Tenormin, which is the brand name for Atenolol, is from the family called beta blockers. They act to slow down the heart rate and lower blood pressure. Many people use these meds to treat high blood pressure. In Afib these medications are known as “rate controlling” meds and they don’t keep your Afib asleep but can slow the rate of it down to make it less symptomatic and more tolerable. This is the simplest and least risky way to treat the symptoms of AFib. See my video on “Rate Controlling Meds in Afib Explained.” Because AFib is not directly life threatening as long as one doesn't develop a clot and a stroke (which is mitigated with a blood thinner), everything else we as physicians do is mainly to treat symptoms. And since everyone's symptoms are different (some people have AFib episodes going at mostly going at rapid speeds of 150-180bpm and they feel like their heart is going to beat out of their chest and others average HR in AFib is 90-100bpm and they barely feel it) and their stage of progression is different (anywhere from spending 1% of the time in AFib to 100% permanent) how we treat those symptoms has to be customized to the patient. It really isn't "right or wrong" way of treatment since everyone's symptoms and time spent in AFib are different. It is more risks and benefits. I could treat your AFib the least risky way by just placing you on a "rate controlling" medication that doesn't keep you out of AFib or get rid of it but just slows down your episodes to a level where hopefully you can tolerate the palpitations. These meds are simple, have no long term side dangerous side effects, but they aren't doing much, just slowing things down. But if you were 90 y/o you might tell me that as long as the AFib symptoms aren't going to kill you that you want the least risky treatment and going in and out of AFib but just slower works for you. But if you were 40 or 50 y/o you might feel that isn't good enough. You want me to keep you in normal rhythm feeling good. So then I can either put you on an antiarrhythmic medication (AAD) to temporarily suppress your AFib by keeping it asleep (until your AFib grows strong enough to override it since it is always progressing onto more walls and stronger). These meds are stronger than "rate controlling" meds and have potentially more dangerous side effects (this is why a non-cardiologist should never prescribe these drugs as they don't know what they are doing and who they can safely use them on) but a cardiologist, especially a cardiac electrophysiologist, can safely use them to keep people in normal rhythm often for years at a time. But these meds don't work forever because they don't get rid of the underlying AFib cells/triggers and they don't keep the pt from getting older and growing more; they just mask the cells until they can't mask them any longer. If you are 70-85 y/o you might feel this is the best solution: keeping you in normal rhythm feeling great but less risk than a procedure. Then there is the AF ablation. If done by a skilled, experienced EP with a lesion set (simple versus advanced) tailored to the pt's stage of progression, often the AFib can be reduced to zero or close to zero and the pt can maintain normal rhythm without a medication. But this treatment option has the most risk since it is a procedure. Plus it isn't a permanent cure as the AF will eventually grow back in other walls that weren't ablated, but this can sometimes take years to occur. This is the reason I take the time explain all of this to patients because everyone's situation is different and their age, goals, and risk tolerances are different. While most 80 y/o tell me that given their age they would prefer to go from least risky to most risky in terms of symptom treatment, occasionally I get an 80 y/o that is healthy and they tell me after the whole discussion that their philosophy has always been to take more risk up front to try to get an ideal result without meds if possible and they still want me to proceed with an ablation. On the other hand, while most patients 40-65 y/o opt for an AF ablation at some point given their younger age, occasionally one tells me that a 1-2% risk of a procedure scares them and they would never consider it. My job is not to bully patients into a procedure or to apply my personal algorithm of symptom control to the pt but rather to give pt's options and to give them the knowledge so they can decide what is best for their specific situation based on age, level of symptoms, and personal preference. Unfortunately there is a dearth of information (and often misinformation) out there about this which is why after 20 + years of practice I decided to do something about it and created this educational series. Unfortunately, over the years I've often seen general cardiologists practice 30 y/o medicine and give their pt's a simple rate controlling med and blood thinner and tell them AFib won't kill them and to live with it irregardless of symptoms or age, and they never refer the pt to an EP or talk about the option of ablation. Similarly, having practiced for 10 yrs in CA and 10 yrs in FL, I've sometimes seen less scrupulous EP's spend less than 5 minutes explaining anything to their pt's and tell them they have to have an AF ablation implying that otherwise they will die, probably because they make more money to do a procedure than to use a medication. Then they do a simple “one wall’s worth” ablation called “Pulmonary Vein Isolation or PVI” irregardless of the pt's AF stage of progression, do it 3-4 times because it isn't enough to get rid of all their AFib but based on our billing codes submitted to health insurances they get paid for doing something not necessarily for getting a specific result, and then they put them back on an antiarrhythmic med to suppress whatever AFib is left over. Obviously the right way to practice is somewhere in between.
Tenormin seems to help me 25mg.
Tenormin, which is the brand name for Atenolol, is from the family called beta blockers. They act to slow down the heart rate and lower blood pressure. Many people use these meds to treat high blood pressure. In Afib these medications are known as “rate controlling” meds and they don’t keep your Afib asleep but can slow the rate of it down to make it less symptomatic and more tolerable. This is the simplest and least risky way to treat the symptoms of AFib. See my video on “Rate Controlling Meds in Afib Explained.” Because AFib is not directly life threatening as long as one doesn't develop a clot and a stroke (which is mitigated with a blood thinner), everything else we as physicians do is mainly to treat symptoms. And since everyone's symptoms are different (some people have AFib episodes going at mostly going at rapid speeds of 150-180bpm and they feel like their heart is going to beat out of their chest and others average HR in AFib is 90-100bpm and they barely feel it) and their stage of progression is different (anywhere from spending 1% of the time in AFib to 100% permanent) how we treat those symptoms has to be customized to the patient. It really isn't "right or wrong" way of treatment since everyone's symptoms and time spent in AFib are different. It is more risks and benefits. I could treat your AFib the least risky way by just placing you on a "rate controlling" medication that doesn't keep you out of AFib or get rid of it but just slows down your episodes to a level where hopefully you can tolerate the palpitations. These meds are simple, have no long term side dangerous side effects, but they aren't doing much, just slowing things down. But if you were 90 y/o you might tell me that as long as the AFib symptoms aren't going to kill you that you want the least risky treatment and going in and out of AFib but just slower works for you. But if you were 40 or 50 y/o you might feel that isn't good enough. You want me to keep you in normal rhythm feeling good. So then I can either put you on an antiarrhythmic medication (AAD) to temporarily suppress your AFib by keeping it asleep (until your AFib grows strong enough to override it since it is always progressing onto more walls and stronger). These meds are stronger than "rate controlling" meds and have potentially more dangerous side effects (this is why a non-cardiologist should never prescribe these drugs as they don't know what they are doing and who they can safely use them on) but a cardiologist, especially a cardiac electrophysiologist, can safely use them to keep people in normal rhythm often for years at a time. But these meds don't work forever because they don't get rid of the underlying AFib cells/triggers and they don't keep the pt from getting older and growing more; they just mask the cells until they can't mask them any longer. If you are 70-85 y/o you might feel this is the best solution: keeping you in normal rhythm feeling great but less risk than a procedure. Then there is the AF ablation. If done by a skilled, experienced EP with a lesion set (simple versus advanced) tailored to the pt's stage of progression, often the AFib can be reduced to zero or close to zero and the pt can maintain normal rhythm without a medication. But this treatment option has the most risk since it is a procedure. Plus it isn't a permanent cure as the AF will eventually grow back in other walls that weren't ablated, but this can sometimes take years to occur. This is the reason I take the time explain all of this to patients because everyone's situation is different and their age, goals, and risk tolerances are different. While most 80 y/o tell me that given their age they would prefer to go from least risky to most risky in terms of symptom treatment, occasionally I get an 80 y/o that is healthy and they tell me after the whole discussion that their philosophy has always been to take more risk up front to try to get an ideal result without meds if possible and they still want me to proceed with an ablation. On the other hand, while most patients 40-65 y/o opt for an AF ablation at some point given their younger age, occasionally one tells me that a 1-2% risk of a procedure scares them and they would never consider it. My job is not to bully patients into a procedure or to apply my personal algorithm of symptom control to the pt but rather to give pt's options and to give them the knowledge so they can decide what is best for their specific situation based on age, level of symptoms, and personal preference. Unfortunately there is a dearth of information (and often misinformation) out there about this which is why after 20 + years of practice I decided to do something about it and created this educational series. Unfortunately, over the years I've often seen general cardiologists practice 30 y/o medicine and give their pt's a simple rate controlling med and blood thinner and tell them AFib won't kill them and to live with it irregardless of symptoms or age, and they never refer the pt to an EP or talk about the option of ablation. Similarly, having practiced for 10 yrs in CA and 10 yrs in FL, I've sometimes seen less scrupulous EP's spend less than 5 minutes explaining anything to their pt's and tell them they have to have an AF ablation implying that otherwise they will die, probably because they make more money to do a procedure than to use a medication. Then they do a simple “one wall’s worth” ablation called “Pulmonary Vein Isolation or PVI” irregardless of the pt's AF stage of progression, do it 3-4 times because it isn't enough to get rid of all their AFib but based on our billing codes submitted to health insurances they get paid for doing something not necessarily for getting a specific result, and then they put them back on an antiarrhythmic med to suppress whatever AFib is left over. Obviously the right way to practice is somewhere in between.