Ramipril and palpitations/ectopics

Hey guys,

So I'm having a weird issue at the moment. I've started to take my ramipril just before I go to sleep lately and last night was awful.

About an hour after taking it I had a massive heart pause that pulled me awake when I was dosing whilst reading.

Then I had another huge 'pause' when I turned over to go to sleep. I jumped to check my pulse twice and couldn't feel it. It stressed me out so much I shot up in bed, felt like my heart had stopped.

Does anybody else have this issue, or has experienced it with BP meds like that?

I've never taken ramipril but I've been taking lisinopril for a couple of years, which is a close cousin. No effects like that whatsoever. The ACE inhibitors don't normally have any effects on heart rhythm.

Not sure what you experienced but I doubt it was actually a pause. A pause lasting more than just a few seconds would have caused you to pass out. If it happens again and you really think it's a pause, it's time to call your EP and get a Holter monitor to find out what's going on.

Davros:

I have been taking 1 tab. of Propafenone (125mg.) at night before bed, my doctor always wanted me to take 1 1/2 tabs. I tried that last year in June and July, it did help with AF but then I started waking up a few hours after taking the 1 1/2 tabs. feeling like my heart was slow and was having a hard time to beat, I have a pacemaker and it had to beat when it reached 50, but it was not very pleasant. I stopped the extra 1/2 and that strange feeling stopped.

But, this past 2 episodes of AF, the first one I took the extra 1/2 and went to bed I did wake up and felt a little strange. Then I had an episode about 2 weeks ago and it was early in the evening so I took the 1 1/2 of Propafenone about 2 hours later I started feeling terrible, I had a hard time walking from room to room, I was puffing and had to sit down, it was awful. I believe if I didn't have the pacemaker I might have passed out or worse. It is hard to believe that just taking a 1/2 a tab. more would do what it did to me. I have quit taking the Propafenone and will use it as a Pill in the pocket, but only 1 tab.

I did let my EP know, the problem is he is not available much of the time, he has given me the name of a good EP that will call and schedule an appt. with me.

Liz

To be honest, I suspect the ramipril isn't a problem.

When you're having ectopics and palps for what feels like no reason, you start trying to tick off what it could and couldn't be!

Yeah, totally understand that. The ACE inhibitors are usually pretty benign drugs so I think you're right it's not the ramipril.

Davros:

I can't tell what is going on with you over the Internet, but I have had incidences like what you describe.
At times I have very heavy Ectopy. More specifically many PAC's. At times 2 Pac's (missed beats), then a regular Beat, and so forth. When its this bad, I often have a harder time feeling a Pulse, but I eventually do, if I move my Finger around where I am trying to feel the pulse. I have had a Pulse Oxymeter on several times while this is happening, and the Oxymeter takes a while to show a reading, then when it does, it is like in the 30's. Within 5 seconds or so, the reading does jump up into the 50's or higher.

If this happens again where you can't feel a Pulse, I suggest try feeling it in a slightly different area. I feel my Pulse often, and even when things are going better with only mild Ectopy, I still notice, especially when I take large doses of Flecainide, that sometimes I cannot find a Pulse feeling my normal way, or when I do, its there, but it feels weaker.

Secondly, and actually the best advice, is to get a Holter Monitor test, like Carey suggested.

Its largely the same for me The Anti-fib, I am always checking for my pulse and, sadly, its become a bit of an obsession for me at times.

That said, due to this, I'm also very aware of any activity that happens and for about 6 months now it's been.. off.

I'm due a heart ehco on Monday and had a 7 day tape in June that showed nothing unusual.

It's all very confusing.

been on ramipril for over 10 years, with 24/7 AF......no effect on AF ever. Always take all my meds in the morning never at night.
Meds include: Warfarin, ramipril 10mg, aspirin 75mg, bisoprolol 2.5mg and a Lipitor 10mg, all taken in the morning at 8am ish