beta blockers and ejection fraction

Do beta blockers effect the ejection fraction results on an echocardiogram?  I have read that one side effect of beta blocker use can be heart failure.  How does this happen, and can long term use (12 years) be responsible for a marginally low EF of 47%?

Sierra

[CCF CARDIO MD JMF]

Beta blockers are a mainstay of treatment for ischemic heart disease, arrhythmias as well as heart failure.  However, due to their effects as a direct myocardial suppresant and through a decrease in heart rate, they may cause heart failure as a side effect.

[Gatal]

I'd also like to know the long term effects of beta bloackers .. i've been taking between 25 and 50 mg of atenolol for the last 9 months.

[Bill Serrahn]

I was put on 50 MG of Atenolol after a heart attack last summer.  I found that it was too much for me and counter-productive to my exercise program.

I reduced that to 25 MG split into two doses which seemed to be ok.  Later I reduced to taking 1/2 of the 25MG daily.  At that level it seemed to be a very beneficial drug.  It reduced my B.P. at moderate exercise by about 10 BPM, which was helpful.

Overall, I think that it has been a very beneficial drug at low level, but, I too, worry about the long term effects on heart function.

I recently have stopped taking it altogether.  I still have a low resting heart rate and am temporarily taking it a little easier on my uphill hiking to keep the exercise heart rate down, until I adjust to being off of the drug.

My guess is that all of these drugs giveth and taketh away.  I personally think that Atenolol is helpful in low dose for 6 months after a M.I., but believe that it could decrease heart function if I were on it indefinitely.  That's why I chose to stop taking it.

[jan]

I am on atenolol to prevent heart failure and cardiomegaly. I have IST, which if left untreated could result in either of the above. So...

[jan]

I just read on cbshealthwatch.medscape.com that an infrequent side affect of atenolol is congestive heart failure.  Thought you might want to know.  Strange isn't it... I am on it for an arrhythmia and to prevent heart failure and both of those are including in side affects.  Go figure.

[lee to cindy]

my husband has been on tenormin (atenolol) 50 mg for the
past two years since his first "episode".  he has been very
unhappy with the results since the only thing it seems to do
is lower his B P from 140/90 (he is 73, always excercised
vigorously,doesn't smoke, use alcohol or caffine)  and adds
a few  negative reactions like slow pulse (sometimes to 43
bpm and low even when excercising), exhaustion, drowsy-
ness and in general less joy.  coumadin  for safety from
possible clotting from atrial fibrillation, and ativan when he
gets anxious about it all, are the only other meds.  i tried to
get  the information you mentioned from cbshealthwatch.
medscape.com but i am so new at this i was all over their
site with no luck. my husband has another followup visit
with his dr. and we'd like to go informed so as to discuss
alternatives.  we have  seen electrophysiologists and are
considering the possibillitiies (though afraid to make things
worse).  we would appreciate it if you could  tell us if this
was an article and the date, or where we can read it.  73 may
sound old to some of you kids out there...but believe me .. it
is not !  our prayers are with all of you young people that
you make it to at least 100!  lee

[Gatal]

Can beta blockers turn you into a total wiped out zombie?  Most of the time I stumble around in a fatigued daze ... fainting spells and pallor ... beeen tested extensively ......... any way over the weekend I skipped taking my atenolol and felt like a different person ... it was amazing ... my energy came flooding back ... only later my BP and HR spiked up again so I was forced to take the meds again ...

[carissa]

Hey,

I suffer from extreme fatigue related to tenormin.  I sleep 12-14 hours a night and still feel drowsy all day.  I can't skip it though because it is supposed to prevent cardiac arrest in my case (I have prolonged QT) and without it I am at high risk.  I am concerned about the long term effects of it now that I have read this.  My doctors never said anything to me about congestive heart failure.  I am on 100 Mg. a day. I still went into cardiac arrest twice when I was on 75 so they had to increase it.  I am 5'2" and less than 100 pounds, so it really hits me hard!  My pulse is usually around 52 or 56, and my BP is usually around 80/50.  I will have to take it for the rest of my life they are telling me.  Should I be really concerned about the side effects?  I have been on it for four years.  Please respond here or e-mail me at ***@****.  thanks.

[jan]

I am on my son's laptop so, I can't tell you what it is exactly, but it's a drug look up feature.  As far as atenolol making you tired, it has actually helped me in the opposite way because of my condition, but it is definitely known to cause fatigue.  As a matter of fact when my electrophysiologist tried to raise my dosage it hit me.  I think maybe it is making me depressed, which is another side affect, but I don't know I have been through alot.  I have to go off it for 48 hrs. before my thallium stress test and if I feel better I will mention it to my dr.  My dr. says it is one of the safest meds there is.  As far as heart rate during exercise, it will be affected but it doesn't matter, according to this website.

[poly]

Last year I had an episode of supraventricula tachycardia (177 bpm) and ended up in ER.  They put me on atenolol, 50 mg, and it made me "EXTREMELY" zombie.  I felt terrible: depression, fatigue, weakness, spacey, insomnia, etc (never felt like that before), so I stopped a week later.
I've always had a very rapid pulse (even at rest), so this year I decided to have my heart checked out.  After doing EKG's, echocardiogram, blood tests, and holter monitor, they said I have Mitral valve prolapse and innapropiate sinus tachycardia because of the MVP.  The cardiologist put me on Toprol xl, 50 mg (another beta blocker).  First I didn't want to take it because of the bad experience with atenolol, but then tried 25 mg the first day, and felt Ok.  Then went to the 50 mg, felt a little sleepy during the first days, but now feel totally normal and my tachycardia is under control (I feel even better than before).
The doctor says that I'm going to have to take the Toprol for life, and I really don't mind now.  My blood pressure is low now: 85/65 (it used to be 100/75), but my pulse is normal and feel wonderful.

[lee to cindy]

thanks jan.  i found the cbshealthwatch. drug  info.  i have the
Worst Pills / Best Pills book put out by Public Citizen's Health
Research Group, but the cbs drug directory made the atenolol
discription much clearer. .not that the book isn't great for detail.
good luck with you thalium stress test.  please keep us informed
on what happens after your 48 hours without atenolol.  lee

[My experience]

I take sotalol and find it VERY fatiguing.  I feel like I'm walking underwater, like every step is an effort, and sometimes am walking in thick water.  Am going to my cardiologist tomorrow to see if we can try a different beta blocker, but fatigue seems to be a side effect of all of them.  Has anyone tried one that doesn't do that?

[Sharon]

I had the misfortune to be on atenolol. It made me feel miserable. I stopped taking it; next day I went into heavy atrial fibrillation and wound up in the hospital. I'm taking another beta blocker and feel fine. Pay a lot of attention to what you are given-- ask questions.

[lee to cindy]

sharon..which beta blocker are you on now,and how much are you on?  glad you're feeling so much better.  thanks for inf.  lee

[jan]

Sharon, did you just up and stop taking the atenolol, how much were you on and how long were you off before going into afib (was it literally the next day)? What were you on the atenolol for? What did the dr.s attribute the afib to?  I hope you don't mind all the questions. Thanks.

[Jen S]

I am also taking 50mg of atenolol a day to prevent episodes of SVT - it has patially worked - I have not had SVT that feels like your heart is going to come out of your chest since I have been on it (3 yrs) but I still have rarely a few episodes  of a racing heart, but on the atenolol I am able to stop them by bearing down, whereas before I had to be injected with Adenocard at the ER room. I also suffer from panic attacks which cause my heart to terribly race - it's weird that so many of us suffer from pvcs, svt, and alos panic attacks that I often wonder if there is some connection - adrenaline sensitivity or something else? Does anyone know if catheter ablation can cure - my atenolol does not seem to help them.
Thanks for this website - it is a great comfort to know I am not alone.

[Jen S.]

Soryy, I wanted to know if a catheter ablation could cure pvc's. I am scared to have the ablation despite its success rate due to possible complications or worsening of my situation. Also the pvc's - can they be fixed with ablation?
Thanks!

[to Jen about pvc's]

Hello,

   From what I understand, most docs won't do ablation for pvc's.  They say it is a benign and harmless condition.  Have you tried medication?  I have pvc's and also svt.  I was prescribed a beta blocker for svt, but haven't had any pvc's that I've noticed since.  Good luck to you.

[jan]

I just had my thallium stress test this morning, so it's back on the atenolol. I can't say if I felt any different being off of it, (other than being a lil short of breath during a period of tachycardia. Maybe just a lil less tired. I don't think 48 hrs. is long enough to really note a change.  I am on a low dose to begin with, 12.5 mg am and pm. I am thinking of asking the doc if I can cut out the morning dose to see if this helps to totally eliminate the tiredness and maybe get some spunk.  I know he'll want to do a holter monitor again, if he agrees, but that wouldn't bother me.
Jen, if I were you and could get an ablation for the SVT and therefore, get off of the atenolol, I would. I even read one of the dr.s on this forum tell someone exactly that.  Why take medication w/side effects the rest of your life?

[lee to cindy]

ablation doesn't necessarily work to remedy the problem, in which case sometimes stronger meds or pacemaker or both need to be used.  that is my understanding of ablation.

[jan]

Hi Lee,from what I've read ablation works pretty well for re-entrant SVT's. Jen had mentioned in her 1st post that she was being treated for SVT's. I guess it really is a personal thing, you have to weigh the risks with how you are feeling (if you have a choice). The truth be known, I think alot of the tests and such are scarey.  That is when you have to sign the consent and they're telling you that you can die from the procedure.  I wonder if anyone actually backs out after hearing that. This whole heart business can be unnerving and I hate having to wait for results of a test!  By the way, I have cut back my atenolol to just the morn. dose, I figured if I feel better I can tell my dr. at my next appt. (in 3 weeks). I am tiring earlier in the evening, I don't feel any peppier,yet, but I do feel clearer headed.  How is your husband doing?

[Jen S]

To Lee and Jan:

I feel dumb - I am not sure what re-entrant SVT's are - I was just told I have SVT!! The atenolol does not have any terrible side effects but I still have PVC's and sporadic SVT attacks - like today - which just happened to be the first day of my menstral cycle - they always seem to happen then, but the docs dismiss it...
Jan, is there no surgery you can have to help you? I was also told by one cardiologist I have MVP - would that affect an ablation? I just am scared to face the possibility of something going wrong, even though "they" say 95% of abltions are successful. Does anyone have any ablation info? You can e-mail me directly at ***@****
Than for caring, I hope you all feel better Let's try and not let his heart thing monopolize our lives, although it is hard!

[lee to cindy]

don't feel dumb jen.  all these initials, denoting conditions are driving me crazy too!  we need some sort of "dictionary" for thee abreviations.  
you're right about "this heart business" getting us down.  My husband gets depressed everytime he reads the forum with me..so guess who does most of the reading?  he see's his doctor this friday and hopefully can cut ack some on atenolol, jan.  take  a look at the question posted by marisha on magnesium, if you haven't already.  i know for a fact that it is very significant in heart problems.  we keep hoping that one day we'll be able to use natural methods methods  with safer or no side effects which can help these heart problems "we" all share.  i have so much compassion for all of you.  once in awhile i get very frightened about something or other and know this must be the fear you experience on an everyday basis.  I use Bach flower essences when this happens (and so does my husband) and it helps.  check your health food store or the web for info.  they have been around for 70 years and becoming more and more known and used.  they do not interact  with any meds or food etc.  good luck.

[jan]

Hi Jen and Lee,
Re-entrant SVT is from an extra electrical pathway.  I have inappropriate sinus tachycardia, this is something wrong with my sinus node.  If I don't respond satisfactorily to the meds. then they will try an ablation, but there is usually a need for a pacemaker then and that is why my dr. wants to try everything else first.  I, also, have mvp with mild regurg. and mild tricuspid regurg.  I don't believe that would interfere at all with an ablation.  You know, Jen, being perfectly honest I would be hesitant to get an ablation, too.  It's scarey.  As far as the magnesium, I do take calcium/magnesium supplements and drink bottled water.  I will ask my dr. about the magnesium.  Last year when I found out about my heart conditions and started reading this forum I felt depressed also ( besides the fact that I had just lost my mother to CHF 4 mos. before).  I think everybody needs some time to adjust and accept the diagnosis.  I do think I feel better since cutting back the atenolol, as far as the depression, but I still am on a wait and see basis. However, I'm not sure it's enough to control the arrhythmia.  I have an appt. in about 1 1/2 weeks. May I suggest Relax-o-zyme by Enzymatic Therapy for stress, I don't take it according to the instructions, that would be too much for me.

[Jen S]

Thanks for your responses, Jan and Lee. I am also concerned, after hearing about other misdiagnoses that maybe I don't have just SVT, but a problem with my sinus node. Can the doctors be sure of what you have without doing and EP study? They looked at my heart rhythm on a sheet of paper from EKG and said I had SVT.
Is that how they tell the difference?

[Jen S]

Thanks for your responses, jan and lee.
I was wondering about having SVT vs. sinus node trouble. I was told by en ER nurse after reading my EKG that I had SVT. How can they tell if that is what it is for sure without doing an EP study?

[jan]

Hi Jen, I was told originally I had SVT,too.  IST is a form of SVT, but it is rare.  (In an encyclopedia it listed SVT as a range of heart rate). Anyway, IST is diagnosed by a process of elimination usually.  Mine was diagnosed because of the occurence during my tilt table test, I have read others were diagnosed that way, too. (But that's not what the tilt table test is for.  It is to diagnose neurocardiogenic syncope, which I have.) Just before taking the test the tech said that seeing my cardio. (my 1st one) said I had SVT, he should have ordered an ep study. So, I guess an ep study is standard for SVT. If you go to "search" on this forum and look up "inappropriate sinus tachycardia" and SVT you'll learn alot, this is how I got most of my info.  I hope this has helped.  :o)

[jan]

Hi Jen, I was told originally I had SVT,too.  IST is a form of SVT, but it is rare.  (In an encyclopedia it listed SVT as a range of heart rate). Anyway, IST is diagnosed by a process of elimination usually.  Mine was diagnosed because of the occurence during my tilt table test, I have read others were diagnosed that way, too. (But that's not what the tilt table test is for.  It is to diagnose neurocardiogenic syncope, which I have.) Just before taking the test the tech said that seeing my cardio. (my 1st one) said I had SVT, he should have ordered an ep study. So, I guess an ep study is standard for SVT. If you go to "search" on this forum and look up "inappropriate sinus tachycardia" and SVT you'll learn alot, this is how I got most of my info.  I hope this has helped.  :o)

[jan]

Hi,
It's been 3 weeks since cutting back the atenolol and it was definitely the cause of my depression. I told my EP this morning and he agreed and said it was a known side effect.  I feel so much better.  Of course he is having me do a holter to be sure the arrhythmia is under control.  Oh, by the way, I passed the thallium stress test!  Yes!  One less thing to be concerned about.  I hope you all are doing well.

[Gary]

I am a 33 year old male suffering from palpatations.  I have always had them since I was 18 but I only got them after drinking a lot of caffeine (once or twice a month).  I am very scared, echo stress tests and thallium test have not led to any conclusive dx.

My marriage is in jeopardy because I am being treated as if I am faking or "crazy" at this point.  I am scared and alone.  In the last three weeks I have experienced them during sexual activity as well as at rest lasting for as long as 10-20 minutes usually around mid afternoon.

I need a friend.  I am so scared.

[jan]

Have you spoken to your dr. about your anxieties over this?  I would think he would give you beta blocker treatment or something for anxiety.  You need to talk to him for your own sake and the sake of your marriage.

[kenny]

I am a relatively young human to be using atenolol...
#39 yrs old after a Mytocardial Infarction at the age of 31.

Using 25 mgs of the drug daily seems to be OK.
It was my decision to go down from 50 mgs. and my Dr. OK'd it.

One day I skipped it, and I "thought" I felt a difference.
Since I am Vegan, very active, I would like to GIVE IT UP>>>!

One Dr. I met with thought I did not need it.

Q:  What can I expect as PHYSICAL manifestations
of not using the drug any more. Should I go down to 12.5 mgs
first....Who has experienced the "withdrawal?"

Mahalo

[Thea on Saturday, Sept. 1,2000]

Aloha, Kenny.  I am also young, 40 yrs old, and my cardiologist is considering putting me on low dose beta blockers, as they are apparently the newest thing for cardiomyopathy.  I still haven't done it yet, but am getting concerned since I have two young children to think about.  I hear/have read you should not stop any beta blocker or other meds cold turkey.  I too worry about taking them and then stopping should there be side effects.  There seem to be so many to choose from.  I'll talk again after checking it out more...try www.google.com search engine for the meds you are taking..there are a lot of articles out there.  My doctor is great, but he doesn't know much about natural alternatives or supplements..CoQ10, L-Carnitine, etc.  If you are a vegan, you should check your levels of L-Carnitine as it is an amino acid used by the heart, and only found in meat and dairy products. I think from reading this forum I am going to stay away from altenolol, unless it can produce miracles..

Glad I found this website.  I'm new.  Will be here again.  Good luck....

[SP]

I also had AV node re-entry. SVT. I had an ablation and was the one in a million with complications.  I felt worse on a daily after the ablation than with the SVT.  I had extrme bouts of coughing --feeling like I was full all the time.  I had runs of sinus node problems.  Apparenlty my path was wiped out.  I was told that sometimes people with AV node re-entry have a wide coronary sinus so ablating was more tricky. I went immediatley into Heart Block.  The next year was pretty horrible although I tried to keep my spirits up--I was essentially trying to avoid a pacer.  After a year I had a pacemaker put in. I am an avid exerciser, hiker, biker and this has cramped my style a bit!!  Do I feel better? On the whole--on a daily basis YES--Although when I am active I still have problems.  I also had pericarditis and continue to have some funny chest pain from it.  The MD's have no answer for the pain or SOB. I take beta blockers (corgard--no problems with extreme fatigue like atenalol) because my rates continue to go up.  I do get frustrated at this whole thing and sometimes feel very preoccupied with it all. Last week--they thought they heard a murmur --or aortic regurg--What next.  I would love to hear from folks with similar issues--forum is great--thanks in advance for any responses.

[Hope]

I currently take 200 mg. of atenolol a day for Svt and I am emtremely tired all of the time and am still experiencing the racing heart.

[jan]

Hi, It's me, again.  The 12.5 mg of atenolol was not enough to keep my heart rate down, so my doc added 180 mg of verapamil. I feel pretty good.  I am still having periods of tachy. and almost passed out recently from it,so I am now taking salt tablets (to help with the tachy and syncope).  I had the choice of florinef or giving salt tablets a try.  I am not going on florinef one way or the other.  I heard it really messes up your electrolytes. He is, also, talking about trying zoloft to help with the syncope (NCS). I told him I am not concerned with the syncope, I always have near syncope with warnings.  The only thing I have to worry about is the tachy,so...  Hope, maybe you could ask your doc about this combo (atenolol and verapamil).  How's everybody else doing?