Palps worse after starting beta blocker

[KLB32]

I am a 33 year old female who has been suffering from palpitations (PVCs and PACs) for a few years.  I started taking Metoprol ER (25 mg) right around Christmastime due to tachycardia and the hopes that it would help control these stupid palps.

So far, it has helped the tachycardia tremendously.  I am very pleased with it.  But, I feel like my palps have gone from bad to worse.  They aren't quite as forceful as they were before the beta but I feel more of them.  I am now getting runs of sustained palps (like every 3rd or so beat).  These runs typically occur at night when I lay down to sleep.

I have been told numerous times they aren't dangerous and to be honest, I really don't get that upset by them anymore but they really irritate me.  They are affecting my quality of sleep which of course just makes matters worse.  I compare it to have hiccups for hours on end.  How are you supposed to get any rest?

I am wondering if anyone else had worse problems after starting a beta and if it helped to switch to a different kind or quit taking it all together.  I am hesitant to stop taking it because it does help my tachy episodes (a few doctors I have seen think I have POTS).

I am also wondering if taking the brand beta Toprol Xl would help better than the generic.  I have heard generics don't always work as well.

[da75]

Its possible that you have something occuring similar to what I did when I tried beta- blockers.

Basically through many holter monitors we discovered that the majority of the pvcs I felt were when my heart rate was slower. When I was on beta blockers (atenolol) I was usually in bradycardia - not really a big dea l to me, as im in fairly good shape. But the extra long pause between beats seemed to allow a greater chance or odds of the pvc's firing from inappropriate cells in the heart.

So in other words - its possible that the slower your heart rate is, the worse the pvcs (or at least the more they are felt).  Unless I were to try Acebutolol, which is the only one studied to be effective against pvc's, I personally have no interest in using them for this symptom any longer.

[iamfaithful]

I take metroprol 25 mg and have been on that dose for over 8 months now.  They have helped a lot, but I don't like taking meds so I am hoping that in March my cardio will wean me off of them.  I get PVC's pretty bad some days....I still don't know if they are NSVT or SVT.  I posted on here a few weeks ago about a run of PVC's (I think that's what it was) that scared me so badly I was a basket case for the rest of the night.  It felt like I was having a string of PVC''s, I thought surley that was it for me.  These things are horrible and I am sorry that we all have to deal with them.  I don't drink caffeine anymore and can't eat chocolate which is really hard fro me.

I also want to wean off of the medicine because it makes me real lethargic at times.  I have been dealing with that on and off since I started taking them, but I know that's one of the side effects of it.

[PikaPika88]

The Treadmill Stress Test doctor probably don't know what's called?  He said best to take that stake of ECGs (printout) to see a rhythm doctor.  I asked my gastro dr and she said was the printer mistake, not my heart.  A normal cardiologist didn't tell me and said ,"show to Dr xxxxx."  That Dr xxxxx always wants to scold me, I am too scared to show and ask him.  My GP said he don't know.  It still with me.  

I didn't feel any abnormal.  All I know was lying down, not allowed to move and kept breathing.  After exercise, I am very SOB.  Chasing for AIR.

Artaud, thank you.

[Artaud]

Hi,

If you have skips, it sounds like you have either PVCs or PACs. They sound random, though I am sure that are very annoying. There are other rhythm related problems, such as pauses and wandering pacemakers. (the heart's natural pacemaker). It's likely that people can feel the pauses, but I am not so sure if they can feel the wandering pacemaker. The interesting thing about life is that regardless of how much you've learned, there's still so much out there that you have never heard anything about.

Ask your Doctor to explain what you have, is it just random skips, or is there a name for it? If you have the name, write to others on the forum to ask their experience with the same condition.

Be well.

[PikaPika88]

After the treadmill, I got this lead V5 (the fourth roll) printed on my ECG.  What you called that 10 beats one skip.  Then 9 beats one skip.  8 beats one skip.  7 beats one skip. 4 beats one skip. 6 beats one skip..... and so on.  The doctor said I didn't have PAC nor PVC.  Is that the pacemaker paced wrong place and wrong time?  Or are these have a name called like: Bigeminy, Trigeminy, Quadrigeminy ,,,,,,,,germiny?

[Barbmag]

I wish I had some good news re. the Beta Blockers. For a little history...I have had skipped beats for years and years and it seems that as the years go by, they increase in  their frequency which is so bothersome. I have had many cardiac tests and supposedly I have a structurally sound heart, just an electrical problem. I was diagnosed w/ MVP in the '70' but the last cardio that I went to said that the Echo did not show that I did have it so I am confused about that!! Anyway, I went for years w/o taking any meds at all b/c the cardiologist seemed to think that the arrhythmias were no big deal and that the BB's would prob not make a significant difference. Then, the PVC's or PAC's just seemed to get to be a real problem for me b/c I would get sustained PVC's almost every day. I then decided to try Toprol XL but only 25mg and did not see any real improvements. I did not have side effects other than weight gain. I stayed on this for about a year and then a cardiologist wanted me to try a calcium channel blocker to see if I had a decrease in the number of episodes but the skips seemed to be worse. In the interim, I moved and so I saw a new cardiologist who wanted me to go back on the Toprol XL but at a higher dose of 50mg. I have been on this for about 2 weeks and have maybe noticed a little bit of improvement. I am waiting  for the weight gain!!! I still get numerous skips and it is hard for me to tell if they are PAC;s of PVC's but some days I will have many and also sustaiined ones and other days they will not be quite as numerous. I have tried to find out was much info as I can about these things b/c they are so bothersome to me. I eat well, do not drink,smoke or do anything that could potentially trigger them but in spite of all of that, I still get them so I just try to not let them cause too much anxiety!!!

I am sorry that this post is so long but there is so much to say about these darn things!!!! I hope you find something that works well...I am always trying to find something that will help!!!

Good luck!!!!

[rosetoes]

I have taken beta blockers twice...once in Nov 05...Toprol XL (50mg per day).  I was sick most of the time with them...Palpitations and PVC's constantly, nightmares, tightness around my head, weight gain....I was so miserable, I weened myself off of them after 4 months.

I started taking Lopressor in July 07 after another SVT episode,  didn't have hardly any palps or PVC's....still had violent nightmares and weight gain.  Recently I had a cardiac ablation and now I am not taking any beta blockers..

My sister now takes Antenol and they work well for her.  By the way, I took generic and name brands and I couldn't tell a difference.....exact same effect.

Good Luck to you,
Rose

[KLB32]

Thanks for your reply.  Mine really don't follow a pattern.  I might get one every 3rd beat, then every 8th beat, then every 4th beat.  It can be that way for an hour or more then just go away.

I don't notice them as much when I am distracted so it makes sense that I would feel them so much more when I lay down to go to sleep.  For whatever reason, they start up when I lay down on my left side (and I love to sleep on my left side!).

I have had extensive testing as well which is why it is probably pointless for me to get more testing right now.  I went to the ER 5 times last year only to be sent home with Xanax and told to quit worrying about it.  I also saw an electrophysiologist.  

I found out recently that I don't exactly have a structurally normal heart.  I have Ehlers Danlos which is a connective tissue disease and due to the Ehlers, I have a dilated aorta.  Even with the aortic issue, the cardiologist is not concerned about my palps.  I really don't think there is a need to get another opinion because he is considered to be one of the leading doctors in heart problems due to Ehlers and Marfan's.

So I guess I just have to learn to live with them.  I did speak to the pharmacist yesterday and she said she agrees with what I read on the internet about some generics not working as well as the brand.  She said there can be a 10% difference which in some people, is enough to cause symptoms.  I switched to the brand and will give it a month as she advised.  If it doesn't get better, I'll talk to my Dr. about switching to something else.

[Artaud]

Hi,

Unfortunately, Beta Blockers are not always successful at controlling the number of PVCs that you have. Even if they don't control them very well, Beta Blockers reduce the contractile force of the heart, allowing them not to be felt as strongly (as you said). Metoprolol never worked very well for my wife or I, we tried it for a short while, but she ended up on Nadolol and I on Atenolol. You can ask your Doctor if changing your Beta Blocker to another one may help. Others are immensely successful with Metoprolol.

Sustained PVCs would be one after another with no normal beats in between. For instance, two in a row would be considered a couplet. Several in a row could be from SVT (Supra Ventricular Tachycardia) or from NSVT (Non Sustained Ventricular Tachycardia).

Yet if a normal beat occurs in between the PVCs, they are often known as Bigeminy, Trigeminy, and Quadrigeminy. With these patterns, one PVC and one normal beat, one PVC and two normal beats, and one PVC and three normal beats occur (respectively). These patterns can develop in some people. I have had Trigeminy for an hour or so without relief over a period of a few weeks. I had an EKG done and the Doctor looked at it and said "oh, it's Trigeminy" and told me it's nothing to worry about.

Try taking your pulse at your wrist the next time you get them. See if they fit one of the patterns above, and post the results. Many other people also get these patterns.

Mind you though, if a person develops these patterns of PVCs, they need to be examined by their Doctor. I had already had extensive testing done when I began to get them, so they Doctor had good results to back his Diagnosis.

The funny thing is that my wife works for my Cardiologist and we had the occasion to visit his home to watch a football game along with several others. The whole time I was there my heart was in Trigeminy. It was very hard not to grab his hand and get him to take my pulse to see how many I was getting. Of course I didn't. She mentioned it to him the next day that I was plagued with them when I was at his house, all he said was "he hides them well".

I'm sorry to hear you get them before bed, it must be distracting. I would mostly get them when I was nervous.

Be well.