Stress, Coumidin,Beta Blocker,Pacemaker

[Tibbar22]

Healthy 150 lb age 61, shaken when I had 1st recorded AFib Nov ’07 (after  dental surgery) causing me to go on 25 mg. Atenolol (taken late evening) & aspirin ( already on Lisinopril  keeping BP under 140/80). Appears Atenolol not good . All Dec light headed & had occasional Afib. Jan fainted one morning after awakin w/ low BP 90/58 after a  night of AFib episode ( I was urinating  frequently). Hindsight: totally stressed out.  After the fainting, cardio ruled out plumbing/ valve.While off atenolol at hospital (stress test had to be done while not on  blocker), I threw 2 pretty good 10 min AFib episodes heart pounded. Again I was sleep deprived & anxious.Jan 16  two lead pacemaker implanted (set to spark  below 50 &  record  beat over 170). In addition to adding Coumidin, they were  going to put me back on 25 mg of Atenolol & increase its dosage or switch me to stronger drugs as needed. And w/ pacemaker they have a record of my heart.. I asked that they try lopressor (Metoprolol) instead ( Bp drug on  before  I was switched off to Lisinopril).
                         Since going  to Metoprolol & taking in AM & sleeping 8 hours & trying to avoid stress, very little afib (my 45 day pacemaker recording (reviewed for the first time yesterday) shows one 2 minute mild Afib episode. The pacemaker has not had to spark or record high reading.. I not waking all night urinating. I am not waking up AM with low bp. I still from time get a weird feeling in my head (like interference) and worry Memory is not as fast at retrieving…..maybe my magination. Very gratefull so far AFib seems to be in check….fingers crossed.
                        My /optimistic ? If someone has a 6 - 12 month  run of only 5-10 short mild Afib episodes, is getting off coumidin a possibility.Aside from bleeding I assume  drug has side effects???aside from issue of  metal in your chest, once implanted successfully does pacem presence effect morbidity for an otherwise healthy person?

[Michael J. McWilliams, M.D.]

My /optimistic ?

It is hard to say why the afib has quieted down.  You aren't on any anti arrhythmic drugs although metoprolol may have some anti arrhythmic properties.  Many people do not tolerate atenolol and find metoprolol has less symptoms.  frequent urination is a common problem with atrial fibrillation when the rate is not controlled.



If someone has a 6 - 12 month  run of only 5-10 short mild Afib episodes, is getting off coumidin a possibility.

Talk to your doctor about the CHADS2 risk score.  It stands for heat failure, hypertension, age greater than 75, diabetes, and strocke/TIA.  If you only have one risk factor (hypertension), you have a choice between aspirin and coumadin.  The risk of bleeding is thought to be about equal to the risk of stroke.  The decision of which medication to take should be an informed decision based on your and your doctors judgement.



Aside from bleeding I assume  drug has side effects???

Bleeding is the main side effect.

aside from issue of  metal in your chest, once implanted successfully does pacem presence effect morbidity for an otherwise healthy person?

it carries a slight risk of infection.  This is risk is highest around the time of a device change (2%).  Otherwise it should not cause any problems.

I hope this helps.  Good luck.

[BostonFan]

Thanks for your reply....If it helps others on the forum....at least for me .....it appears all beta blockers may not be the same in how people respond to them......also, for me rest and less stress has so far helped..........Good luck to all in dealing with their Afib and heart issues.....THIS FORUM IS VERY HELPFUL!!!