an update... verapamil??

Well so I ventured into the cardiologist office today. Interesting visit to say the least. We talked about many things including my recent issues. After much discussion and debate we did increase my upper rate to 125. We debated turning the rate response back on but both decided we didnt want that. We stopped my midodrine (suppose to help me not pass out when I stand up) because my blood pressure has been high, so this ought to be interesting to say the least. I told him about my high blood pressure since starting the Effexor and unfortunately he does not have experience with this med and didnt know anything about it interacting with toprol. Going to give it another week and if my blood pressure is still high then I am going to stop the medication. I asked about switching off of metoprolol since I am on a fairly hefty dose to maybe something not so fatiguing. He thought Verapamil would be a good option. I have heard some people talk about this med but personally have no experience with it. I asked to hold off on switching just yet until I can adapt to the high rate of 125 because many changes totally throws my system off. Finally he threw me into a stress test a couple hours later to evaluate my terrible activity intolerance. Go figure, my heart seemed to behave for the test. Still failed just after 6 minutes I believe it was, no shocker to me. I have decided that they need to rename that test to "kick your ass" (sorry for the language) test. Seems to be more appropriate. I will wait to explain to what happened in the "kick your ass" test in another post when I actually know what the fine rich doctor has to say about it. Thanks for everyones support! Oh and anyone with experience with Verapamil... do share please

6 Comments

Verapamil

by J.B. - 2010-01-19 11:01:04

Verapamil is a calcium channel blocker. I have taken it or the calcium channel blocker diltiazem (the one I take depends on the doctor I'm seeing at the time) and both have done an excellent job controlling my high blood pressure. The only precaution I'll suggest is calcium channel blockers have caused arrhythmia but reducing the dose solved that problem for me.

Good luck.

i've had that test LOL

by Tracey_E - 2010-01-19 11:01:16

Six minutes isn't bad at all when they're making it steeper and faster every minute or so! The first time I had a stress test to watch my pm- the official kick your ass version- they put someone on either side of the treadmill and said they'd catch me when I fell... and they kept cranking it up until I did.

Small changes are best! Then if something works or doesn't work, you're not guessing about which change it was. Good luck getting off the metoprolol, that stuff kicked my butt.

No definite answers but it sounds like he's at least listening to you, that's a start!

Upper rate

by ElectricFrank - 2010-01-20 01:01:01

With Rate response off the only upper rate that can be programmed is the upper tracking limit. Increasing it doesn't affect your heart rate unless you exercise hard enough to produce a natural increase to the limit. So there should be no adapting to be concerned about.

As an example I had my upper limit turned up from 120 to 140 in one office visit. Never felt anything different until I did some vigorous walking that raised my HR into the 135 range. That felt great to have my heart actually pumping enough blood to support my activity.

frank

Upper rate

by Dr P - 2010-01-20 01:01:01

The above comment is NOT TRUE. The upper sensor rate (USR) controls many things in many pacemakers. If you have a Medtronic in DDD mode and you mode switch (most likely from atrial fibrillation or flutter), you automatically go to DDIR (note the "R" which means "rate responsive"). So the USR must be set on all Medtronic devices. If there is no unique setting, then it will be the same as the upper traking limit.


If you have a St Jude with "Afib suppression" enabled then the USR controls the maximum rate to which the Afib suppression will drive your heart rate in the overdrive pacing mode. For both Boston Scientific (Guidant, CPI) and St Jude, the mode for atrial arrhythmias is separately programmable from the basic mode, and most physicians use rate responsive even if the basic mode does not include this feature.

upper rate

by sam78 - 2010-01-20 06:01:37

Yes thank you Dr P. I do have medtronic and I do have mode switch programmed. I am very much affected by changing the upper limit as my atrial rate (my own rate) goes up to my upper limit everyday whenever I exert myself (minimal exertion like stairs). This Frank, is why I have to get used to it because increasing the rate will allow my heart to go faster on a daily basis which I feel. (Remember I have a fully functioning atria, it just that it gets tachycardic at minimal activity (inappropriate sinus tach). Of course by increasing my upper limit we also had to change my mode switch rate and the upper sensor rate (I believe it has to be 10 beats higher than my upper rate so I think it is now 135). I will say that when I did my stress test I was able to tolerate more activity after increasing my upper rate which I am hoping will help with my daily chest pain and not make me feel so crummy when I walk up stairs every day. The last time my rate was this I felt terrible because when I mode switched it dropped my rate to 60-70 for about 15 seconds and then increased. They saw this happen on my treadmill but he says there is nothing we can do to prevent it (I dont understand that but whatever). Anyways thanks for the feedback.

treadmill

by sam78 - 2010-01-20 12:01:32

Yah they put two people in with me as well. I told them they should pad the wall behind the treadmill as it was a tiny room. They stopped me because apparently I turned white as a ghost.

The doctor wanted to put me on diltiazem but I have terrible headaches with this

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