you. However, having said that, if you get symptoms ie shortness of breath, lightheaded or chest pains from the pvc's they can treat the symptoms.  Your heart is not stopping when you take your pulse, thats the premature ventricular contraction (arrythmia) or (irregular heartbeat).
Stop taking your pulse so much.  Try not to worry , that makes more pvc's. Stay away from caffeine  in chocolate, soda tea etc.alcohol also.....these will bring them on. Enjoy your new bride and stop worrying.  If you cannot stop wprrying, then talk to your doctor. If he'she won't listen. Find one who will.
Take care.

[madgeOwens]

I am sorry I di not know why that doubled up. :)