I am struggling with what is apparently “lone AF” since March 2021. Fairly fit walker and bike rider. Had resting HR of 62. Now get reading of 140-160 during AF. Freaks me out each time. Doc has me on Metoprolol, first 25.mg. Tartrate, and recently tried 50mg slow acting. He wants me now to take Multaq as well, which scares me due to resting HR already goes down to 50 of even high 40’s during rest and sinus rhythm. Doc says don’t worry about low HR on both meds. I am too scared. Days like today BPM according to Apple Watch was a roller coaster from 63-167. Trying different Cardiologist takes about a month to get appointment. Glad to find this forum,etc. , so thank you.

The purpose of the Metoprolol is to reduce your heart rate during afib. If your heart rate is going to 167 during afib, it clearly isn't keeping your heart rate low. As you may know, there are two big risks with afib. One is a stroke caused by a clot (so you may have been prescribed an anticoagulant med) The other is having high heart rates for an extended period of time (>100). This can lead to cardiomyopathy and heart failure. This is the risk your cardio is trying to address. How frequently and how much of the time are you in afib? Just a thought, if the Multaq is effective in keeping you in rhythm, perhaps you can lower or eliminate the Metoprolol?

Without meds, my heart rate during sleep is commonly is in the low 40's and has dropped into the upper 30's without issue. Don't know how hard you ride your bike, but exercise can be a double edged sword. See my post here and my others in the thread.

What is your age, and what other medical issues do you have?

Thank you for your response George. I am almost 63 and no other health issues. My exercise was vigorous spin bike 30 minutes, 3 days per week or 50 to 90 minute outside bike rides not very intense. The AF started as occasional but lately has been every other day for 2-3 hours. Yesterday was the first all day affair. I am on Eliquis. I will be seeing the electrical guy in mid October . Since Multaq also lowers heart rate, I need to ask about Multaq without Metoprolol.

A resting HR in the 50s and even 40s is nothing to be afraid of as long as you're not lightheaded or dizzy. Multaq has only a very mild HR lowering effect, so it's not a problem with the metoprolol. But if it works for you, there's really no reason to be taking the metoprolol at all. What you can do is reserve the metoprolol for times you're actually in afib, but for that you'd want the fast acting version, not the extended release. Talk to the EP about this, but in the meantime don't fear the Multaq. It's pretty mild stuff.

Thank you for your input. That was more reassuring than my doc