Anyone on very low dose beta blockers?

[Laura Corin]

Experience?  This would be a long-term prescription for svt. Side effects? 

My heart rate in the doctor's office was 66bpm and the cardiologist expects it to go down just below 60 with medication. I'm worried about fainting/dizziness. 

I might end up opting for ablation instead.

[Melissa in Australia]

I am on low dose beta blocker  and another heart medication   that is not a beta blocker.

It is to try keep my  pulse in the 80s.  My heart rate is all over the place, either  dropping to the low 50s or rising rapidly over 110+ with the slightest exertion . Multiple  times a day.

I naturally have very low blood pressure. 

When my pulse drops to anything below 64 I feel absolutely awful , very fatigued, chest pain , headache, cold. Symptoms disappear as soon as pulse is up over 70.if my pulse goes over 110 I feel breathless, have chest pain, tightness across chest. If it goes over 120 my vision blures, am panting , and I feel so yuck that I lay down on the floor wherever I am. 

I am not doing any exercise that would rase heart rate, still using a walker am completely house bound.

[eagleynne]

Not me, but my mother has been on a low dose of metoprolol for SVT for years. I asked her about side effects, etc., and she reports that she hasn't noticed any significant change in her heart rate or blood pressure. She feels that her anxiety may have improved a little on it.

For whatever it's worth, my heart rate regularly falls into the upper 50s without my noticing. If it were me I would try the beta-blocker first for awhile. Changes to your heart rate or blood pressure would become evident within a few days to a week of starting treatment. If all was well then great, if not then consider your options.

[Pawz4me]

DH has been on metoprolol for years. He was a little fatigued the first week or two, which his provider told him to expect. But that wore off, or he adjusted to it, and after that it hasn't seemed to have any side effects for him. 

My resting heart rate has always been in the mid to upper 50's. It's never made me feel faint or dizzy.

ETA: DH is on metoprolol for BP control.

Edited November 25, 2023 by Pawz4me

[alysee]

I've been on labetalol for half of my twenties and the other half and all of my thirties I've been on metoprolol. Currently doing metoprolol and perindopril. I use it for high blood pressure from heart surgery when I was a baby not SVT, but I've not had any alarming side effects. Some people do develop a cough kinda like a tic but I've never experienced it. 

[historically accurate]

Neither of my DD's who were/are on metoprolol had any side effects. Both of them have tachycardia, so the beta blocker kept the heart rate down during any sort of exertion. They do have very low blood pressure naturally which caused fainting in one, which was treated with midodrine. That one did have some side effects (severe tingling along the scalp).

Both take/took it for POTS. One recently went off of it (about 6 months ago) with no issues; she had taken it for about 5 years. The other is currently on it and has been for about a year, and she hasn't had any side effects although she says she did notice her anxiety was a little better when she started it (now the anxiety seems to have gotten worse lately).

[EKS]

I'm on atenolol for svt (that sometimes converts to a-fib).  My resting heart rate on it is around 57.  No dizziness. 

That said, in my case, it's not a cure.  But, thankfully, now that I'm well into menopause, my heart seems to have settled down a bit.  I really should explore ablation because it would be nice not to have to worry about weird rhythms ever again.

[kbutton]

I have been for several months and feel so much better. I am not anymore lightheaded or dizzy than I was before (have always tended toward lightheadedness on standing), though it helps to stay on top of my water intake. I have a family member with a very low heart rate on a large dose for an aneurysm, and he does fine. I think he didn’t like it at first but has adjusted. No issues with passing out for him.

I am procedure-averse and would try the beta blocker. I didn’t notice anything except relief from the palpitations. 

[Laura Corin]

4 hours ago, Melissa in Australia said:

I am on low dose beta blocker  and another heart medication   that is not a beta blocker.

It is to try keep my  pulse in the 80s.  My heart rate is all over the place, either  dropping to the low 50s or rising rapidly over 110+ with the slightest exertion . Multiple  times a day.

I naturally have very low blood pressure. 

When my pulse drops to anything below 64 I feel absolutely awful , very fatigued, chest pain , headache, cold. Symptoms disappear as soon as pulse is up over 70.if my pulse goes over 110 I feel breathless, have chest pain, tightness across chest. If it goes over 120 my vision blures, am panting , and I feel so yuck that I lay down on the floor wherever I am. 

I am not doing any exercise that would rase heart rate, still using a walker am completely house bound.

 

1 hour ago, eagleynne said:

Not me, but my mother has been on a low dose of metoprolol for SVT for years. I asked her about side effects, etc., and she reports that she hasn't noticed any significant change in her heart rate or blood pressure. She feels that her anxiety may have improved a little on it.

For whatever it's worth, my heart rate regularly falls into the upper 50s without my noticing. If it were me I would try the beta-blocker first for awhile. Changes to your heart rate or blood pressure would become evident within a few days to a week of starting treatment. If all was well then great, if not then consider your options.

 

1 hour ago, Pawz4me said:

DH has been on metoprolol for years. He was a little fatigued the first week or two, which his provider told him to expect. But that wore off, or he adjusted to it, and after that it hasn't seemed to have any side effects for him. 

My resting heart rate has always been in the mid to upper 50's. It's never made me feel faint or dizzy.

ETA: DH is on metoprolol for BP control.

 

1 hour ago, alysee said:

I've been on labetalol for half of my twenties and the other half and all of my thirties I've been on metoprolol. Currently doing metoprolol and perindopril. I use it for high blood pressure from heart surgery when I was a baby not SVT, but I've not had any alarming side effects. Some people do develop a cough kinda like a tic but I've never experienced it. 

 

1 hour ago, historically accurate said:

Neither of my DD's who were/are on metoprolol had any side effects. Both of them have tachycardia, so the beta blocker kept the heart rate down during any sort of exertion. They do have very low blood pressure naturally which caused fainting in one, which was treated with midodrine. That one did have some side effects (severe tingling along the scalp).

Both take/took it for POTS. One recently went off of it (about 6 months ago) with no issues; she had taken it for about 5 years. The other is currently on it and has been for about a year, and she hasn't had any side effects although she says she did notice her anxiety was a little better when she started it (now the anxiety seems to have gotten worse lately).

 

32 minutes ago, EKS said:

I'm on atenolol for svt (that sometimes converts to a-fib).  My resting heart rate on it is around 57.  No dizziness. 

That said, in my case, it's not a cure.  But, thankfully, now that I'm well into menopause, my heart seems to have settled down a bit.  I really should explore ablation because it would be nice not to have to worry about weird rhythms ever again.

 

16 minutes ago, kbutton said:

I have been for several months and feel so much better. I am not anymore lightheaded or dizzy than I was before (have always tended toward lightheadedness on standing), though it helps to stay on top of my water intake. I have a family member with a very low heart rate on a large dose for an aneurysm, and he does fine. I think he didn’t like it at first but has adjusted. No issues with passing out for him.

I am procedure-averse and would try the beta blocker. I didn’t notice anything except relief from the palpitations. 

Thank you, everyone.  That's reassuring.

One of the reasons that I am considering the ablation is that I am relatively young and fit right now, so if I ever want to do it, now might be the time to do the procedure. 

[catz]

My husband has been.  I has some sort of arrythmia.  He hasn't had any problem at all.  

The ablations don't always work as expected so he is hoping to manage with drugs.  

[gardenmom5]

1ds was on beta blockers for a few years as a tween/young-teen.  I was extremely uncomfortable with them.  They didn't resolve the issue, merely put a bandaid on it.   We eventually discovered his issue (a vertebra pinching a nerve) and were able to successfully treat it, no thanks to his neurologist who prescribed the beta blockers.   Incidentally, his current dr thinks what happened to him then (and how many years it took to be correctly diagnosed), might have been the original trigger of his hiatal hernia.

[EKS]

1 hour ago, kbutton said:

I am procedure-averse and would try the beta blocker.

It's kind of a trade off between lifelong medication and a single procedure.  There can be issues with prolonged beta blocker use, including weight gain, memory problems, and heart failure.  I think I maybe just talked myself into a visit with my cardiologist!

[PeterPan]

9 hours ago, Laura Corin said:

was 66bpm

Did you lose a digit there? It was 166?

Have you been losing weight or having other symptoms of your svt? Every single time I get covid (or the vax, grr) I get heart inflammation and my heart rate goes up. This time I've lost a bunch of weight, and I think my maybe my heart rate was up a % and I didn't realize. Losing weight for me is fine, haha, but it's sort of the not cool way of doing it. Granted I was eating healthy, but still, doing nothing and dropping weight is not good.

I had one relative I cajoled and had straight talks with about the meds because person was so worried about side effects. They kept ending up in the ER, which is also a bad side effect of not treating. 😉 They took the meds and the side effects were so nominal in comparison to the benefit. Are you not having enough symptoms to notice/care? 

I'm sure my doc will listen to my heart when I go next week and we'll make our plan. Usually they just say wait a dab and it has died down. But if it didn't, I'd take the meds in a heartbeat (haha). Well and it's not going THAT high. Never over 150. And with time it goes back down. I have another relative who didn't realize they were having the (afib, etc.) and ended up almost dying from a stroke before 30. So to me, the risk of not medicating, if it's really happening and not going away, outweighs, the unfortunate, potential, hopefully mild side effects.

My person who went on the meds had a slight downtick in energy and was a little more careful hauling their laundry up and downstairs. Not ending up in the ER over and over was huge. I would suspect you'll actually feel better and it will outweigh the rest. I know every time my heart does this I'm tired and just have this slower overall pace. If it's giving you symptoms and fatigue, etc., it might feel better to improve that.

[PeterPan]

4 hours ago, Laura Corin said:

ablation

My relative who almost died did (after that) have the surgery and it has definitely been a miracle. For this person, the afib was so severe that medication struggled to control it. Maybe look for or ask for some research on success rates with your degree of svt? I can tell you when they got the procedure they got it done by someone out of state by someone who was the best in a multi state region. You could start with a meds and get a 2nd opinion on the ablation.

[TravelingChris]

I takr atenelol becausepf dysautonomia. Heart rate too fast.

 

[Laura Corin]

50 minutes ago, PeterPan said:

Did you lose a digit there? It was 166?

Have you been losing weight or having other symptoms of your svt? 

No other symptoms.  With SVT my heart rate is normal between episodes of ultra-high heart rate. I wasn't having an episode when I was at the cardiologist, so 66bpm is correct. 

[KSera]

The ablation could be worth it, honestly. The success rate of controlling symptoms is better with ablation. If it’s infrequent, I wouldn’t jump to ablation, but if it’s happening a lot or badly enough that you can’t stop an episode pretty quickly yourself through the usual valsalva type method, I’d be considering an ablation just to be done with it (and doing it while you’re younger, like you say). 

[Laura Corin]

6 minutes ago, KSera said:

The ablation could be worth it, honestly. The success rate of controlling symptoms is better with ablation. If it’s infrequent, I wouldn’t jump to ablation, but if it’s happening a lot or badly enough that you can’t stop an episode pretty quickly yourself through the usual valsalva type method, I’d be considering an ablation just to be done with it (and doing it while you’re younger, like you say). 

The SVT is starting to get irritating. It used to happen quite randomly, but recently it has been exercise induced. It's not much fun to be half way up a Scottish hill and having to sit around and wait for my heart to click back to its normal rhythm.

[kbutton]

9 hours ago, EKS said:

It's kind of a trade off between lifelong medication and a single procedure.  There can be issues with prolonged beta blocker use, including weight gain, memory problems, and heart failure.  I think I maybe just talked myself into a visit with my cardiologist!

I’ve heard more mixed things about ablation, so I’m glad to hear it’s more reliable than what I’ve heard!

I have not heard this about long-term beta blocker use, but my relatives taking higher doses don’t have an option. It’s first-line therapy for aortic aneurysms. 

[EKS]

1 hour ago, kbutton said:

I’ve heard more mixed things about ablation, so I’m glad to hear it’s more reliable than what I’ve heard!

I don't know what you've heard, and I don't know how reliable it is.  I do think that long term use of any medication needs to be carefully considered.  Before deciding on ablation, if I ever manage to see my cardiologist, I'll definitely look into how well it works!

[SHP]

15 hours ago, eagleynne said:

Not me, but my mother has been on a low dose of metoprolol for SVT for years. I asked her about side effects, etc., and she reports that she hasn't noticed any significant change in her heart rate or blood pressure. She feels that her anxiety may have improved a little on it.

 

This is my experience with metotoprolol as well. I tried another medication and had side effects and didn't benefit me as much. 

I noticed how much better I felt with the metotoprolol really fast. 

[sassenach]

I had an ablation for SVT more than a decade ago. Over time my symptoms have occasionally popped up but overall it was very effective. I’m terrible at taking daily meds and the SVT was quite bad at the time. 

[sgo95]

My oldest DD had an ablation in her senior of high school for SVT and it has been 99.9% effective. Recovery from the procedure was a piece of cake, as well. 

[Amethyst]

The CABANA trial indicates that ablation is NOT superior to medication, although that trial was for AFib. Admittedly, my bias is always less invasive treatment.