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    Side effects of Metoprol to prevent AFib
    Vince4ltci posted:
    Background: Healthy 71 year old male. Yes, a bit overweight: 5' 10" and 194 lbs. High blood pressure controlled with Lisinopril. High cholesterol, no longer on "statins". Have gone to gym 4 days a week for most of my life. On 3/29/13, had back surgery (Transforminal Lumbar Fusion) which was successful. While on the operating table, suffered (1st time) Atrial Fibrillation and minor stroke that created some aphasia (now in speech therapy).
    Taking Warfarin (5 mg/2.5 mg/alternate days) for blood thinning and Metoprol 25 mg x2 (Lopressor) to prevent AFib. The PROBLEM is the Metoprol, controlling my heart rate at a level that will never allow me to get back in shape. Experiencing: Shortness of breath, weakness, and dry mouth. Are there alternatives? Pacemaker for prevention of AFib? Other drugs that might control my heart rhythm, rather than my heart rate? Skip the Metoprol—I never had AFib before, so what is risk of returning to that condition. The AFib ended on 1st day after surgery and has not returned. All knowledgeable opinions appreciated.
    cardiostarusa1 responded:

    "Are there alternatives? Pacemaker for prevention of AFib? Other drugs that might control my heart rhythm, rather than my heart rate? Skip the Metoprol—I never had AFib before, so what is risk of returning to that condition."

    Please consult with your doctor(s).

    In the meantime, in general, atrial fibrillation (AF) has various causes (also known to be associated with many cardiac conditons) or triggers, sometimes being a one time-only occurrence, or may/can come and go or be chronic.

    During AF, electrical signals in the atria occur in a very fast, uncontrolled, and chaotic manner so that the atria quiver instead of contract, producing ineffective and disorganized atrial contractions. These disorganized electrical signals then arrive at the ventricles in an irregular fashion.

    As reported, AF is an independent risk factor for a brain attack/stroke (increasing the risk about 5-fold), and significantly increases all-cause mortality in most age groups. Additionally, some individuals with AF are at an increased risk of heart failure or cardiomyopathy (heart muscle disease).

    There are a small % of individuals in which a reversible cause for AF can be readily identified, e.g., alcoholism, hyperthyroidism, or diabetes, and thus AF does not recur once the cause has been alleviated.

    As applicable, goals for managing recurrent or chronic AF are to restore and maintain the normal atrial rhythm and pumping function, control the ventricular rate, prevent any correlating major adverse cardiac event.

    AF Management

    Correct any electrolyte imbalance/defficiency, in particular, potassium, magnesium. Consider cardioversion (externally shocking the heart into normal sinus rhythm, which may/can fail). Control the ventricular response. Consider anticoagulation (Coumadin) therapy, or new drugs that may be/are becoming/have become available.

    Best of luck down the road of life.

    Take care,


    WebMD member (since 8/99)



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