Verapimil and GERD

Hello! Thanks so much for providing this service, it is very informative and helpful! I am a 48 year old, 114 pd., 5'5" female and have been being treated for an abnormal heart rhythym for 7 months now without much improvement, but plenty of bad reactions to several different meds. In the process my Doctor's have found that I am allergic to Beta Blockers after taking several different ones (something about they leak through my brain barrier) and Diltiazem which caused a facial rash and swelling. I don't remember all of the technical terms, but my Cardiologist explained it as there is something wrong with the top of my heart and something else wrong with the bottom of the heart. The top being the most dangerous because if untreated it can go into Atrial Fibrillation. The last 48 hour holter monitor recorded 60,000 abnormal beats even on Verapimil so the Electrophysiologist increased it to 240mg which hasn't made a huge difference with the abnormal beats, but gave me SEVERE indigestion so he decreased it to 120mg. That helped for several weeks but now it has come back with a vengeance. I am taking Aciphex 2 times a day and Maalox day and night along with a light, bland diet. The Dr. has mentioned adding Reglan if it doesn't get a lot better, but I am a little leery of adding another med. It seems that my abnormal rythym hasn't improved much and the medicines are just causing more problems. I would REALLY appreciate any thoughts and information you may have about the heart, meds and GERD!

[Michael J. McWilliams, M.D.]

It depends on what the what the heart rhythm is. What you describe sounds like you have PVCs and PACs, but I am not sure.  Just because you have PACs, does not mean you are going to have atrial fibrillation.  If you have atrial fibrillation, this is not the end of the world.  Many people live with atrial fibrillation.    Beta blockers and calcium channel blockers do not prevent atrial fibrillation.  If your heart rate is controlled and  you have PVCs/PACs and you have a structurally normal heart, medications aren't always necessary.  It is unfortunate that you have problems with beta blockers and diltiazem because they can be helpful medications in the right situations.  If the medications are making things worse and there is no definite indication for them, it might be worth trying to live with the extra beats.

As always, you need to discuss any medication changes with your doctor. It is tough for me to say anything concrete with knowing all the details.

I hope this helps.