What to replace my Beta Blocker with??? I’m a month out from my ablation. So far no bouts of AFib since the ablation. I’ve been on Nebivilol since 2010 to reduce my BP and most importantly I was told to reduce the pressure ( not sure if it’s preload or after load) in my LV as I have mitral valve prolapse with moderate regurgitation. Apparently the BB helps reduce the regurgitation and thus possibly pulmonary hypertension. I take the lowest dose they make, 2.5mg and it does a fine job of reducing my BP and HR. However I think I’ve learned it’s the very thing that makes me tired and feel unwell often. I learned this recently as my EP wanted to do a 24 hr Halter monitor on me to see how slow my HR was going during sleep thinking I might be a candidate for a pacemaker. He had me stop the Nebivilol for the 24 hr monitor. As a result my HR and BP has gone up, thankfully not to a dangerous level but enough I wouldn’t want it to go untreated. I have noticed though since stopping the Nebivilol I’m not as tired as usual and feel better. So pretty sure the BB may be the culprit in causing my fatigue and malaise that I and doctors have been trying to figure out for some time. So I’m wondering what BP med I can take that does what the BB addresses but without making me feel so tired & crappy?? ACE inhibitor, CCB, other??? Pokey https://www.afibbers.org/forum/read.php?9,198207,198207#msg-198207 Sun, 25 Oct 2026 07:44:17 +0000 Phorum 5.2.23 https://www.afibbers.org/forum/read.php?9,198207,198319#msg-198319 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198319#msg-198319 Pokey AFIBBERS FORUM Sun, 22 Dec 2024 15:11:25 +0000 https://www.afibbers.org/forum/read.php?9,198207,198302#msg-198302 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198302#msg-198302 Pokey AFIBBERS FORUM Thu, 19 Dec 2024 14:32:58 +0000 https://www.afibbers.org/forum/read.php?9,198207,198298#msg-198298 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198298#msg-198298 Carey AFIBBERS FORUM Thu, 19 Dec 2024 05:13:06 +0000 https://www.afibbers.org/forum/read.php?9,198207,198295#msg-198295 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198295#msg-198295 Pokey AFIBBERS FORUM Thu, 19 Dec 2024 03:53:02 +0000 https://www.afibbers.org/forum/read.php?9,198207,198277#msg-198277 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198277#msg-198277 Carey AFIBBERS FORUM Mon, 16 Dec 2024 23:56:12 +0000 https://www.afibbers.org/forum/read.php?9,198207,198276#msg-198276 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198276#msg-198276 Pokey AFIBBERS FORUM Mon, 16 Dec 2024 21:43:51 +0000 https://www.afibbers.org/forum/read.php?9,198207,198274#msg-198274 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198274#msg-198274 gloaming AFIBBERS FORUM Mon, 16 Dec 2024 19:32:43 +0000 https://www.afibbers.org/forum/read.php?9,198207,198272#msg-198272 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198272#msg-198272 Pokey]]> Pokey AFIBBERS FORUM Mon, 16 Dec 2024 17:32:17 +0000 https://www.afibbers.org/forum/read.php?9,198207,198257#msg-198257 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198257#msg-198257 gloaming AFIBBERS FORUM Sat, 14 Dec 2024 17:12:49 +0000 https://www.afibbers.org/forum/read.php?9,198207,198252#msg-198252 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198252#msg-198252 to my regular cardiologist to determine if I am to go back on the Nebivilol, something different or nothing at all. My BP seems to be doing fine w/o the BB. I feel better without it but I have mitral prolapse with regurgitation and I was initially put on the BB I was told to reduce pressure ( preload??) in my LV & thus not worsen the MVR if I understood my cardiologist correctly????]]> Pokey AFIBBERS FORUM Sat, 14 Dec 2024 03:52:36 +0000 https://www.afibbers.org/forum/read.php?9,198207,198245#msg-198245 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198245#msg-198245
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Pokey
I’ve had strain “bullseyes” done with echoes in the past and they were ok.

Which raises two questions for me:
* How far in the past, and
* What does 'ok' mean?

If we're talking years ago, then things could certainly have changed.

Also, this isn't the time or the place to dive deeply into it, but ... I finally got my answers after two separate years-long medical odysseys (first, eyes, then, heart) by trusting the tests more than I trusted the people whose job it was to interpret those tests.

Locally, Cardiology deemed my wife's strain echo to be 'ok.' It wasn't.

Particularly when a technology is rather new, the expertise in using it doesn't come on day one. That's another reason why I ask how long ago yours was done.

Again: none of this really gives you the answer you need -- how to control HR (and BP) without stapling you to the sofa -- but I'm a big believer in understanding exactly what's going on before taking steps to try to address it. Minimizes potential risk, maximizes potential reward.]]> NBeener AFIBBERS FORUM Fri, 13 Dec 2024 13:52:54 +0000 https://www.afibbers.org/forum/read.php?9,198207,198227#msg-198227 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198227#msg-198227 Pokey AFIBBERS FORUM Wed, 11 Dec 2024 14:33:40 +0000 https://www.afibbers.org/forum/read.php?9,198207,198218#msg-198218 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198218#msg-198218
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Pokey
My annual echoes and a nuclear stress test ~2 years ago say I still have a pretty healthy heart. My EF is still 65% with no LV dilation or segmental defects and I am 75. I attribute that in part to the fact I was a mountain hunter while living in Alaska where I carried all I needed to survive for 7 days at time on my back at 5-6-7,000ft and I trained year round for such strenuous pursuits.

I hope you don't take this as snark -- I don't intend it to be -- but you could have all of the above and still have a 'stiff' heart. This is the kind of thing that strain echocardiography is pretty good at teasing out.

Also, spending thousands of hours training as you describe (which, OhByTheWay, sounds awesome to me!) can induce the kind of myocardial fibrosis that's usually associated with stiffening.

Think about a balloon. Now stick six more balloons into that first one, one inside the other. It's very difficult to inflate the seven balloons, but the air comes out under quite a bit of force.

As LVEF (Left Ventricular Ejection Fraction) tends to increase as we age, it's probably reasonable to hypothesize that this is at least partly due to fibrosis that reduces the distensibility of the heart. The net effect of this would be an increase in ejection fraction, just as in my balloon analogy.

Which, again, would limit your ability to augment stroke volume substantially and increase your reliance on heart rate in order to increase your cardiac output.

Again: the Global Longitudinal Strain number determined by Speckle Tracking Echocardiography (STE) yields a pretty good surrogate for degree of fibrosis.

It would explain your response to BB's ... even if it doesn't paint a clear picture of how to treat what needs treating without dramatically worsening your quality of life.

But if nothing else ... you'd have my sympathies :-)]]> NBeener AFIBBERS FORUM Tue, 10 Dec 2024 19:14:47 +0000 https://www.afibbers.org/forum/read.php?9,198207,198217#msg-198217 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198217#msg-198217 Pokey AFIBBERS FORUM Tue, 10 Dec 2024 17:26:09 +0000 https://www.afibbers.org/forum/read.php?9,198207,198216#msg-198216 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198216#msg-198216
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Pokey
Why do BBs make a person so bloody tired? I assume because they affect HR so profoundly??

That's what I think. I wrote a bit more on the subject in this post:

[www.afibbers.org]

And, obviously, RF catheter ablation just adds more scarring to the equation. That's ... kind of the goal :-)

And scarring ... adds stiffness. It's like starching your blue jeans.

I hope you find a better way forward.]]> NBeener AFIBBERS FORUM Tue, 10 Dec 2024 15:30:44 +0000 https://www.afibbers.org/forum/read.php?9,198207,198214#msg-198214 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198214#msg-198214 Pokey AFIBBERS FORUM Tue, 10 Dec 2024 12:55:21 +0000 https://www.afibbers.org/forum/read.php?9,198207,198210#msg-198210 Re: What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198210#msg-198210 Carey AFIBBERS FORUM Tue, 10 Dec 2024 00:27:34 +0000 https://www.afibbers.org/forum/read.php?9,198207,198207#msg-198207 What to replace my Beta Blocker with??? https://www.afibbers.org/forum/read.php?9,198207,198207#msg-198207
Pokey]]> Pokey AFIBBERS FORUM Mon, 09 Dec 2024 23:17:27 +0000