Rate Response On since 10/18/18 and Metoprolol 12.5mg

Hi! So I was diagnosed w 3rd degree heart block, Dual chamber Pacemaker implanted 8/28/18...I was also prescribed 25mg metoprolol 10/01/18 for arrhythmias occasionally.  on my 6/7 wk check up last wk I explained to my surgeon that I felt lethargic after simple things like walking up stairs or walking more within the day, also I’m waking up EVERY night @ 2am n not getting a full nights rest. He recommended only taking 12.5 mg per day...which I have done....lethargy has stopped, they also fine tuned my pacemaker and increased it to 130/60 But they have added Rate Response...which feels very uncomfortable. My BP is also up for have the day averaging 140/103 pulse 102 and I feel a heaviness n my chest now. The 25 mg metoprolol made me feel down/depressed also. I go tmrw for a check up but I feel the rate response isn’t for me..I don’t have a problem increasing my heart rate on exertion n feel that I need to have it turned off n have a different med for BP. I rarely experience the arrhythmias n need to just get my BP under control and I will b fine. This is frustrating I’m only 2 months in and understand I’ll need some fine tuning. My NP is talking about a possible calcium channel blocker rather than the beta blocker prescribed. I just want to feel like myself again! 

3 Comments

Pacemaker downloading?

by Blessed31 - 2018-10-25 02:47:30

Thanks for the advice and encouragement Robin1! I am still learning about my device and didn’t realize that it could possibly b that it is downloading every time I awake early. I’m up @ 1:43 am as we speak. I have definitely considered diet and changing my eating habits, I eat terrible alot  of processed, fried, junk foods. I understand those changes in my BP take time as well to change but I hope to consider that instead of taking BP meds. I’m 32 yrs old and haven’t had any BP problems until Post op so I’m assuming it’s stress and dealing w the whole pacemaker implant. I’ve had numerous visits to my doctor and hope to get things right eventually. It’s only the beginning I know. Hopefully tmrw I get some better answers. 

Just a few thoughts

by IAN MC - 2018-10-25 09:11:37

Hi Blessed  I hope that your Dr makes some beneficial changes to your treatments :-

-  rather than an actual download It is possible that your pacemaker has been set to perform a self-test at 2 in the morning. This can feel unpleasant.  It is an easy fix to have the setting altered so that it self-tests any time of day that you choose.  As it happens I had my self-test function switched off completely so that may be an option for you.

-  Rate Response doesn't have to be only an "on" or " off" option.   It is possible that your RR has been set to respond to minimal levels of exertion and it may just need a tweak to its sensitivity setting.

- Controlling blood-pressure has never seemed to be an exact science to me. Usually it is done by trial-and-error by prescribing a little bit of this and then adding a little bit of that.  Your present lower dose of metoprolol seems not to be causing you problems so maybe a calcium blocker will be added.  Having said that I would not myself be TOO concerned if I had your BP levels. ... they are just a tiny bit on the high side  ( on the other hand you are only 32 and I am not ! )

Best of luck

Ian

Metoprolol makes you tired....

by BOBTHOM - 2018-10-27 00:27:44

Many people get tired from taking beta blockers like Metoprolol and Ace Inhibitors.  A couple of things to try, taking them at night, with/without a meal, splitting 1/2 morning 1/2 night, make sure you have the extended release.  You need to experiment a little to see what works best for you.  What's really fun is when they "titrate you up" which means they gradually increase the dose until you can't tolerate it any more. 

Good luck!

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