out of breath while exercising.

I had my device installed in February.  Prior to that surgery I had been taking coreg 3.125 mg twice a day.   I was able to frequently get on our ellipical machine for 45 minutes for a comfortable session with heart rate at 120.   After the insertion of the PM, the EP doc took me off the coreg and substituted Metoprolol succinctate 50mg.

Now I have no stamina.   Walking uphill I get winded very quickly.   I am unable to use the elliptical at the same level I have been using for years.

Is it the new beta blocker, the PM or both?    They have adjusted the PM for almost maximum reactivity to motion with very little difference.

Also, I have developed LBBB after the PM.   I never had that before, only RBBB.  Is this normal?


5 Comments

SOB with exercise

by AgentX86 - 2021-06-05 20:10:53

It could be anything but metoprolol will afect some that way.  It can also make one lethargic, perhaps to the point of bein unable to function.  It may take a dosage change or another beta blocker to make it right.

RBBB -> LBBB isn't unheard of.  It's really not surprising that the cause of nerve damage in one area might affect another.  It's highly unlikely that the PM has anything to do with it.

Bundle Branch Blocks

by Julros - 2021-06-06 00:49:56

Regarding bundle branch blocks:​

The typical electrial conduction of the heart travels from the sino-atrial node, to the atrial venttriclular node, and then down the septum, branching into the right and left bundle branches, causing the ventricles to contract simultatneously. If something has damaged one of the branches, the electrical conduction travels to the other side of the heart, although slightly slower, and one ventricle contracts slightly sooner than the other. This electrical conduction shows up on an ECG and is described as a right or left bundle branch, and they each have specific criteria. If this is a new change, it could indicate heart muscle damage. 

A  paced rhythm genderated in the right ventricle will look like a left bundle branch block: a wide QRS complex that is downward going in lead V1. There is also ST and T wave deflection opposite the direction of the QRS. This is because rather than the electrical signal coming from the inner septum, it starts in the right ventricle and travels to the left. 

Unless they have can do an ECG without pacing, it is expected that your ECG would show LBBB. 

Talk to your doc

by Persephone - 2021-06-06 09:59:35

Keep up the conversation with your doc, PK, and keep letting them know you can't do the things you want/ need to do for your health.  And as Julros points out, your EKG is different now post-implant - it seems that often we don't get explanations like this from our medical team and need to learn to decipher the information ourselves - one of the many reasons that this forum is so helpful for us all.  Best of luck to you.

Metoprolol

by doublehorn48 - 2021-06-06 17:14:03

Several years ago a Doctor put me on metoprolol.  I've been a runner most of my life.  But, after he put me on metoprolol, I couldn't run but a short distance.  I complained to my cardiologist and she said to quit taking metoprolol.  That was about 7 years ago.  My problems with running disappeared.

metoprolol

by finsfan1012 - 2021-06-07 11:56:59

i started metoprolol about 6 weeks ago,, i too felt very very tired all the time,,,had to nap everyday,,,,i was on 25mg once a day,,, i cut it myself back to a half a pill,, and wow,,,within 3 days,, i had more energy,,didn't need a nap anymore,, and my bp has been stable around 120-130/60'....talk to your doc,, maybe you can cut your dose too,,,,,,

 

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Sometimes a device must be tuned a few times before it is right. My cardiologist said it is like fine tuning a car.