beta blockers

Beta blockers

by Gemita - 2021-04-20 05:10:57

Hello Hayden,

We are doing okay, thank you.  Hubby goes back for another pacemaker check today since his device flipped over when he was in the shower some weeks ago.  It seems to be okay now but they are going to do some checks, to make sure it is secure.

https://en.wikipedia.org/wiki/Nadolol

I attach a link above which might be worth a read.  Yes beta blockers can affect us and cause many unwanted symptoms and sometimes by changing to another beta blocker it can help.  I note that Nadolol is a non selective beta blocker (it targets other areas as well as the heart) so the potential to cause more side effects is possible than with a selective beta blocker which would mainly target the heart, especially at a low dose.  Having said that, I see Nadolol is effective at controlling ventricular arrhythmias and perhaps this is why they have put you on this particular beta blocker?

Yes I got very sleepy, achy and couldn't move very much when I first started my beta blocker but its powers has worn off, especially at a lower dose.  

Palpitations (ectopics) can be normal.  When you say you get them once a day, how long do they last, a few minutes, or are we talking about once a day, but lasting for a few hours?  My pacemaker minimum heart rate is set fairly high at 70 bpm and at this rate I can usually keep ectopics firmly in check.  Sometimes beta blockers can worsen arrhythmias like ectopic beats and there may be other meds that they can try.  I wouldn't suffer in silence Hayden.  Keep the dialogue up with your team.  Let them know how you are feeling but also be reassured that occasional ectopics are usually harmless and most of us get them.  I get them all the time. It is only if they become prolonged and cause symptoms that they may need treating.  

Would you say you feel better with your dual lead pacemaker overall?  I do hope so, since that was the main reason for your upgrade.  There may be a few settings they can adjust, together with an adjustment of your meds.  You are only just starting your journey with your upgrade.  It took me more than four months to adjust settings and meds to reach a level that I could comfortably live with. It is a process Hayden that most of us go through but it usually gets better and you have a very caring team backing you so I would feel encouraged.  

When do you go back for another review?   Maybe keep a diary note of any particularly bad symptoms like worsening palpitations, fatigue, with the time, date and duration, to discuss with your team.  They can rule out any major problems or correlate your symptoms with your palpitations to arrive at a diagnosis.  

I wish you well Hayden 

thank you

by PacerPrice - 2021-04-20 08:45:59

Hello Gemita,

I am glad to hear you are okay, and glad to hear you husband is feeling okay after the shower incedent, I hope his appointment goes well for you both.

Thank you very much for the link. I'm sure the beta blocker can cause these symptoms, it is just not nice having them everyday at such a young age, but like you said one reason is for the control of possible arrhythmia, and for that reason i'm not sure if i can come off of them until they find a cause.

 with the palpitations, i will feel a slightly harder beat, almost like a skipped beat, this happens at complete random, and will go just as quickly. but sometimes i will get 2/3 or 4 of them, with a few normal beats in between. I have told the team and they gave me a ZIOPATCH for 2 weeks, I sent it back off to them yesterday. I know ectopics are usually normal, but on my last exercise test i experienced 2 ectopics in a row, which i was told can be normal? i'm not sure how 2 in a row is normal but they know best  

I would say that i do feel better with the new pacemaker, i feel with exercise i can work harder and longer. But i think the introduction of strong medication after the new pacemaker has stopped me seeing the full effects so far.

My next appointment is in july, i will have more tests, another stress test and some other things, to confirm what caused the slight non sustained arrhythmia. 

Thank you so much as always Gemita, 

Hayden 

Ectopics are a real nuisance

by Gemita - 2021-04-20 14:55:22

Hello Hayden,

We had a long wait for Michael's pacemaker check this morning since the receptionist failed to book us in properly and we were hanging about for a couple of hours unnecessarily.  When we did get in to see the technician, she was lovely and very helpful.  Michael hasn't done any lasting damage but he got told off for fiddling with his device.  His electrics are okay apparently but the plumbing needs attention and next week we shall have to see the cardiologist.  

Yes to prevent the non sustained VT from occurring they will want to keep you on Nadolol but there will be other beta blockers you can try if you feel Nadolol affects you too much. It is surprising how one beta blocker may suit us better than another, so all is not lost.  It is often trial and error with meds until we find something that suits, so do not be afraid to speak up if you are struggling with any of your treatment.

Yes we can get runs of ectopics and when we get runs of three ventricular abnormal beats (called triplets) in a row, it would be classified as a non sustained VT, but it would have to last over 30 seconds to be classified as Ventricular Tachycardia.  Two PVCs in a row would be called a ventricular couplet.  I am getting ventricular couplets and triplets and these of course can lead to non sustained VT, but episodes are short lived Hayden fortunately.

When you get your Ziopatch results, I would ask them to explain how many ectopic beats you are getting in say a 24 hour period or the total during the period of monitoring?  They are usually not too concerned unless the total percentage of PVCs exceed 10-15% of all heart beats.  Before I got my pacemaker my ectopic beats were truly awful and leading to other arrhythmias.  It is known, for example that atrial ectopics can be a trigger for atrial fibrillation and that frequent ventricular ectopics may trigger non sustained VT, so it stands to reason that they would want to control them if they are numerous and we become symptomatic.  Yes I am afraid Hayden my doctors keep telling me that my ectopics (couplets, triplets) are not a cause for concern and may be normal for me.  Whatever they say, however benign, ectopic beats are still arrhythmias and when prolonged and frequent they can cause symptoms.  The only problem is "what to do about them"?   Sometimes anti arrhythmic meds or rate control meds like beta blockers cause more unwanted symptoms than the ectopic beat itself, so it is really difficult to know whether to treat ectopic beats or not.  I find my pacemaker treats my ectopic beats by outpacing them.  As I mentioned earlier, 70 bpm minimum setting really takes care of my daily ectopics.  It is when my heart rate starts falling, that my ectopics are more likely to be triggered and keeping my heart rate up is a good treatment for me.

I hope you will soon find the best treatment for you

Ectopics

by PacerPrice - 2021-04-20 16:51:10

Thank you again Gemita, I am happy to hear about your husbands electrics are going well. and i am hoping for a good result from his cardiologist. 

Ectopics are extremely annoying, but I guess they are harmless, just annoying and anxiety inducing. The medication does seem too be taking a toll on me but if it is needed, hopefully there can be a replacement. 

There is a chance that if no other diagnosis can be made, i will be taken off of the beta blocker itself. 
Thank you as always and stay well,

Hayden 

PVCs, couplets, triplets...

by AgentX86 - 2021-04-20 22:57:06

There are also bigemy (very other), trigeminy (two every beat), and so on. BTW, geminy = gemini, the astrological twins.   I had bigeminy PVCs a few months after my PM implant.  I can say that it was the worst feeling I've had.  Even worse than flutter and that wasn't tollerable. 

Pacemakers won't record any of these arrhythmias because they are "normal" and happen so often that internal memory isn't big enough.  Your Zio shoud give them a good look at the problem.  Like Gemita, my EP upped my pacing rate (to 80bpm in my case) to chase away the VPC goblins.  It worked and haven't had them since.  He's now dropped my nighttime rate to 50bpm without problems so I would probably be OK dropping the daytime rate too.

Thank you for your help

by PacerPrice - 2021-04-22 04:30:41

Thank you AgentX,

That is some usueful information thank you, perhaps asking for an increase in resting rate will help. I have been told before about how normal pvcs are, but they really know how to give you some anxiety. 

The zio report should give me a nice insight into what is going on at the times i feel these palpitations  

Thank you very much 

Hayden 

Maybe this explains my experience

by TLee - 2021-04-22 13:11:38

I don't know how I missed this before, but I may have found an answer to an odd experience I have had recently.

I started a beta blocker a couple of months ago (metoprolol), and I was feeling quite a bit better & more energetic, until...I walk every morning, and noticed that my legs were feeling less reliable than usual. They felt very tired & heavy, almost like I couldn't be sure my next step would clear the ground. That feeling left me after a week or so. Now I am thinking that maybe my body was adjusting to the new medication. 

Isn't it amazing how we can get so in tune with our bodies that we can identify each new sensation & look for an answer. That is new to me since I started having heart issues, and maybe it is one of those strange blessings that come from adversity. 

Adapting

by Persephone - 2021-04-22 13:51:33

NIce way to express this shared experience, TLee - thanks for sending out your positive spin; it really helps :)

good to be aware

by ak - 2021-04-22 15:47:08

everyone's body reacts differently to medicine - its good to be aware of what side effects you are experiencing . i was on several medication with variying degres of side affects until we landed on sotalol. Worse one for me was amiodrine and nadolal and i didnt do well with them. Talk to your doctor and if side affects dont work with you they will put you on a different medication. Good luck