Exercise and Beta Blockers...

Hi all,

Since having my afib lite episodes, my cardiologist has put me on Metropolol, the beta blocker. It’s worked 100% to keep me out of afib, but it’s had a profound negative effect on my ability to cycle. My heart rate has dropped about 25 bpm. My heart rate has always been pretty low ( max at about 145-150 ) but now I can’t get it above 110. I haven’t really pushed myself above this as I’m a bit scared.

Any thoughts on getting my performance - heart rate up?

As always, thank you all in advance!

Steve

If the BB is in fact helping to keep you out of afib, it indicates you likely have an adrenergic trigger <[www.afibbers.org] The reason the BB may work is because it is acting as a governor on your heart rate. Hence overriding this would be counter productive.

Same thing happened to me on Beta-Blockers. I asked 3 EP's about if a low HR response from exercise is anything to be scared of, they all said no, just keep exercising as you feel comfortable. Possible options to rectify this would be to reduce your Metroplol dosage, or switch to a Cardio-selective Beta-Blocker like Bystolic, that doesn't impact exercise as much.

Beta blockers have the same effect on me. They make me feel like someone tied bowling balls to my arms and legs. Merely climbing a single flight of stairs becomes a chore, and doing any serious cycling is almost impossible. I found them utterly intolerable. So much so that I'd rather be in afib. Afib at a rate of 180 is less limiting to me than 100 mg of metoprolol because the afib eventually stops but the metoprolol never does.

Beta blockers don't prevent afib directly. As George said, they can prevent afib in those with adrenergic afib, but they do so by limiting the body's response to adrenaline, which is counter-productive to an athlete who wants to continue their athletic activities. You shouldn't have to give up your (healthy) lifestyle activities due to afib in the year 2018. There are better options.

Anti-Fib's suggestion of a cardio-selective BB like Bystolic (nebivolol) is worth trying, but my preferred solution was to get rid of rate control and rhythm control drugs altogether. They all suck.

Ditto on the beta blockers. I am also on Ticosyn right now as well. @75mg 2x metoprolol I am able to run my Heart rate over 130 bpm. However the results are less than desirable. If I were you I would talk to your EP and look for a better option. It’s obvious the governor on your heart is keeping you in rhythm. When I was just on 25mg metoprolol and 50 mg flecanide I was able to push my rate higher without adverse effects. That drug combination no longer works for me.

I had the same effect of metoprolol as the previous two members. I stopped taking them because of the horrible tiredness. The cardiologist prescribed Sotalol instead and that worked much better for me. He did recommend 80mg 2x/day but i soon cut that to 40 mg/day and after 1 year and reducing it further i stopped taking all drugs.

Same for me. I'm taking flecainide + bisoprolol. I've still short duration afib from time to time, but without the meds it's worse and my symptoms are worse too (higher average HR in afib).
I couldn't cycle normally, experiencing the same unwanted effects: shortness of breath, heart unable to go above 100bpm, low BP.
The EP who made my recent touch-up ablation told me to take 100mg flecainide and 2.5mg bisoprolol in the evening only, instead of 50mg+1.25mg two times/day. The consequence is I've better sleep, but more ectopics (sometimes triggering afib) during the day. My HR while exercising is a little better (-->120bpm), but I'm a poor performer.
Nevertheless, I'm happy being still able to ride my bicycle, enjoying the landscape and forgetting my bike computer.

Thank you all for the great responses!

I am seeing my cardiologist in a week. I will discuss it with him then, but not hopeful as I find most doctors are not sympathetic to real world issues. They prescribe, it works, but they don’t seem to care about any other consequences.

One thought is to just take my morning dose after I exercise. Or half the dose. Oh, if it matters, I am taking 50mg twice daily. Not sure I want to experiment with any other drug at this point because the metropolol works perfectly.

Again, thank you all and any other advice would be greatly appreciated!

Steve

Joe, I take 80mg of Sotalol twice a day too. Did your afib return when you cut back, and you just live with it? Sotalol doesn't bother me too much, until I hit one particular big hill on my morning walk :-) But I'd rather not be on it if I don't have to!
Irene

~ IreneJ

No, it didn't , Irene. Not permanently. I had a few hours of AF earlier this year which converted taking B12 and more Mg. Don't know if the conversion would have happened without taking supplements.
Also had another 5 to 10 minute one early last month. Nothing taken, just breathing to increase CO2.

I do get ectopic beats irregularly.



Edited 1 time(s). Last edit at 07/07/2018 06:20PM by Joe.

Quote
Carey

Anti-Fib's suggestion of a cardio-selective BB like Bystolic (nebivolol) is worth trying, but my preferred solution was to get rid of rate control and rhythm control drugs altogether. They all suck.

Assume you have not had an ablation.....is that an option. I absolutely detested the anti-arrhythmic mediation....had just about every side-affect plus it did not completely prevent arrhythmia. Initially, was adamant in that I would not consider an ablation, but eventually opted for the procedure and have been problem free since.....without any medication other than an aspirin daily. Have zero issues with my exercise regime.

Steve

Quote
JAYHAWK
Assume you have not had an ablation.....is that an option.

LOL... You assume wrong. I've had six.

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Joe
I had the same effect of metoprolol as the previous two members. I stopped taking them because of the horrible tiredness. The cardiologist prescribed Sotalol instead and that worked much better for me. He did recommend 80mg 2x/day but i soon cut that to 40 mg/day and after 1 year and reducing it further i stopped taking all drugs.

The Metropolol is really not a great drug for me. Tired all the time, exercising is just no fun, even walking my dog is a chore. I cut back to 25mg 2 times a day, but it still sucks!

I’m considering just stopping the drug altogether. I mean, what’s the worst that could happen? End up in the ER? At best, I get my life back.

Thoughts, opinions, experiences?

I wonder if I was just completely depleted of needed electrolytes and was dehydrated. I’ve been super mindful to drink lots of electrolyte drinks, especially during and after exercise.

Oh, my cardiologist said that if they put me on Sotalol, I have to be hospitalized for 3 days. That seems really crazy!

Socalsteve,

At least they are concerned that they do no harm by monitoring the medication. Over here inOZ they just give you a script and good luck if you have adverse reactions.
When I mentioned this to my Dr he said "oh, it's just a waste of everyone's time"