BETA BLOCKER/Tachycardia Question

[dkak8]

I am 40 years old. I have always had tachycardia and it bothers me "sometimes" but not normally. My resting heart rate is around 90-110 and the instant I get up my "normal" heart rate for me is around 120. Of course if I do anything like clean house, walk stairs ect my heart can jump up to 148-158. I DONT get dizzy dont have any problems.  I went to see my cardiologist this week as I had an episode of bigeminy which hasnt happened in about 5 years, so I went to get checked out. He wants to put my on a beta blocker. I am concerend as I DONT take any meds for ANYTHING,  I tried beta blockers once about 10 years ago and I basically sat in front of my TV and drooled..I couldnt function, I would have non stop PVC's because my heart wasnt use to going so slow..dropped to about 70-80 bpm, my normal blood pressure is 120/68 and it drops signifigantly.ALTHOUGH I am 5ft and weigh 105 lbs, my cardiovascular is very out of shape.  DO YOU THINK that if I started working out that it might condition my heart so I dont need beta blockers?  I ride horses and maybe walk about 1-2 miles a day just in general every day chores ect. I dont work out with weights or treadmill or anything it scares me when my heart gets up there SO high..150-180bpm.  I have a GREAT recovery time which is under a minute it drops back down to 98-100bpm. My doctor told me my heart is like an engine it is never ideling, its always at a high RPM.  He said I might eventually get Heart Failure or tachycardia can also induce cardiomyopathy.  Just basically get worn out from being over used. What do you think? Also once I start Beta Blockers (Toprol XL 25 mg) will I have to stay on it the rest of my life?  My thyroid is fine, everything is fine, just a sensative S node from what I was told years ago. I dont want my heart to get dependant on some medication!!!  Is exercise and alternative for me?  Or no matter what I should take the beta blocker?

[Michael J. McWilliams, M.D.]

There is not a great data based answer to your question.  A very small percentage of people that have elevated heart rates develop a cardiomyopathy.  Many but not all doctors will recommend to people like yourself that you try a beta blocker or a calcium channel blocker to slow down your heart rate.  There is published data that people with faster heart rates have an increased incidence of cardiovascular disease.  What is not known is whether the fast heart rates are causing the cardiovascular disease or if there is another problem that causes the fast heart rates that also contributes to cardiovascular disease.

When I see patients like yourself in clinic, I explain what I mentioned above.  You can approach the problem in two ways -- 1. get back into shape and see if your heart rates improve, 2. starting taking the medications while you also exercise and consider trying to decrease the medications if the heart rates improve with exercise/fitness.

I do not think there is only one right answer.
I hope this helps.

[b8k3p]

Aerobic exercise is a great way to lower a resting heart rate for most people, but with your history of cardiovascular disease, I don't know if you would benefit from it, or not.  There are several different beta blockers, and each works in the same general way, but at a different intensity and with different effects (eg. one may lower blood pressure more than another).  Ask your cardiologist if exercise is an apropriate alternative.  I'm going to guess s/he'll say no... if s/he recommends a beta blocker, explain your concerns with your previous medications, and try something different.  Like hearts, not all beta blockers are made the same.

[kitcurious]

The post is a little long and I have Hashitoxicosis( attention span is shorter)so if I missed a detail I apologize.
From what you describe, your heart rate during exercise isn't necessarily that high.
I had tachycardia (100-130s) for a long while, but increasing my level of exerise completely normalized my pulse.
Ask the doc about cutting the beta blocker in half for a week or two to start and taking it before bed. It may be fine. I actually stayed at half of a 25mcg tablet and exercised and my pulse, off medication, is now about 70 most of the time.
Your doctor would needs to approve an exercise plan, but if your heart is currently normal and the doctor approves, it can be very helpful to be better conditioned.

[dkak8]

I was wondering if I could take 1/2 of the 25 mg if that may do the trick. Like I mentioned the high heart rate DOESNT bother me, I do get concerned sometimes when I ride my exercise bike or try and lift weights because my heart rate just goes from 90-100 to 140-150 immediantly!  There isnt a gradual climb it just SPIKES and that concerns me because I want to PUSH myself to get a good work out and I always stop without really exerting myself because my heart rate goes up so quickly so high.  It only bothers me mentally, I dont get SOB or dizzy or anything. I JUST turned 40 and I laughed yesterday when I read that my 75% rate is 143bpm....haha, I guess I just need to get out of bed and take a shower to get my daily work out!!!  no need to really WORK OUT with only needing to stay at 143 for 20 minutes a day.......hahaha, my heart is pretty much there ALL day long with any walking or moving around!  SO kitcurious are you now OFF meds and your heart is at 70bpm? And if so how long did you take the meds?

[kitcurious]

I took the small doses of med only for a few weeks. The exercise is what got my rate under control. I had been doing aerobics three times a week for years but it wasn't enough for the rate, so I bought a bike and started riding. Staretd at like, 8-12 miles a week and over  the summer got up to 30-40 miles a week on average, in addition to my  30-minute aerobic workouts. The only problem is that if you are slim you will lose even more weight, and I was also hyperthyroid, so now I have cut back so as not to disappear entirely. Pulse is still fine.
If your doctor says your heart is normal, and ask the doc about the advice I am giving you before you try it, you may want ignore watching the rate for a while and just go by how you feel.

[dkak8]

Thank you for the information. And YES you are correct that I need to just go by how I feel. I dont "feel" bad when my heart gets up that high I just mentally think I am going to jump  into SVT or something....its a mental battle with me and I worry about getting up too high. But on my holter monitor that was just done I jumped up to 154 and didnt even know it and so I just have to get over that fear!  I know when I ride my horses my heart rate gets up there pretty high and it doesnt bother me so I just need to DO IT!  And I know all of you that have SVT or any high rythms you are like 154..THATS nothing, haha, but its scary to me. I have GOT to do something and I think riding my bike and doing some aerobic will help me alot. My husband and I talked about it and we decided to try 4-6 weeks of exercise and see how my heart rate is at that time and then decide if I take the meds or not. I do notice that when I am active for a couple of days my heart rate goes down but then if I am LAZY for a few days it gets up there again, so its going to have to be a daily routine with me of working out. But thanks everyone who posted here and gave me some advise, I truely appreciate it.  

[charmednks]

A related discussion, Dear dkak8 are you still out there.. was started.