HCM, AT/AF: TOPEROL from DILTIAZEM

Dr

I have HCM (36M). I have had problems with AF/AT and disabling heart failure as a result. Ablations have not worked. Then I started with Fleccanaide a year ago and I have been in a normal rhythm since. Diltiazem was part of my regiment before I cardioverted and after and since.

Recently, my heart failure doctor suggested Toperol for better treatment of DHF and for less digestion problems. I have taken betablockers (Sotolol and atenolol) in the past without problems.

The thing is I don’t want to risk going back into AT/AF by switching from Dilt to Toperol. Is the upside of trying Toperal for Dilt worth the risk of going into arrythmia again? Is the AT/AF risk of playing with my Dilt even a legitimate risk? It seems that Flecc is the major player not Diltiazem.

The doctors have left the decision to my discretion. Thanks for any insight you can give me.

[curmudgen]

Isn't Diltiazem a calcium channel blocker?  Toprol is a beta blocker.  These are two different class of drugs so I don't think switching from one to another is appropriate.  Are you having digestive problems?  Unless you have a reason not to trust your Cardiologist I would seriously consider his/her recommendations.  But you are the one with the symptoms and must decide based on the risks vs benefits.