Slowing A Chronically High Heart Rate
Medications To Control Heart Rate And Rhythm
Your cardiologist may prescribe antiarrhythmic medications, beta blockers, or calcium channel blockers to control the hearts rhythm and rate.
Antiarrhythmic medications can control electrical impulses to the heart, thus encouraging a healthy rate and rhythm. Medications such as amiodarone, flecainide, Multaq®, and sotalol are commonly used for these purposes.
If you regularly take over-the-counter medications or herbal supplements, please let your doctor know. These can trigger arrhythmias and interfere with the effectiveness of antiarrhythmic medications.
Beta blockers can lower your heart rate by inhibiting the effects of stress hormones, such as adrenaline, on the heart and blood vessels. These hormones are responsible for the fight or flight response to stress, which can trigger an arrhythmia.
Calcium channel blockers, such as verapamil, relax the walls of blood vessels and slow your heart rate. This can help lower the fast heart rate associated with AFib.
Side Effects Of Beta Blockers
Most people taking beta blockers have either no or very mild side effects that become less troublesome with time.
Contact your GP if you’re having symptoms that bother you or last more than a few days.
Side effects commonly reported by people taking beta blockers include:
- feeling tired, dizzy or lightheaded
- cold fingers or toes
- difficulties sleeping or nightmares
It happens rarely, but some people have serious side effects when taking beta blockers.
Tell a doctor straight away if you have:
- shortness of breath with a cough that gets worse when you exercise , swollen ankles or legs, chest pain, or an irregular heartbeat these are signs of heart problems
- shortness of breath, wheezing and tightening of your chest these can be signs of lung problems
- yellow skin or the whites of your eyes turn yellow these can be signs of liver problems
These are not all the side effects of beta blockers. For a full list, see the leaflet inside your medicine packet.
You can report suspected side effects using the Yellow Card Scheme.
For more information on the side effects of beta blockers, read about the specific medicine you take in our Medicines A to Z.
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How And When To Take It
Always follow the instructions on the medicines label for your beta blocker dose.
Its common to take beta blockers in the morning.
Beta blockers do not usually upset your stomach, so you can take it with or without food. It’s best to take it the same way each day.
Swallow tablets whole with a drink of water.
If you find them difficult to swallow, ask your pharmacist if you can cut them in half.
Its important not to stop taking beta blockers without asking your GP. Stopping suddenly may make your health condition worse.
If they work well for you, beta blockers are generally safe to take for a long time. You may need to take them for the rest of your life.
When Are Adrenalin Blocking Effects Of Beta
An adrenalin blocking medication is good when your heart is in AFib and beating at 150 beats per minute, but, if you are in normal rhythm, theadrenalin-shielding property of these drugs can literally put you to sleep. Thatwhy fatigue is one of the top complaints among users of these drugs. In womenbeta blockers are often additionally associated with weight gain. In men, one ofthe big problems is erectile dysfunction.
One of the most beneficial effects of beta blockers is that they often have acalming effect on users, which is good for people with AFib that is triggered bystress or anxiety. These drugs also tend to lower blood pressure, and sincemost people with AFib have high blood pressure that a good thing, too. Beta-blockersalso often improve sleep, and since a lack of sleep can be a trigger forAFib, that also a significant benefit.
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Getting Further Supplies Of Dronedarone
You may find that your GP is unable to continue to provide you with further supplies of dronedarone tablets. This is due to funding restrictions by the Clinical Commissioning Groups .
Your GP may prescribe dronedarone for you if they have an agreement from the hospital, known as a shared care document. This details the responsibilities of both the GP and the hospital.
If you are having difficulties obtaining a regular supply of your tablets, please contact , senior arrhythmia pharmacist.
Atrial fibrillation is an abnormal heart rhythm. It is the most common heart rhythm disorder in the UK.
What Are The Symptoms Of A Low Heart Rate
It is very possible to have a slow heart rate and experience no symptoms. However, if you have symptoms but ignore them, it can sometimes cause more serious problems.
Consult your doctor if you are experiencing some of these symptoms and you have an associated slow heart rate:
- Lack of energy.
- Heart palpitations or flutters.
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What If I Forget To Take It
If you forget to take a dose of your beta blocker, take it as soon as you remember, unless it is nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
Common Medications To Treat Heart Rhythm Issues
Just like a band doesnt function right without its rhythm section, your body wont function right without a heart that stays in time. When heart rhythm issues occur, a medical procedure may be necessary to get it back in rhythm. But in many cases, medications can help regulate your heart rhythm without any additional interventions.
There are two general categories of heart rhythm medications: antiarrhythmics and anticoagulants.
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Causes Of A Slow Heart Rate
Its normal for your heart rate to change throughout the day. It speeds up when you exercise, slows down as you recover from exercising, and is usually at its lowest while you sleep.
Sometimes people have a slower heart rate than normal. This is called bradycardia, and it isnt necessarily a problem. Its diagnosed when your heart beats less than 60 beats per minute.
There are several causes of a slow heart rate. The most common are being young or physically fit. The heart is a muscle, and just like the other muscles in your body, it responds positively to exercise. When youre in good shape, your heart doesnt need to beat as often to supply your body with enough oxygen.
But a slow heart rate can also be a sign of a medical problem, such as a heart condition. If your resting heart rate is slow and you have other symptoms of bradycardia such as lightheadedness, call your doctor or go to the ER.
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Most Popular Afib Rate Controller: Digoxin
Digoxin, often known by the brand name Lanoxin, is the least prescribed ratecontroller. This is the drug that was derived from thefoxglove plant and, as the very first AFib medication, doctors have been using itto treat arrhythmias for a very long time. However, digoxin, is rapidly falling out of favor among doctors.
That because research has indicated that it mightincrease usersrisk of premature death. Even before this startling concernwas revealed, however, this nearly century-old medication was losing marketshare due to its myriad negative side effects, including loss of appetite, visionproblems, fatigue, and confusion. It also has a very narrow margin between adose that is strong enough to be effective and a dose that is strong enough tobe toxic, making precise dosing a precarious endeavor.
And, compared toother rate controllers, it is relatively weak in its rate-slowing effects.Despite all of this, however, digoxin is quite inexpensive and can be helpful in asmall subset of patients. One possible advantage of this drug, which comesfrom a class of heart-slowing medications known as cardiac glycosides, is thatit doesn lower blood pressure like beta blockers or calcium channel blockers.That can be good for people who struggle with low blood pressure.Beta Blockers, calcium channel blockers, and digoxin all have anappropriate place in the pharmaceutical quiver that doctors use to treat theirpatients.
Can These Afib Rate Controlling Drugs Slow Your Heart Too Much
Wee seen countless patientssually olderonesdmitted to the emergency rooms of the hospitals where we work withheart rates of under 45 beats per minute and are either fainting or comingclose to fainting from such a slow heart rate. That why,if you are on a rate controller, it vital to invest in a smartwatch or other device with which you can monitor your heart rate.
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Medications To Prevent Stroke
In AFib and atrial flutter, the backup of blood in the hearts upper chambers can cause blood clots and microclots to form. The pumping action of the heart can move these clots to the brain, causing a stroke.
Anticoagulants or antiplatelet medications may be prescribed to prevent these clots. Anticoagulants, such as Coumadin®, Eliquis®, Xarelto®, and Pradaxa®, affect the bloods ability to clot. Antiplatelet medications prevent plateletsblood cells involved in clot formationfrom clumping together. Aspirin is a commonly prescribed antiplatelet medication.
If you are unable to tolerate the side effects of these medications, your doctor might recommend you receive a left atrial appendage occlusion device, which limits the ability of clots to form in the heart.
If You Forget To Take It
If you miss a dose of sotalol, take it as soon as you remember, unless itâs nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
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How And When To Take Sotalol
Take sotalol exactly as your doctor has told you, and follow the instructions on the label. If youâre not sure, check with your doctor or pharmacist.
Youâll usually take sotalol once or twice a day.
Your doctor may advise you to take your first dose before bedtime, because it can make you feel dizzy. After the first dose, if you do not feel dizzy, you can take sotalol in the morning.
If you take sotalol twice a day, try to take it in the morning and in the evening.
What Happens During A Chemical Cardioversion
The procedure may be done in a hospital. Or it may be done in a healthcare providers office or in your home. Your healthcare provider will give you an antiarrhythmic medicine. This is given by mouth or through an IV. If you are treated at home, you will need careful follow-up with a cardiologist. If you have chemical cardioversion at a hospital, someone will check your heart rate and rhythm.
The type of medicine used will vary based on your type of abnormal rhythm and your other medical problems. The following are some examples of medicines that your healthcare provider might use:
- Flecainide, dofetilide, propafenone, amiodarone or ibutilide, for AF
- Adenosine or verapamil, for supraventricular tachycardia
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Calcium Channel Blockers To Slow Your Heart Rate
These are another type of blood pressure medicine. They relax blood vessels in your heart and slow your heart rate. Examples are:
Some of the possible side effects of calcium channel blockers:
Precautions: Skip grapefruits and grapefruit juice if youâre taking calcium channel blockers. They can change the way these medications work.
What Causes A Low Heart Rate
Many things can bring on a slow heart rate.
A heart malfunction
The most common cause for bradycardia is a malfunction in the hearts natural pacemaker, the sinus node. It controls how quickly the top and bottom heart chambers pump blood through the body.
AV Block
Another cause of bradycardia is atrioventricular block , in which the top and bottom chambers dont communicate well and your heart rate drops as a result.
Its like having virtual electrical cables and wires inside the heart, Dr. Baez-Escudero says. These deteriorate as we age. Common medications used in older populations can also often make bradycardia more significant.
Age
Age is the most common risk factor for developing bradycardia. The condition is most common among men and women over age 65.
Having certain illnesses or conditions
Illness or other conditions may also cause bradycardia. These include:
- Heart attacks due to coronary artery disease.
- A bacterial infection in the blood that attacks your heart.
- Inflammation of your heart muscle.
- Low thyroid function.
- Too much potassium in your blood.
- Certain medications, including beta blockers and antiarrhythmics.
Congenital heart defects, diabetes or long-standing high blood pressure all may make bradycardia more likely, says Dr. Baez-Escudero.
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What Do Beta Receptors Control
Beta receptors come in three different sub-types and have different functions depending on their location.
Beta-1
The beta-1 receptors are found mainly in the heart and kidneys. When activated, they do the following:
- Increase your heart rate.
- Activate the release of renin, an enzyme found in your kidneys.
Beta-2
The beta-2 receptors are found mainly in smooth muscle tissue. That tissue is in your respiratory system , blood vessels and your nervous system). When activated, these receptors affect various body systems in the following ways:
- Respiratory: Cause smooth muscle to relax so people breathe more easily.
- Blood vessels: Cause smooth muscle to relax and lowers blood pressure.
- Liver: Activate livers conversion of glycogen into glucose .
- Heart: Increase pumping force and heart rate.
- Nervous system: Cause muscle tremors.
Beta-3
Beta-3 receptors are found mainly in fat cells and in your bladder. When activated, they do the following:
- Cause fat cells to break down.
- Cause relaxation and increase in bladder capacity
- Causes tremors, which limits potential medical applications for B3 receptor-targeted medications.
Why Do You Need To Slow The Afib Heart Rate
Whenyour heart is beating away at 150 beats per minute, slowing things down is agood thing. But rate controllers slow your heart no matter if its in an activestate of AFib or not. And that can result inbradycardia, a condition in whichthe heart is beating too slow and thus the heart isnpumping enough oxygen-richblood to the rest of the body.
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Do You Also Need An Afib Rate Controller If You Are Also On An Antiarrhythmic
Given the side effects and other concerns of the AFib rate controlling drugs, people often wonder ifthey really need these drugs, especially if they are also on an antiarrhythmic. Ifthe antiarrhythmic your doctor has prescribed is flecainide or propafenone, theanswer is es.This is because the atrial flutter proarrhythmic effects offlecainide and propafenone are serious enough that you need a rate controlleraround to make sure the heart never beats too fast.
However, some antiarrhythmics do have some rate controlling effects. This isespecially the case with amiodarone, sotalol, and Multaq . As aresult, if you are combining antiarrhythmics with rate controllingmedicationsnd especially if your are elderlyou will need to monitor yourheart rate very closely, lest you find yourself with a heart rate that is so lowthat you pass out from lack of oxygen to your brain or or develop severe lowblood pressure.