AFIB AND SVT WITH SKIP BEATS AND HEAD FLUSH

[FRED220]

I was diagnosed two years ago with afib and svt after wearing a monitor for two weeks. I was given Metropolol Tartrate and I took the Meds for 2 months (25mg). I then got off them since I felt it could have been anxiety and never had episodes again until last month I began to have them again. I felt afraid as I did the first time and I began taking half of the Metropolol (25mg) each morning to see how I do. This time again I felt the urge to go to the ER but I did not since I know all they are going to do is send me to a cardiologist. I really hate the feeling of the palpitation, the head rush and the skips beat , I feel like I am going to pass out.My wife thinks its all due to stress and not a heart problem.  The symptoms I feel come and go very fast but then I feel the fear, it only happened once this morning but I spend the whole day thinking about when  the next one will come.I like to know if anyone has had this similar symptom come back after two years of not having them and what you suggest/or did about them.

[tom_h]

Well, I don't advocate self doctoring, but if you wanted to reduce your dose from the apparent 50mg which I think the doctor prescribed to 25mg, I'd cut the pill in half and take essentially 12.5mg in the morning, and 12.5mg in the evening.  This is a very low dose, Fred, and if you're an average sized male, probably much less than what you should be taking to provide any degree of efficacy

I wanted to clarify what I said in the first paragraph of my last post.  For most people, stress can elevate their pulse, but it won't send them into Afib or SVT.  For guys like you and me, stress or anxiety can produce adrenaline which can aid in starting an event if conditions are just right.  If you keep getting these episodes, I push for a long term monitor with hopes of catching a couple of events.  I lived 54 years, or almost my entire life with SVT, so I wouldn't be as concerned with that as I would be with the Afib.  That is not good, and if you get it consistently, that would require medication to keep you safe,  Good luck!

[FRED220]

Tom, I was told by the Doctor to take it twice a day but I hate to take meds and I just took it in the morning. I also skipped days that I am not going to do now. I did hear from a client about Metropolol Succinate and I will ask my Doc when I go see him.I am debating if I should see a cardio or EP and weather to have the monitor again since last time I had it was two years ago. It was suggested to me to do ablation in the ER  before I knew what it was and I turned it down since I thougth it was all stress. I am 54 years old and I guess I have to start to accept that as I get older I will need some meds to keep healthy. For me, marrying my wife 28 yrs ago has also been one of my best moves. I thank you for your time and suggestions:)

[tom_h]

If you have confirmed Afib together with SVT, the "heart problem" is there. Stress may help contribute to breakthroughs, but what you're experiencing is not stress alone.

As a long time Metoprolol user, I can tell you what I know about it.  It's available in two forms, Tartrate and Succinate.  The latter is the timed release version.  One dose will take you through the day.  Strengths of each are eqivalent, but here's the thing:  Metoprolol Tartrate has a plasma half life of about 5 to 7 hours.  So the 25mg dose that you take in the morning is metabolized in half within 5 hours of taking it.  I'm sure you can see where this is going.  By the following morning, only a tiny amount remains in your blood.  So taking a single dose of Metoprolol Tartrate is NOT the way to use this drug.  You end up having a huge roller coaster effect with a sharp spike when you first take it, followed by a deep continuous fall throughout the day.  The Tartrate version is usually prescribed as a twice a day medication with doses 12 hours apart.

Now the amount you're taking:  25mg is typically a low dose.  I'm on 75mg. following my ablation 4 years ago for controlling mild hypertension.  Prior to my ablation for near life long SVT, I was on 100mg. per day to help control it which it was completely unsuccessful in doing.  Such is usually the case with Metoprolol. I had been as high as 200mg. per day.  That dose really made me feel lousy, so it was backed off to 100mg. and I tolerated that well.

I can't speak for Afib, but for many people, episodes of SVT seem to become more frequent with age. Mine had increased to 3 to 5 times per month as I approached 60.  So I think what you're experiencing is not at all unusual.  You may find that your best bet is to go after the SVT with cardiac ablation and eliminate one of your problems once and for all.  For me, that decision was one of the best ones I've made since marrying my wife.  Good luck!