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Old 08-07-2022, 09:41 PM
 
Location: Juneau, AK + Puna, HI
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Definitely some abnormalities in that EKG. Hopefully you can get a cardiologist to evaluate.
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Old 08-07-2022, 10:51 PM
 
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If they are bad enough you might need a cardiac ablation of some type or even a pacemaker. Best not to ignore it and hope it goes away.
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Old 08-07-2022, 10:55 PM
 
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Is your medication in a time-released capsule? I take a different type of beta blocker for psvt in an extended-release form. Before that, I had to take a tablet TID, which was a pain. BTW, I was in my mid-30's when dx'd. It was pretty alarming as I was fit, non-smoker/drinker. But, I'm still here.

Last edited by CalWorth; 08-07-2022 at 11:06 PM..
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Old 08-08-2022, 01:53 AM
 
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Quote:
Originally Posted by Parnassia View Post
Its more than the potassium. Coconut water is also high in magnesium and calcium. Magnesium is equally if not more important than potassium in regulating heart rhythm. Calcium, magnesium and potassium are closely intertwined. An imbalance of magnesium-potassium (too much OR too little) can cause irregular heartbeat. IMHO, someone with a known heart condition shouldn't start swilling lots of extra electrolytes without running it past their cardiologist. You can overdo it. If your mag/pot/calcium levels are already out of whack, you could do more harm than good.

https://www.dailybody.net/how-does-p...ect-the-heart/

OP your doc has probably already done so, but if not, they should monitor for magnesium deficiency. Many folks with arrhythmias are deficient.
I mentioned potassium specifically because it is difficult to supplement for it on the one hand while, on the other, having enough of it is very helpful for preventing/terminating arrythmias. True, there are potassium chloride pills or potassium gluconate pills you can take, but the dosage (or at least the amount of potassium you are going to absorb through that route) is very low. Potassium pills are not available OTC because there are real dangers with potassium overdose that you do not have with magnesium or calcium. Of course this means that you have to be careful not to drink too much coconut water. Personally, I never have more than 4 cups within a relatively short time frame (an hour or two). Another excellent source of potassium (better than bananas) is orange juice. Unfortunately, OJ is also a lot higher in sugars and calories than coconut water. But when coconut water is not available, I turn to OJ.

Yes, magnesium is just as important for preventing/treating arrythmias, if not more so. You need a good level of magnesium in order to be able to absorb the potassium. However, magnesium levels can be pretty easily increased through supplementation (and the amount of magnesium in coconut water varies depending on the brand whereas they are all high in potassium).

I am less sure about the necessity for calcium supplementation specifically for heart rhythm issues and am still researching this. I have seen some people swear that a low calcium diet helps them. I have also seen experts advise a lower calcium/magnesium ratio for those who suffer from arrythmias vs those who don’t. Also, a class of anti-arrhythmic meds are called “calcium-channel blockers.” They restore sinus (normal) rhythm by preventing calcium from entering thr cells of the heart. All food for thought.
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Old 08-08-2022, 06:27 AM
 
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Yes, my meds are time released. I'm only on 25 mg a day because I naturally have very low blood pressure already and they didn't want it getting too low.

Thanks for the suggestions, I'll definitely ask my Dr about all of them.
My next appt is in November with my cardiologist but I am waiting for an email back from him in the meantime.
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Old 08-09-2022, 05:32 AM
 
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Quote:
Originally Posted by KH02 View Post
Yes, my meds are time released. I'm only on 25 mg a day because I naturally have very low blood pressure already and they didn't want it getting too low.

Thanks for the suggestions, I'll definitely ask my Dr about all of them.
My next appt is in November with my cardiologist but I am waiting for an email back from him in the meantime.
I personal found that an extended release betablocker (Metoprolol succinate) had no effect on my arrhythmia episodes, but that an immediate release betablocker (Metoprolol tartrate) taken as a pill-in-the-pocket was very effective at terminating any episode once it had begun.

On the other hand, my blood pressure is normal, not very low.
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Old 08-09-2022, 07:44 AM
 
Location: The Driftless Area, WI
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Given IV, metoprolol can take 10 minutes to build up an effective blood level. Taken orally, it takes 1-2 hrs. If you noticed an "immediate effect," it was a mere coincidence. These dysrhythmias come and go spontaneously.

It's always a matter of individualizing doses-- balancing effects with side effects. Sometimes you need to compromise. We put up with nasty side effects in chemotherapy that we'd never tolerate if treating a common cold.

In this particular case, we have a young man hoping to live another 50 yrs with a situation that makes lethal V fib more likely than in someone who hasn't shown PVCs/V tach, but over-all, still unlikley...What to do? Fifty yrs of treatment for a thing that may never happen?...and tx could have some undesired side effects (low BP)?

The problem is that while the risk of sudden death may be statistically low, if it happens to you, your risk has suddenly become 100%, and it's too late to start treatment then.

The low dose of metoprolol seems to have worked without causing symptomatic hypotension. Because he has shown at least one run of V tach, I'd recommend continuing it.
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Old 08-09-2022, 08:17 AM
 
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Thanks! I have no plans to stop taking it. Also, for what it's worth, I am a female. It's the sudden death aspect that I worry about the most since I still have kids living at home who need me.

I would assume that metoprolol should lower incidences but not egt rid of them totally, correct? Mine are much less frequent since being on beta blockers so I'm thankful for that.

Now I also have the aneurysm to worry about as well though they don't seem too concerned.
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Old 08-09-2022, 03:17 PM
 
Location: The Driftless Area, WI
7,261 posts, read 5,139,849 times
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My apologies for my error in identifying you.

You may find these meta-analysis papers encouraging about metoprolol and prognosis.
https://pubmed.ncbi.nlm.nih.gov/10526698/
https://pubmed.ncbi.nlm.nih.gov/7625625/

Aneurysms need to be watched to see if they're getting bigger...and how fast they're getting bigger. BP should be kept in the normal range. No need to worry unless they are changing. ...It sounds like your are in good hands.
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Old 08-10-2022, 12:53 PM
 
2,391 posts, read 1,407,070 times
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Quote:
Originally Posted by guidoLaMoto View Post
Given IV, metoprolol can take 10 minutes to build up an effective blood level. Taken orally, it takes 1-2 hrs. If you noticed an "immediate effect," it was a mere coincidence. These dysrhythmias come and go spontaneously.

It's always a matter of individualizing doses-- balancing effects with side effects. Sometimes you need to compromise. We put up with nasty side effects in chemotherapy that we'd never tolerate if treating a common cold.

In this particular case, we have a young man hoping to live another 50 yrs with a situation that makes lethal V fib more likely than in someone who hasn't shown PVCs/V tach, but over-all, still unlikley...What to do? Fifty yrs of treatment for a thing that may never happen?...and tx could have some undesired side effects (low BP)?

The problem is that while the risk of sudden death may be statistically low, if it happens to you, your risk has suddenly become 100%, and it's too late to start treatment then.

The low dose of metoprolol seems to have worked without causing symptomatic hypotension. Because he has shown at least one run of V tach, I'd recommend continuing it.
Hey guido,

I am not sure if you were responding to what I posted about my experience with metoprolol tartrate. (You didn’t quote me, but you did post right after my metoprolol tartrate post).

I said I found it “very effective,” not that it had an “immediate effect.” It usually takes about 20 to 30 minutes for metoprolol tartrate to end an arrhythmia episode for me. You say it takes 1-2 hours to buildup to an “effective” blood level, however, what I have read is that it takes 1-2 hours to build up to “peak” blood levels which are not necessarily the same as “effective” levels.

Yes, arrhythmias come and go. But when you have a pattern of 6 to 8 hour arrhythmia episodes once a week, then start taking metoprolol tartrate as a pill-in-the-pocket and see these episodes terminate in 20 to 30 minutes, you have something going on. Either the metoprolol tartrate is effective or there is a strong and lasting placebo effect.

BTW, one thing I have always wondered is why the same dose of medication is considered therapeutic for everyone, no matter their size. As a petite woman, I have had many experiences of the standard dose being too strong and/or having strong therapeutic effects on what are not supposedly therapeutic dosages.
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