I have been taking beta blockers since I was in grad school at age 24 at Arizona State University. Iin 1981 when while playing basketball my heart beat sped up, and after driving myself to the hospital my pulse rate was measured at 256 beats per minute. The ER gave me medication to slow my heart rate down, and I followed up with another doctor who told me that I had a mitral valve prolapse, but although symptomatic, after conducting an echocardiogram, he stated that it was not of concern, but gave me a prescription for a beta blocker to take once a day to prevent further episodes of tachycardia.
I maintained taking the beta blocker because I would still occasionally have intermittent tachycardia, usually occurring shortly after I fell asleep. However, my heart rate would come back to normal within a few minutes. About three years ago I had another episode and went to the ER, and although my heart rate was measure at only about 130, my cardiologist said the data told her what was causing the problem (may not even have been MVP; she said if I had MVP it was a mild case), and that it wasn't serious, but that if I desired they could stop future instances by doing a cardiac ablation. Since my symptoms were not serious, I decided against the procedure.
During late spring/early summer of this year I went off the beta blockers because I had not had an tachycardia episodes in a couple years, and my blood pressure readings were becoming low; e.g., 90/60. However, I had no associated symptoms with the lowered blow pressure other than perhaps some shortness of breath that I thought could have been a reaction to a three month use of 100 mg of Nitrofurantoin a day as a prophylactic for UTI's. However, a pulmonologist did a comprehensive pulmonary function test and said my lungs were perfectly normal, and I could exercise without shortness of breath.
However, I noticed that my heart rate was mostly over 100 when I went to the doctor’s office, and when it was 121 one visit I inquired of my primary care physician regarding my concern for the elevated heart beat the last two months. He ordered a blood count and thyroid test, and the results showed they were normal. He replied, "Your blood count and thyroid test are normal, meaning anemia and thyroid problems aren't causes of the tachycardia we're seeing. Anxiety could be a cause, or just a benign tendency for a fast heart rate………we could consider restarting metoprolol, though if you're feeling OK, we could just observe. I recommend you ease into regular exercise again." I went back on the beta blocker and my heart rate returned to normal (65-70). MY PCP said in response that, "Yes, it's possible to have rebound tachycardia after stopping metoprolol. Not exercising and stress could be additional factors as well." He also ran a blood panel which showed normal levels with the exception of
Lymphocyte which measured 17% (normal was noted at 26-46%). Abs Lymphocyte was measured at 1.2,, barely in the normal range.. MY PCP said that,, "Long explanation short: the lymphocytes are of no concern; I had an urgent care nurse who expressed similar sentiments, saying that my high end Neutrophil % of 72 had a balancing effect.
I also had a stress test at my cardiologist’s office (treadmill), and the results were normal. I asked if I should go back on the beta blocker on a regular basis, and asked whether every other day would be a good idea. She said yes.
However, this morning my pulse rate was 125 (I had not taken a beta blocker in three days as my pulse was normal through Sunday evening), so I took a beta blocker and within a few hours my pulse was down to 75.
I know it may be difficult for you to respond without an examination and the limited data, but do I know need to continue to take the beta blocker every other day to prevent this from occurring, or could I somehow wean myself off of the beta blocker to prevent a rebound effect.
Appreciate reply and any additional observations you may have. Follow-up will be asked as new question(s).