Thanks for the post.
First, some patients can develop worsening palpitations with beta-blockers, although this is uncommon. The patients who develop this usually have vagally-mediated atrial fibrillation so that when the get a slower resting heart rate, it triggers afib. One way to see if the beta-blockers are causing a real phenomenon is to up the dose as you were advised, but do so while wearing an event monitor. This way, the doc can see what is happening when you are having symptoms.
Another possibility is that some people just feel their heart more when they are going slower.
A third possibility is that you have a baseline lowish blood pressure. When you take the beta-blocker, your blood pressure drops further which leads to a compensatory increase in heart rate. When you feel the relative tachycardia, then you develop anxiety which further speeds the heart rate, thus cauing a vicious cycle. I see 2 or 3 patients per month that develop this type of syndrome. The treatment is the combination of proper hydration and beta-blockers.
Don't worry too much about what is too slow. You'll know that your rate is too slow when you begin to feel tired or run down.
Hope that helps.
I forgot to mention that alot of these palps actually feel different than when I don't take meds. If that means anything.
Beta Blockers don't actually cause palpitations. However, they slow the heart rythm down to the point that palpitations are more noticeable. When we are Beta Blocker-free are hearts beat faster and that in itself supresses the palpitations. The heart's pacemaker does't have time to fire off a premature beat when the heart is beating fast enough. You'll probably notice that during Tachycardia you never feel these premature beats. But Beta Blockers and Calcium Channel Blockers will prevent some people from having an episode of A-Fib. I take both Toprol XL and Cardizem and I haven't had A-Fib in two years. Good luck to you.
I was moved from CCB back to beta because my sleeping heart rate was down to 15bpm. My resting heart rate is about 50. The doctors don't seem to think that a low heart rate is a problem unless you pass out. Because I have cronic a-fib, it's also not a problem when my HR goes over 200. It seems like, if they do the tests and there are no other heart problems, the rate really doesn't matter, unless it cause you to over focus on the problems.
Thanks to everyone! It just feels good to just know you're not alone. Mo I don't feel any palps during tachycardia, but on the other hand, it was a strong palp that actually stopped the tachy. I just can't see how my number of palps went down the tubes after having a-fib. Can a-fib make everything worse suddenly, does anyone know?
How does your EP : cardiologist explain why and where your pvc's,pac's are occurring ?
Did they go over diet, exercise, heart tests ?