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ICD and Carvedilol and LBBB
ICD has been in for over two weeks now. During the last doctor visit, I was told my ICD is working 100% of the time. That means lower battery life and my Sinus node pace is overriden by the ICD.
My question is this: Why do I need Carvedilol (beta blocker) to slow my heard down when the ICD determines the rate?
I know Carvedilol is a Beta blocker and Aplha blocker. I stoped taking 5mg of Lisiopril which is an Alpha blocker.
I tried increasing the Carvedilol dose from 3.125 to 6.25 and I got chest pains. Doctor decided to go back to 3.125. Doctors believe in Carvedilol as a miracle drug. Help would be appreciated.
12 Comments
LBBB
by Baz - 2013-07-12 03:07:57
Hi everyone.
I have LBBB and this is how it was explained to me by my Doctor.
With LBBB your left ventricle beats out of sync with the right ventricle. They use a beta blocker to lower my natural heart beat to allow my Bi-ventricular PM to take over to synchronize the ventricles (thus the PM is needed 100% of the time).
When I was on a lower dose of beta blocker my natural heart beat was still doing it's own thing and the vents were out of sync still.
I'm now on a higher dose of beta blocker and at my last PM check they said my PM was working at 100% , thus synchronizing my ventricles with every beat.
My problems with the beta blockers are always tired and depression, apart from that I'm cooking with gas.
Best wishes
Baz
Carvedilol
by Vinnie - 2013-07-12 09:07:34
I just upgraded to a CRT-P from a 2 wire pacemaker
( AV-node ablation 4 years ago ) I started taking Carvedilol about 6 years ago ( COREG )-- I started at a low dose and built up to 25mg twice a day --- for me they are using it for CHF and blood pressure-- I also take DIOVAN for the same problem ---
Vinnie
Welcome to the club
by Grateful Heart - 2013-07-12 11:07:43
I have an ICD and am 100% too. I also have SSS and LBBB and take Carvedilol. I started taking it before my implant at 3.125 mg (5 years ago) and my Cardio at the time (no longer) raised it to 6.25mg, then 12.50 with no problems. It was then raised to 25 mg. and at that point I didn't feel right, so he lowered it back to 12.50, never explaining with this drug was for or the reason for the increments. I thought my condition was getting worse (maybe it was at the time).
Another Cardio told me to try and tolerate the 25 mg. because the higher dose would help strengthen my heart, not that my condition was worse. He explained they start off low and slowly double the dosage to see how you tolerate it. The 2nd time I started it at 25 mg. my body was fine with it, no ill effects. Still on 25 mg. now and I guess I will be for life.
The ICD will keep your heart rate from going to low. The Beta Blocker helps your heart from beating too fast and it also helps lower your blood pressure. So you have protection on both ends of the range, higher and lower. That's my simple explanation...LOL. There are others here who will explain it much better.
So, miracle drug?? So far, I'm sold !
My EF 5 years ago was 24%. It is now 50-55% so for me, the drugs and ICD have helped me tremendously. Having similar conditions, I hope the same for you.
Grateful Heart
I also take
by Acin - 2013-07-12 12:07:06
Carvedilol - 6.25mg twice a day and I have LBBB and I'm getting an ICD next week. It took me 3 months to get used to my meds. I used to take Lisiopril but it cause me to have an annoying, dry cough. I cannot tolerate anything in the Lisiopril family. So in place of the Lisiopril, I take Bidil but I don't know the mg.
Welcome to the club!
Typos
by HKS - 2013-07-13 09:07:14
I was hoping to edit out typos in the above post but can not locate where to do that.
Thanks Everyone and New Question
by HKS - 2013-07-13 09:07:45
I will keep on trying to go the the next step of 6.25mg carvedilol twice dayly. Since the ICD-D is working 100% of time I would assume Cavedilod would reduce the force of ventricular contractions in order to lessen the load on the heart. It is also suposed to increase oxygen in the blood.
Next question: I have had my ICD-D for two weeks an four days now. And the CRD-D moves to the top of my colar bone when I sleep and moves below the colar bone when I get up.
If this keeps up, I am worried about the leads breaking near the ICD-D. Leads are not repairable and people die on the operating table during lead removal.
Comments would be apreciated.
HKS
No worries
by Grateful Heart - 2013-07-14 01:07:07
There is plenty of room with the leads. If you were to look at an x-ray of your heart/ device, you should see a coil of the leads near your device. They leave plenty of slack for movement and stretching, etc.
Mine moves up upon laying down too....or sideways if I lay on my right side, left side is still not comfortable after 5 years. Freaky isn't it?
It's all normal so, all in all, it sounds like you are doing good.
Grateful Heart
Reply to Smitty
by HKS - 2013-07-14 06:07:32
Smitty,
17 years ago when I was running two miles 3 times a week I was taking Atenlolol (beta-blocker). It gave me heart pain until running. It went away during heavy exercise. I finally convinced my doctor to stop the Atenolol and the heart pain went away.
I am trying to increase the carcendilol dose but if pain starts, I will not go over the 6.25 mg two times day dose. Doctors are always reluctant to discontinue a medication. It still seems that the ICD-D is doing all the work. By the way, I feel great when I do some work in the yard. Of course I am (the ICD-D) overriding the effect of cervedilol by exercising? Maybe we have a tradeoff between long life and a good life. One more thing, I have swelling in my right ankle and lowering the efficiency of the heart with carvedilol would be so not good here?
ICD-D Movement 3 leads
by HKS - 2013-07-14 06:07:32
Greatful Heart, I greatly appreciate hearing this from you. You see, I used to run for exercise but had to stop after bad knee, torn hamstring and back surgery. Then I went to the gym at the university. I did all upper body exercises and I will continue after 6 weeks from implant. Strange, three people I talked to post surgery said I should never do this again. They were female practitioners. But, my male doctor, who did the procedure, said I should go back to doing my upper body exercises after six weeks. He did not want me to stop exercising.
Thanks all of you. By the way the ICD-D did not move so much this night.
No trade off
by Grateful Heart - 2013-07-15 01:07:24
It takes time to feel completely better sometimes and you are only 2 weeks out. The ICD is not overriding the effect of the drug by exercising...they are both doing independent jobs. Try not to over think it and just go by how you feel.
Interesting, all my Cardios are male and they know I exercise...no one has told me not to. Basically, do what you feel you can do and if it hurts, stop. Start off slow and see how it goes. I ran many years ago so I know you miss it. I have hip and back issues now so walking and the gym for me too.
The swelling in your right ankle, if not an injury, may be you are retaining water and may need a water pill. Check with your Doctor on that. If that's the case, you want to take care of it.
Good luck to you and happy exercising,
Grateful Heart
Oops!
by Grateful Heart - 2013-07-15 01:07:43
I just told an engineer not to over think it.
I just glanced at your profile, sorry, I should've checked first. So disregard that statement and.......carry on! :)
Grateful Heart
You know you're wired when...
You have an excuse for gaining an extra ounce or two.
Member Quotes
I just had this miracle implanted two weeks ago and Im feeling better.
Beta Blckers & Pacemakers
by SMITTY - 2013-07-12 01:07:48
Hello HKS,
Beta blockers are used to treat several different problems. Two of which I am familiar with are arrhythmia/afib and high blood pressure. When I was using the beta blocker to treat those problems they slowed my heart rate to an unacceptable level so I have a pacemaker to speed it up to the low PM set point. When I started this treatment that low set point was 60, but as the years have gone by (I'm now 84) that low set point is now 80. Also I no longer take a beta blocker as in addition to doing what it was supposed to do it caused severe fatigue. I felt like I had just finished a long distance run all the time, so I haven't taken a beta blocker in 6 or 8 years - or maybe more.
A pacemaker really can do only one thing for our heart and that is speed up the rate. We get pacemakers to increase our heart rate when the heart's natural PM lets the rate get too low. This low rate can be from the heart's natural PM to function as needed, or it can be from some medication such as beta blockers. The PM accomplishes this by monitoring the heart rate 24/7 and when the rate from the heart's natural PM drops below the low PM setting the manmade PM steps in and brings it up to low set point. By doing that the PM will sometimes cause our heart to have a more steady heart beat.
In case you missed it, I have always thought of beta blockers as while treating a heart problem they create one (slow heart rate) that a man made device (pacemaker) can correct.
While writing this I see Mz.A posted a message about their experience with Multaq, which is a beta blocker. What they describe is ever so typical for some of us that have had to take beta blockers.
Good luck,
Smitty