Experiencing Increased Stress During Periods. Should I Increase The Dose Of Atenolol?

Posted on Wed, 27 Nov 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 27 Nov 2013 Answered on

Wed, 18 Dec 2013 Last reviewed on

Question : In 6 yrs ive had 5 bouts of afib highly symptomatic all terminated in cardioversion approx 2 hrs after onset. Since my early 2o's have 3500 pac's/ day. During periods of increased stress including the flu or edpecially upper gi upset ill have days when the pac's become highly symptomatic and theyre bothersome. Why do i feel them during these periods of time and should i increase my atenolol during these times . Cant tolerate fleicainide causes mecto have migraines. Thx

Answered by Dr. Anantharamakrishnan (33 minutes later)

Brief Answer: Atenolol up to 100 mg / EPS can help Detailed Answer: Hi friend, Welcome to Health Care Magic Stress stimulates the sympathetic nervous system, which will up the heart rate and/or pressure – directly or by production of adrenaline The maximum dose of Atenolol is 100 mg. It helps in Anxiety and stress too – but, can bring down the resting heart rate and blood pressure... If there are no clues and if the problem is still bothering to the extent of interfering with life style, you may need advanced investigation – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. There are advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS. The treating doctor may suggest them depending on need, based on his assessment of the situation. Good luck Take care Wishing all well God bless

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (1 hour later)

Thank you I turn 55 in XXXXXXX probably time for epstudy thanks for the info. So the increase in adrenaline is why I feel the pacs more right? Thx again happy holidays. Good news is I'm otherwise healthy ex athlete and had a negative angiogram recently along wih NL echo did not do stress echo as when my hr increases over 100-110 trigger for a fib. Thx again

Answered by Dr. Anantharamakrishnan (7 hours later)

Brief Answer: You are well / you will be well Detailed Answer: Hi A negative angiogram and normal echo are greatly reassuring – practically rule out diseases of the heart muscle, valve and coronary arteries. The cause is the conduction system (nerves) and that can be addressed by EPS Prognosis is excellent Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar