Beta-blockers for PVCs in nursing/pregnant mom

[LibraryMom]

Thanks for taking my question.
I am a 29 yo female who first started having PVCs during my first pregnancy.  They have come back a couple of times since my daughter was born, and I am currently in the middle of a pretty yucky bout with them that has lasted about a month.  I had an echo during my pregnancy, and two since then.  I also had a stress echo shortly after her birth.  Holter moniters and event moniters show occasional PVCs, but no structural problems.  My potassium tends to run on the low side for some unknown reason, and I have been taking supplements to help that.  I'm also insulin resistant.  My cardiologist has suggested I start on Toprol (sp?).  I am still nursing my two year old daughter and my husband and I would like to have another baby.  My understanding of beta-blockers is they don't cure PVCs, or even stop them, they just make you less likely to feel them.  But they are classified as a class "c" drug by the FDA and not really recommended for pregnant or nursing moms.  My questions are, 1. other than suppressing my ability to feel the PVCs, do beta blockers actually offer any additional health benefits (ex. reduce the risk of a more dangerous arrythmia)?  If not, might I just be better off dealing with PVCs with relaxation, diet, etc.? 2. Should I be concerned at all about PVCs posing a risk during a second pregnancy?  Should I have any additional tests done before becoming pregnant?
Thanks!

[Cleveland Clinic]

librarymom,

thanks for the post. You might read a few post down and see you are not alone in the PVC boat after preganancy.

1. other than suppressing my ability to feel the PVCs, do beta blockers actually offer any additional health benefits (ex. reduce the risk of a more dangerous arrythmia)? If not, might I just be better off dealing with PVCs with relaxation, diet, etc.?

Not unless you have specific heart problems or hypertension.  They do have some side effects, such as worsening insulin resistance, so if you are able to deal with the symptoms it might be better in the nursing state to avoid them.

2. Should I be concerned at all about PVCs posing a risk during a second pregnancy? Should I have any additional tests done before becoming pregnant?

No. Without any significant structural heart disease the PVC will pose no significant threat. You should discuss your work up and concerns with your OB-Gyn prior to your next pregnancy so that he/she can hopefully allay any fears you have prior to the preganncy.

good luck

[uptowngirl]

Hi.
I really liked your question and share the Drs. response.

Just wanted to relay a similar experience that I encountered about 5 1/2 years ago, when I found out I was pregnant.

  I had been diagnosed with moderate MVP/mild to moderate MR at age 20. My cardio could hear the murmmur through ausculation, and confirmed everything with echo.  Anyway, I was put on a beta blocker and baby aspirin once a day, which worked just fine.  Also, have serial echos every 6-12 months.  Fast forward 12 years and found out I was pregnant.  Immediately I call my cardio group, OB/GYN, and a physician in our family.  The consensus was get off the aspirin ASAP, taper off the beta blocker for at least the first trimester.  We did all that, worked out okay until 4-5th month, lots of strange beats, rhythms, etc.  Counseled with a team of cardiologists, high risk OB/GYN's who said the benefits of the atenelol outweighed the risks of some of the heart arrhythmias.  Got back on the beta blocker and everything smoothed out.  We had a healthy 8 pound baby girl.  I did have to have antibiotics at the time of delivery, I forgot why, but it was some sort of precaution. I did experience some strange beats after delivery which they said was due to "hypovolemia--change in blood volume", which they said was pretty common. My OB team highly reccommended that I NOT nurse my baby with being on the atenelol, so I didn't.  That was hard.

Anyway, just wanted to share my experience, and wish you all the best.  I'm no Dr. but felt greatly helped with all the medical professionals who supported me. Personally we decided 4 years ago not to have any more children.

Uptowngirl

[ngkk]

Hiya

I also liked your question and totally agree with both responses.
I'll give you a little insight on my expierence with beta blockers and pregnancy.
I was diagnosed with SVT's approximately 4 yrs ago - have been on toprol since.  Originally started at 12mg then recently after a failed ablation my Dr. upped it to 25mg.
I got pregnant on 12mg and stayed on it throughout my pregnancy from start to finish.  I had one bout of SVT during my 5th month - but it had no affect on the baby. I delivered a healthly 7lb14oz baby boy.  I also had gestational diabetes and was on insulin shots from about my 25th week on. I did alot of research on toprol, including contacting my pharmacist,his pediatrician, and both my gyn/ob and cardiologist - and I did nurse throughout his whole 1st year with no problems.   We are now trying again for another baby and everyone agrees that staying on toprol  will be fine and I do put my trust with their opinions, and I will nurse again.  Hopefully this will ease your concerns about toprol!