Effects of Verapamil

On April 27 of this year, as part of my open heart surgery, I had ablations in the left atrium for atrial Fib and in the right atrium for atiral flutter.  Since that time, I have had a very rapid and irregular rhythm secondary to any activity. I was started on toprol and verapamil 180 mg twice a day.  A few days ago, I was cardioverted since they felt I was in atrial fib again.  My rhythm is now a regular accelerated junctional rhythm, rates 80-100 (faster and irregular with activity).  Atrial rhythm appears to be from an ectopic focus, not very well organized. I do have a pacemaker that has been reprogramed to a VVIR (rate 50) because the atrial lead no longer works. I have been told to continue with the drugs and we will watch and see what happens. My question is can verapamil suppress the SA node and prevent return of normal conduction? I don't want to do anything that would decrease my chances of a return to normal rhythm but I do understand to need to keep the rates at a reasonable level. Is Toprol alone a better option?  Cardiac rehab has been a challenge..any ideas about how to handle that at this time? I realize that it could take many months before we will know the outcome of this surgery.

[Cleveland Clinic]

1) My question is can verapamil suppress the SA node and prevent return of normal conduction?

Verapamil can act on all of the pacemaker cells of the heart. Most likely this is realted to variations of the atrial focus of activity and not the effects of the agent.

2) Is Toprol alone a better option?

Impossible to say. In some yes, in some no. If your worried about it you could discuss a trial of a single agent alone with your electrophysiologist.

3) Cardiac rehab has been a challenge any ideas about how to handle that at this time?

One day at a time. Progress can be frustratingly slow at times. Just keep working!

good luck