Beta blocker or calcium channel blocker?

Hello all! I'm writing in regards to my mother who received a pacemaker on February 2, 2020. She had a fall brought on by 3rd degree heart block. After a life flight to a bigger hospital and emergency surgery- she now has new hardware. Because of the fall she also has a skull fracture and brain bleed. She was put on dilitazem after a few rapid heart rate events within the last month but has experienced the flushing and breakthrough tachycardia. Her doctor has advised her to start taking propanolol instead, which she was on for 20+ years prior to the complete block. She is anxious about going back to the propanolol even though she got along really well with it before the cardiac incident. 
Has anyone been through these two meds? Do you have an encouraging words or personal experiences I could share with her? She's also tapering off Fioricet too (don't ever go on this med it's awful) and she's just very unsure of everything. As her caregiver I'm trying to gather all the info I can. Any info or input is greatly appreciated!! 


Channel Blocker Vs Beta Blockers for Tachycardia Control

by Marybird - 2020-04-10 21:19:48

My best wishes for your mother's recovery. Her uncertainty about everything right now is understandable considering evrything she has gone through.

As for whether channel blockers or beta blockers are better for arrythmia/tachycardia control, it's really an individual thing. And I don't know any way for someone to determine that for themselves other than trial and error with each medication, if the first one doesn't seem to be effective.

My sister takes a low dose of diltiazem (120 mg/day) to control her afib, and finds this works pretty well. She says she does have some breakthrough, and she may be facing a higher dose for this reason, but she likes the drug. Consideration of the side effects for each drug, and the person's tolerance for them also plays a part in choosing a drug.

I find that a combination of low dose diltiazem and metoprolol work better than even higher doses of either diltiazem or metoprolol alone to control my atrial tachycardia.  This combination also controls my blood pressure better, though my EP recently doubled the diltiazem dosage I take for better blood pressure control. I have fewer breakthroughs with this combination, than with either one. But that's me, others may not find this to be the case. 

It might take some time,and adjustments in dosage to determine how well diltiazem works to control your mother's tachycardia. Alternatively if her doctor wants to switch her to propanolol, or another beta blocker, it'd also take some time, and perhaps adjustments in dosages to find what works the best with the minimum of side effects.



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I have an ICD which is both a pacer/defib. I have no problems with mine and it has saved my life.