After stopping Nebivilol my anxiety level has gone up

I was on Nebivilol for at least 14 years at the lowest dose, 2.5mg 1x/day. It kept my BP and HR nice and low, well, except when I get really stressed!! After my ablation my cardiologist had me stop it. Since stopping my BP and HR are higher but within acceptable levels. But my anxiety level has significantly increased and my sleep has become very fractured. I'm working with sleep specialists on that matter. I'm thinking of asking to go back on the Nebivilol. At my age I'm not ashamed to admit I have an anxiety disorder. Unfortunately its a wart, a part of who I am. I live with it the best I can. If Nebivilol helps it is there any post ablation cardiac reason I shouldn't go back on it???

Pokey

I'm not in a position to either remember or go back and get a better sense of your history, but I do seem to recall that beta-blockers were more or less knocking you flat.

Have you been diagnosed with any degree of heart failure?

One thing to remember is that what you're terming "anxiety" may not be exactly what you think it is. If your body is elevating your heart rate in order to meet your metabolic demands, then your body is going to goose the gas pedal to get that done. It's going to use the neurohormonal system to accomplish this, essentially increasing the output of the sympathetic nervous system.

The feeling? Stress. Jitters. Like you've had too much coffee. Like 'fight or flight.'

And after an ablation -- temporarily (one hopes) stiffening the heart by way of adding strategic scarring? That could cause an elevated HR to try to increase output -- same way: via the neurohormonal (or "RAAS") system. Gas pedal.

Which can call for a tricky balance: how to tamp down the activity of the sympathetic nervous system without stapling you to the sofa.

My point is: this may be far more cardiac than 'psychiatric,' and might be something to discuss with your cardiologist and/or EP. They should understand the pathophysiology plenty well enough to have an opinion on this, and may be the best to help you try to strike the balance.

FWIW, as a guy with ZERO ability to increase stroke volume, I rely solely on increasing heart rate to 'go faster' or 'do more.' It makes me shake and perspire rather dramatically. It's just that ... what some might chalk up to 'anxiety,' I understand that's really not quite the right term.

The BB wasn’t knocking me flat. I did fine with it most those 14 years. As a comparison they tried me first on Metoprolol and that kicked my ass. I couldn’t tolerate 1/2 of the lowest 25mg dose, or 12.5mg. I couldn’t climb a single flight of stairs on that crap. That’s when my then cardiologist put me on the Nebivilol. After my ablation they had me stop the Nebivilol for a 24 hr Holtor monitor. I told my regular cardiologist I thought I felt less fatigued with stopping the Nebivilol and he told me to stop it. If my BP was to go up beyond acceptable levels then he’d put me on lisinopril. So I don’t know if the bump in my anxiety is cardiac related as you discuss or my worrisome mind getting the better of me. I do know my sleep is pretty bad right now, but I’ve struggled with sleep much of my life. And I’m quite ancy. It seems it’s been worse since my ablation. But it’s really hard to decipher what’s causing what. I guess at this point I’m not sure what to ask my cardiologist-if my sympathetic system is more out of whack due to the ablation, stopping the BB or it’s all in my head.
And no , I don’t have any degree of HF. Thankfully