AF and medication

[Ricko250]

I am 52, pretty healthy and have reently been diagnosed with AF. I have been prescribed with Atenolol for the AF and Warfarin (5mg) to reduce risk of blod clotting leading to stroke. Sie effects of Atenolol fr me are making me very tired and quite dizzy with BP dropping to 100/60. I understand the need for Warfarin  (although I thought maybe aspirin would do given I have no othr complicating factors) but wat's the point of Atenolo? It puts my heart back in regular rhythm but not all the time and if the only problm with AF is increased risk of stroke then why not simply manage this with Warfarin to reduce this. Is taking atenolol worth the side effects?

Thanks

[Sweetwaterguy]

  I had a fib for a couple of years, but it was generally controllable with sotolol.  I did take a daily aspirin--but again, I had good control.  Even though I was in reasonable control with meds, I opted for ablation for two reasons.  Like you, I did not like feeling tired.  My stamina was not affected, but when I stopped doing whatever I might be doing, I felt like I wanted a nap.  The second and deciding reason for ablation came after a week of a fib, I believe triggered by a reaction to a flu shot.  A couple trips to the emergency room, and one night in ICU convinced me that "reasonable" control was not enough.  I enjoy an active outdoor lifestyle and did not want another episode of my heart acting up when doing wilderness hiking, miles away from any medical care.  (that happened before sotolol)
   Ablation did the trick for me.  No meds other than a daily aspirin and a statin.  
   Your question about Atenolo is interesting.  It is really a question of risking a stroke.  Communicate your concerns with your physician, but by all means follow medical advice.  
   Have you discussed ablation with your doctor?  If you are a candidate, ablation has the potential to resolve your issues and actually cure a fib.  

[BLM_56]

A-fib is not by itself lethal but it does cause other problems.  As Rita said asparin doesn't begin to control the clotting problem.  When your atria are fibrillating that generates turbulence that can cause clots.  If the clot is generated in the right side of your heart then the only place it can go is to your lungs.  Google "pulmonary embolism".  Not a nice way to go.  If the clot is generated on the left side of your heart then the fun really begins.  The coronary arteries come directly out of the left ventricle even before the aorta.  Clots in coronary arteries can be lethal.  Google "coronary thrombosis".  The aorta is the main distribution manifold for oxygenated blood.  The first tap off the Aorta is to the carotid arteries.  Look up "ischemic stroke".  If the clot misses the carotid, there is still the other main arteries for it to go into.  Google "deep vein thrombosis" or look up the effects of a blood clot in the blood supply to your liver, or kidneys.  Not nice things to experience.

As for atenolol, I took it for a couple of years.  I very quickly got used to it.  Unfortunately it did not keep me straight.  If you go into persistent a-fib then your ventricles loose their synchronization signal.  The result for me was not only irregular heartbeat but IRREGULARLY irregular heartbeat.  My heartrate literally changed from second to second.  Your body NEEDS a beat like an orchestra needs a metronome or someone beating time.  Plus, in the absence of a good signal from the atria you can easily go into ventricular tachycardia (v-tach) which can escellate into ventricular fibrillation (v-fib).  FYI, absent cardioversion by a defibrillator v-fib is pretty much 100% lethal.  When the ventricals are in fib they aren't pumping.  That tends to be lethal.  I suspect that you're being given atenolol to control your heartrate to keep you out of v-tach.  Again, I got used to it pretty quickly.  But it for sure knocked me on my butt when I started it.  Fortunately that did not last long.

As for low blood pressure, my family Dr. noticed that mine was kinda low one time and sent me to check with my cardiologist.  In his own inimitible style, (Sal Barbaro is definately a "one off") my cardiologist asked me "Do you fall on your head when you tie your shoes?".  When I responded in the negative he told me not to worry about it until I started to.  My wife runs consistently around 90/50 and has no problem.  At least with a BP of 100/60 you don't have to worry about popping a gasket in your head! ;-)

Bionic Bill

[RNRita]

Hi.  A blood pressure of 100/60 is not bad at all.  It is considered very good.  It used to be that 120/80 was considered normal, but now they say that is borderline high!!!!  If you don't mind the feeling of A-fib, then you probably don't really NEED the beta blocker.  A-fib is not a lethal rhythm.  However, you DO need the warfarin.  Aspriin would never control this.  Talk to your doctor and tell him you don't like the side effects.  I've been on atenolol for 31 years and I may be a bit more tired than other people but I can still run circles around people at work!