Fitness

Finding that extra gear while on a beta blocker can be difficult

by Gemita - 2024-11-05 17:04:07

Jane,

All I can say is that some of us find it extremely difficult to exercise on a beta blocker, however low the dose and however hard we try.  It will be trial and error to find the best med for your particular activities while at the same time controlling your rhythm disturbances.

There are lots of different meds out there that will help control an atrial tachy arrhythmia.  I am unclear whether your difficulty stems from the beta blocker or from your rhythm disturbances which may not be under good control?   It is a real balancing act to control a high heart rate without slowing conduction through the AV Node which is what a beta blocker does so effectively, as well as blocking adrenaline.  Beta blockers cause the heart to beat more slowly which reduces the force at which blood is pumped around your body.  No wonder we feel so lethargic.

Some members absolutely cannot tolerate beta blockers.  It could be that you will never reach a good level of fitness while taking a beta blocker.  If you cannot achieve a level of fitness that you can live with, I would respectfully suggest asking your doctors for an alternative beta blocker or switch to another medication, perhaps a calcium channel blocker.  You may just find something that suits you better.  After years on Bisoprolol, I am now taking Diltiazem, a calcium channel blocker.  I no longer have brain fog and have far more energy.  I take the brand Adizem-XL 120 mg prolonged release capsules once daily.  No side effects whatsoever since the drug is released slowly over a long period of time.

May I ask what optimum settings you have tried to help with your Atrial Tachycardia and other disturbances, what algorithms have been switched OFF?  I see you have a complex history of arrhythmias and ablations and have had an AV Node ablation which means that you have lost the atrial contribution to cardiac output.  In some cases this can be a loss of up to 35% of total cardiac output, which is substantial and can make a difference when you are trying to excercise.  

An AV Node ablation should effectively have stopped all your atrial tachy arrhythmias from passing through the AV Node and adversely affecting your ventricles.  Although your atrial tachy arrhythmias will still remain active in the atria, you should no longer feel them after an AV Node ablation.  I don't really understand the need therefore for a beta blocker, unless you are having arrhythmias in the ventricles or needing a beta blocker for other reasons?   Is your atrial lead and Mode Switch still in operation by chance or are they no longer tracking your atria?

Effort

by piglet22 - 2024-11-06 05:06:34

I can't add much to Gemitas response.

I too suffer from exercise fatigue. In the space of a year or two, I went from keen cyclist and walker to slow walker. Sometimes my legs just ache and I have to stop 

This was a result of ventricular ectopy taking over for a while and having to take a higher dose of Bisoprolol (10-mg daily).

I spoke to one of the EPs recently in preparation for device replacement and the proposal was to in his words, introduce a more aggressive rate response 

I'm not holding my breath for a big improvement and will have to wait until January. Sometimes you just have to accept things as they are.

I would add that I take a cocktail of medication and both my parents had hypertension

 Apart from the beta blocker, there is s a calcium channel inhibitor (Coracten), Angiotensin inhibitor (Ramipril/Losartan) and a diruretic (Bendroflumethazide) and a statin.

I'd rather not have to take them all but  am very much medication dependant. No amount of dieting, exercising ever made a significant difference.

I still manage walking 4 million steps and nearly 2000 miles a year.

Good luck 

Exercise

by Jane S - 2024-11-06 16:38:41

Thank you both for responding 

The beta blocker is to stop any atrial rate going too high, pm set at a max of 150. The pm was following my rate as it increased then going into block as I maxed out. Originally my upper limit was 140 so after a few treadmill tests we got to 150; as I hit it I go into 2:1 block,unfortunately flecanide doesn't agree with me. 
I honestly don't know what settings were switched off, I certainly felt " quieter, less fluttery"  I still have spells especially at night when I'm aware of ectopics, flutters etc though nothing apparently has shown up. 
The bottom line seams to be make the best of how I am. 

Your points I'll rise at my next appointment 

Jane x