How to manage my low heart rate and skipped beats?

Question

Hello Doctor,

I have been taking Amlodipine besylate 10 milligrams and Atenolol 50 milligrams daily for the past 10 years to manage an elevated heart rate of 120 beats per minute and high blood pressure measuring 150/90 millimeters of mercury (mmHg). Over the past two weeks, my blood pressure has averaged around 130/80 mmHg, and my heart rate has decreased to between 48 and 57 beats per minute. However, for the past week, I have been experiencing irregular heartbeats, such as skipped beats. I am unsure whether I should stop taking Atenolol or consider reducing the dosage.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your current situation, having well-controlled blood pressure around 130/80 millimeters of mercury (mmHg) but a low heart rate (48 to 57 beats per minute) and experiencing irregular heartbeat sensations such as skipping, requires careful evaluation, especially after long-term use of Amlodipine besylate 10 mg and Atenolol 50 milligrams. Atenolol is a beta-adrenergic blocker (beta-blocker) that works by reducing heart rate and blood pressure. However, your current heart rate is quite low, a condition known as bradycardia, which can cause symptoms such as palpitations, irregular beats, dizziness, or fatigue. The sensation of skipped or irregular heartbeats could be due to premature atrial contractions (PACs) or premature ventricular contractions (PVCs), and may be related to Atenolol’s effect on your heart's electrical conduction system.

Given that your blood pressure is under control, a change in your medication regimen may be appropriate. However, it is important not to stop Atenolol abruptly, as sudden withdrawal can lead to rebound tachycardia (increased heart rate), elevated blood pressure, or even angina (chest pain). You should consult your physician or a cardiologist as soon as possible to discuss your symptoms. They may recommend an electrocardiogram (ECG) or a Holter monitor (a 24 to 48-hour continuous heart rhythm recording) to better understand the cause of the irregular heartbeats. Depending on the findings, your healthcare provider may adjust the Atenolol dosage or consider switching to another medication.

In the meantime, continue monitoring your blood pressure, heart rate, and any related symptoms closely. If you experience chest pain, fainting, severe dizziness, or worsening palpitations, seek emergency medical attention immediately.

Regarding lifestyle, your efforts to lose weight and reduce refined sugar intake are commendable and beneficial for long-term blood pressure control. Maintain a heart-healthy diet, engage in regular physical activity as advised by your doctor, and avoid stimulants such as caffeine if palpitations worsen.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.