Beta Blockers even with a low blood pressure?

Hello everyone

Has anyone got a low blood pressure but is still fine with Beta Blockers? My blood pressure is usually 80-110 and so the docs have refrained so far from prescribing them. 

Another question, do they help alot in getting arythmia reduced (I have extra beats and what have you not the whole day, my heart is just bouncing around and since I have the arythmia I have a constant dizziness). So I thought I would give it a try anyway and hopefully they would help. The doc suggested if so to just try a 5mg dose per day. Ablation is not an option as the scar causing the electrical chaos is at a critical location so I would risk of being in a permanent Grade III block if it goes wrong. 

I have an intermediate II-III Block (I have cardiac sarcoidosis) and am fitted with a pm whith the pulse rate programmed at 50 bpm so of the pulse falls too low it would kick in. 

Thanks so much for your replies! 


4 Comments

Beta-blockers

by TAC - 2022-03-14 13:20:57

I have a normal and sometimes low blood pressure. However, my EP put me on a smal dose of a beta blocker. She said: "to relax the myocadium muscle". I do feel fine, my PVC's have practically gone and have no ill-effects. If you had been on beta blockers for some time, after discontinuation you can have a rebound effect of many PVC's or PAC's. Perhaps a small dose of a beta-blocker might be helpful.

I would ask for an increase in base rate first

by Gemita - 2022-03-14 15:52:19

Carol, I am on Bisoprolol lowest dose 1.25 mg to prevent high heart rates during Atrial Fibrillation.  My blood pressure is running around 85-100 systolic over 55-60 diastolic.  They have set my pacemaker base rate at 70 bpm and that keeps me feeling okay with my low blood pressure.  During an arrhythmia, my blood pressure may plummet before surging and I can feel awful, but I cannot do without low dose Bisoprolol otherwise my heart rates would go sky high during an episode of Flutter or Atrial Fibrillation.

While beta blockers may calm arrhythmias, I haven’t found them particularly helpful in stopping them, but a higher base rate setting of 70 bpm certainly helps to outpace my slower irregular ectopic beats, so this has been a really good treatment for me.  Which beta blocker is your doctor recommending?  5 mg dose of Bisoprolol, for example, would be too high in my opinion.  I would try 1.25 mg-2.5 mg and no higher initially and see how you go.

Looking at your base rate setting of 50 bpm, that is too low in my opinion for someone with low blood pressure.  I would get it raised at least to 60 bpm (ideal heart rate would be between 60-80 bpm).  If I may offer an opinion, why not try an increase in base rate first to see if that helps before you start a beta blocker?  A higher base rate setting may help support your blood pressure.

Beta blockers

by AgentX86 - 2022-03-14 17:04:26

If your doctor suggested it, it's probably worth a try. Given your already low blood pressure, I wouldn't do anything dangerous for a while until you know how it affects you.

If an ablation would help, I'd ask about it some more.  You already have a 2/3 intermittent block and a pacemaker to correct it.  Even in the worst case scenario, you haven't lost much.  Your pacemaker is still there to do exactly the same thing as it does now but more regularly. There may be a lot to win and very little to lose. 

I  intentionally went from no heart block to no AV connection at all (no A/V node and no pacemaker replacement) to get out from under flutter. Unless there is something else to the story, your worst case scenario isn't horribly bad.  It comes down to your quality of life.  How badly do you want to get rid of your arrhythmia.

You'd want one of the best ablationists that you can find. There are only a few superstars in the US.  Of course, I don't know about Switzerland or the rest of the EU for that matter. There is a big difference in the outcomes depending on who does it.  A good ablation EP will do more than a hundred per year and have a thousand under his belt.

thank you for your comments

by Carol7 - 2022-03-15 04:41:05

Thank you everyone for your comments. Ok, I will ask my cardiologist to raise the bpm first. I am actually just wanting to get rid of the dizziness which I feel the whole day which started initially with the arythmia so there must be a relation even though my cardiologist thinks it doesn't. It's just so debilitiating when you go around thinking you are going to fall any minute or faint and that basically the whole day more or less...

 

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