How to reduce heart rate in flutter

I have primarily flutter (but also afib) with an ablation scheduled with Dr. Natale in late March. Lately, I've been in sinus for a day or two and then in flutter for a day or two. The problem is getting my pulse down in flutter. It's usually 150. I have been taking metropolol but it seems to be losing its effect. I am now up to about 200 mg (about 100 ER and 100 tartrate). Ideas?

Have you asked Natale's staff?

Good idea.

Kevin

You need to speak with either your local EP or call your assigned NP St Davids and ask for a very low dose 12.5mg Toprol XL and an upper normal range daily dose of either diltiazem or verapamil Calcium channel blocker. This especially works great when you are in persistent flutter, but combining a very low dose BB with a hefty upper normal range daily dose of a CCB often works like a charm to drop an aggressive and hard to control flutter down to under 100bpm.

I had the same thing going in and out of Amsterdam hospitals in Holland once a week for a few days at at time for a couple months prior to my index ablation in Austin with Dr Natale, and my local Hawaii EP gave me that formula ( I think I was on 12.5 mg time release metoprolol and either 240mg to 320mg of Verapamil a day) and my raging 170bpm highly symptomatic 24/7 flutter with interspersed pounding runs of AFIB too suddenly dropped to around 80 to 85bpm for the final 6 weeks befire flying to Austin to slay the beast at the hands of the maestro!

Shannon

As always, thanks much Shannon. I will take this advice. I am concerned that my heart has been running at over 140 for almost 2 days.

kevin