Could my Atenolol be causing syncope?

[Khanra1]

Quick Bio.  44yr old male .  Diagnosed with cardiomyopathy and CHF when I was 24.  Heart has returned to normal measurements and EF is good.  Have been in permanent afib for about 15yrs.  I have an ICD.  I have taken a large dose of atenolol (100mg twice a day) for about 10 yrs.  Would get the occassional shock when ICD read a high afib as vfib.  I finally quit smoking in August.  September- felt like crap-tight chest, heart racing, thumping in my neck.  Have now experienced 2 different episodes of syncope brought on by vtach.  my question- is it possible that the atenolol is causing the syncope? Maybe the dose can be lowered now that I have quit smoking?

[itdood]

When you quit smoking your body chemistry will change.  For instance, I know it will throw off liver enzymes for a short period of time.   I'm not saying the liver enzymes are the cause....   you get my point though.   Maybe that's what's happening.  The good news is this will all return to normal after a bit.

I'm still thinking not to mess with the med right now so you're not changing too many body chemistry issues, but I could be wrong as heck.

If the VT continues and it's monomorphic you might benefit from ablation.

Why was the ICD originally implanted?  I'm guessing it must've been from vtach.  Have you had the ICD interrogated to see what's up?

[Khanra1]

Cardiomyopathy was caused by viral infection. I remember 20 years ago when my cardiologist told me that "viral" meant he didn't know what caused it.  Just got home from work.  Had a near-syncope episode at work again. This is so perplexing, frustrating and scary.  I had been improving and feeling great for so long and then this just suddenly appears.  I have cut way back on alcohol consumption, weight is perfect. Trigs and chol are low.  It's the timing of it that has me wondering about atenolol dosage.  All this happening right after I finally quit smoking. I'm going to call my EP on Monday.

[itdood]

p.s., what caused the original cardiomyopathy?  was it viral?

[itdood]

Good question for your doc.

my thoughts are, the vtach is causing the syncope.  So does atenelol cause or make vtach worse?    Personally I've never heard that before so I doubt it but I could be wrong.

You've been on a high dose for a long time, I would consult with your cardiologist about it.  Lowering it could have other undesirable side effects.

afib coupled with vtach is a lot going on at once.  Since you are in permanent afib, the atenelol is probably keeping your heart rate down to a manageable level.  That's such a complex issue.