SVT,MVP,high thyroid, and metoprolol

[nexxus6]

Hi, I am a 31 year old male with a history of GERD and mitral valve prolapse with regurrgitation.  I should note that I've had occasional bouts of PVC's for about 10 years.  In the last two months, it has been discovered that my free T3 and T4 levels are high (6.0pg/mL and 2.43ng/dL, respectively).  These levels were normal 18 months ago.  Within the last 6 to 9 months I have experienced random occurrences (couple times a month) of an accelarated heart rate which lasts from about 5 to 30 seconds (I do not get dizzy or short of breath).  My cardiologist got the readings from an event recorder, and told me it was SVT (about 150bpm).  Just last week, he prescribed Toprol XL 25mg bid for the SVT which I haven't started to take yet due to fears of it leading to other problems (impotence, diabetes mellitus, etc).  Here are my questions:

1.  Am I at an increase risk of sudden cardiac death and/or V-fib from the SVT runs, especially due to the bad mitral valve?

2.  Will taking the metoprolol actually DECREASE the chance for serious cardiac events that may be caused by SVT or just relieve symptoms?  (If there is no actual medical benefit besides symptom relief, I would rather not take the medication)

3.  My ejection fraction is around 60%, will the beta blocker put me at risk for edema and a decrease in ejection fraction?

4.  Is there a chance that when my T3 and T4 are normalized, that I can stop the metoprolol?

5.  Without knowing the actual mechanism behind the SVT, can metoprolol actually cause more harm than good?

6.  Can SVT be position dependent?  This may sound dumb, but it occurs more frequently based on how I sit or how full my stomach is.

7.  Can I still go out and enjoy an occasional drink or two?

Thanks for taking a look at my question and I appreciate any feedback that you may have.

Worried in WI

[spiritflow1]

A related discussion, ejection factor was started.

[Michael J. McWilliams, M.D.]

1.  Am I at an increase risk of sudden death syndrome and/or V-fib from the SVT (psvt) runs, especially due to the bad prolapse valve?

No, your risk is essentially the same as anyone else.

2. You aren't really at risk for serious cardiac events, so it really can't decrease the risk.  The beta blocker is intended to treat your symptoms of palpitaitons.

3.  My ejection fraction is around 60%, will the beta blocker put me at risk for and a decrease in ejection fraction?

No, it will not decrease your ejection fraction.

4.  Is there a chance that when my T3 and T4T4 test are normalized, that I can stop the metoprolol?

Yes.  You should probably see an endocrine doctor about treating the thyroid problems.

5.  Without knowing the actual mechanism behind the SVTParoxysmal  (psvt), can metoprolol actually cause more harm than good?

People take beta blockers for this all the time.  If you had WPW and got atrial fibrillation, a beta blocker could cause problems.  But this is very rare.  I think you are letting your anxiety about the medication get the best of you.

6.  Can SVTParoxysmal supraventricular tachycardia (psvt) be position dependent?  This may sound dumb, but it occurs more frequently based on how I sit or how full my is.

Changes in autonomic (nervous system) tone after eating can affect arrhythmias.  It is possible that food affects the SVT.

7.  Can I still go out and enjoy an occasional drink or two?

Yes, this is not a problem.

[kitcurious]

If you don't mind my asking, what degree is the regurgitation?