Toprol Benefits

[rossi]

Good morning,

I was prescribed toprol when I was diagnosed with AF. I didn't ask why. My sister has since been prescribed toprol to lower her blood pressure and slow down her heart rate a little. I have never had high blood pressure and my pulse has always been on the low side. What is toprol supposed to do for AF'bbers like me then?

Also on a different board, they said AF's possible causes include: chronic inflammation of the heart lining, high cortisol levels or low DHEA levels. Supposedly all three can be easily detected by blood tests. But I was never prescribed any blood tests. Do you prescribed blood tests for your patients?

Many, thanks.

Ross

[va_tony]

Small point. Beta blockers are not recommended for all types of arrhythmias.  They may actually worsen the vagal form of afib, especially for those who already have low resting heart rates.  See, for example: http://members.aol.com/mazern/afib101.htm

[Clenn Camp]

Right, beta blockers are good for helping control arrythmias. However, that's all they do is HELP control them. In my case they are 'helping' to control pvc's but do not entirely control them.
As Arthur said in a previous post and I agree with him..."I believe a heightened PVC activity can also result from localized trauma and it's concomittant effect on the autonomic tone."
Pulmonary Vein Ablaton does cause trauma to the heart and of course the scars from the burns takes a long time to heal.

Glenn

[wmac]

I thought beta blockers were for any kind of arrthymia's. As far as I know it should help pacs and pvcs.
wmac

[arthur]

My comment re. heightened PAC activity is a personal observation...I believe a heightened PVC activity can also result from localized trauma and it's concomittant effect on the autonomic tone.

-Arthur

[Clenn Camp]

trudyjh,

Your post got in right ahead of mine of me responding to Arthur.
Yes you are right about my cardiologist prescribing both atenolol and Lopressor.  They are both in the same family of meds. Yes I have two different Dr's and the EP that did my ablations is located 200 miles south of me and the cardiologist is 30 miles to the west of me.  I was on atenolol and the EP knew I was but the cardio doubled my  dosage and last week because of blood pressure also added Lopressor as well.  I have emailed the EP about the med regimen change and haven't heard from him as of now.

I know that atenolol is making me awfully tired and pulling me down to the point I do not have any energy.  When I go for a walk I have to really push to walk any distance.

My cardio told me to try the Lopressor for awhile to see if it would also help control pvc's as well as B/P.

Glenn

[trudyjh]

Ross,

Another benefit of a beta blocker is that it does reduce ectopics.  I don't recall if it acts against PACs, PVCs, or both.  This is not widely known.  PACs trigger afib.

As to causes, some triggers for many people are caffiene (includes, alas, chocolate), stress, alcohol, drinking or eating cold things, lifting weights or climbing stairs, indigestion is a biggie.  Lying flat instead of sightly inclined at night.  Some record keeping may show you useful info about your own triggers.

[Clenn Camp]

Hello,

It has been seven weeks since I had pulmonary vein ablations to be rid of afib.  I had pvc's for several years as well as afib, sometimes just afib and then sometimes both at the same time.

At present my medicine regimen is as follows:
100 mg flecainide twice daily for preventing any afib signals from 'sneaking' through.  25 mg of atenlol twice daily for helping to control pvc's but doesn't control completely.  I have to keep taking coumadin for awhile.  I take 5 mg of norvasc twice daily for blood pressure.  Now my cardiologist has added 25 mg of Lopressor twice daily.

Is there a better medicinie regimen for helping control of pvc's?  These things are eating my lunch everyday.  I haven't had any afib since the procedure..... so far.


Thank you,
Glenn Camp

[arthur]

As one who has had a successful rf ablation for PAF a few years ago, I can say that the PAC activity was heightened post ablation for quite a few months.  The cardios will tell you to expect some increase in PACs/etc post-ablation for at least a few weeks.  This will vary with the individual, since it all depends on the foci left behind, the degree of trauma incurred during the ablation, and your overall mental state.  After about a year, things settled down quite a bit...going from 2-6 PACs/min to 0-1/min these days.  I remain athletically active and have grown to accept the occassional noise as a part of life.

The tambocor/beta-blocker combo was also given to me...I stopped taking it (with the doctor's consent) a couple of months after the ablation.

-Arthur

[trudyjh]

Glenn, I'm a little confused about why the doc has you on both atenolol and lopressor.  As I understand it, they are both beta blockers.  I would think he or she would have just increased your dose of atenolol rather than adding in lopressor.

Do you have more than one doc and maybe they aren't each aware of what the other is prescribing?  Or the doc has forgotten?

I can't remember if beta blockers suppress PACs or PVCs (I know they help suppress one of them).  If they work for PVCs, you may just have to have your doc increase the dose and wait a week or two for it to kick in.  Although it starts having an effect within an hour or so, my doc told me that it also builds up in the blood and that takes some days.  Also, it takes awhile for the heart to calm down.

[Clenn Camp]

I'm having pvc's, not pac's.  I had pvc's prior to ablation for several years and still have them.  We're hoping for them to subside as the heart heals but I was wondering if a Dr. could or would suggest a different medication regimen than the one I described in an earlier post.

Glenn Camp

[CCF-M.D.-RCJ]

Ross,

Thanks for the post.

Q:"What is toprol supposed to do for AF'bbers like me then?"

Beta-blockers are used to control the heart rate when patients develop atrial fibrillation.

Q:"Do you prescribed blood tests for your patients?"

Yes, but I do not routinely check cortisol or DHEA levels -- the evidence does not support this measurement in most patients.  Pericarditis cannot be diagnosed from a blood test.

Hope that helps.