我患有快速性心房颤动（AFP）。您在接受心率加快治疗（RETA）后有过怎样的经历？

[keangkong]

I've only had one episode of Afib- but it sticks with ya forever!

I really want to add reta to my tirz, but I hear about the elevated HR and I worry it will agitate my heart. I take beta blockers for the Afib RVR, so maybe that will combat the heartrate issue?

Is the elevated HR temporary?

Is there a sizable group of people that don't get those symptoms at all?

I started taking reta 10 weeks ago. I currently take 1.9 mg per week. My average resting heart rate went up to the mid-50s. Yesterday I received an Apple Watch low heart rate warning stating that my heart had been beating at less than 40 beats per minute for 10 minutes. I decided to disable that feature. My cardiologist previously told me not to worry about my low heart rate. Still, it seems like for me the elevated heart rate passed quickly. Of course, that would likely change if I increased my dose.

I am unqualified to give even a lay opinion as to the dangers of a person who has had afib taking reta.

 

[Garbo]

What dose did you start Reta on and what was your titration schedule/protocol? When did you notice the HR sides?

Started at 2mg, titrated by 2s to 8mg over the course of a few months. Heart rate increased from the get-go and kept going up. Like 30, 40 points.

I ignored it. Why?

Short version: I was a willful idiot, deliberately wearing blinders.

Longer version: I was living in fantasy dreamland. I was energetic, thin as a rail, and told myself I mustn't waste all those expensive vials left in the kit. (Was back when Reta cost a lot more.)

Ended up paying a lot higher price than the Reta cost.

Make no mistake, my heart issue was my fault .

If I had stopped using sooner, I would've been fine. That's my only caution to fellow researchers: "Don't be like me." Pay attention and act accordingly and you'll be fine.

Reta is a wonder and appears to be safe for the majority of folks. I just wasn't one of them.

 

[Cantthinkofauserna]

What was your heart scare, if you don’t mind my asking? I had a bout of persistent afib last year that was ‘fixed’ with a cardioversion and seemingly ‘cured’ with an ablation. I’ve since lost 50 lbs on Tirz (plus diet plus intense exercise routine) and have been maintaining for the last 6 weeks or so. I’m also super fit now as well. Am curious about Reta as a tool to help me maintain (currently experimenting with various Tirz doses, from 3-week hiatus to 5mg, and various doses in between). I’m obviously weary about Reta given the reports of heart issues. Given I’m in maintenance I would start/stay at microdose levels.

Started at 2mg, titrated by 2s to 8mg over the course of a few months. Heart rate increased from the get-go and kept going up. Like 30, 40 points.

I ignored it. Why?

Short version: I was a willful idiot, deliberately wearing blinders.

Longer version: I was living in fantasy dreamland. I was energetic, thin as a rail, and told myself I mustn't waste all those expensive vials left in the kit. (Was back when Reta cost a lot more.)

Ended up paying a lot higher price than the Reta cost.

Make no mistake, my heart issue was my fault .

If I had stopped using sooner, I would've been fine. That's my only caution to fellow researchers: "Don't be like me." Pay attention and act accordingly and you'll be fine.

Reta is a wonder and appears to be safe for the majority of folks. I just wasn't one of them.

 

[runawayjim123]

Y'all are scaring me, my resting is 85-95 Maybe I table the idea of reta.

Mine is similar, I haven’t seen anything indicating this is a problem, have you?

 

[GimmeABreak]

I was diagnosed with Atrial Flutter (similar to AFIB) in Jan-24 which basically caused high heart rate (in the 160's) for a few hours at a time. I had a bunch of testing done by my cardiologist and basically my plumbing was fine but my electrical system wasn't. Treated with Nebivolol 2.5mg and told to monitor it. Went on vacation on a chartered yacht in April in the BVI's and my heart rate went to 161 and stayed there for >24 hours. (I think massive quantities of alcohol was to blame). Went to an ER on Tortola (I don't recommend) and they tried to chemically cardiovert me 8 times with no success. They called my cardiologist and he recommended meds to get it under control. Got stable enough to fly home and had a cardiac ablation in May. My heart rate has been kind of under control since the ablation but still all over the place and can go over 100 for no reason just sitting on the couch.

I started Tirz in late July and noticed about a 5-10bpm increase. I regularly hang out in the mid-80s. Made it to maintenance earlier this year and started reducing Tirz and ramping Reta with a slow titration (2mg 4w, 3mg 4w and now at 4mg). My average heart rate for Jan/Feb/Mar was 80 and RHR has been in the 65-67 range for the past 4 months. So far, Reta has not increased my HR any more than Tirz.

If you are switching from Tirz to Reta I recommend you follow a low and slow titration schedule and closely monitor your HR. If you find it is increasing too much (or you fall out of sinus rhythm) you can alway stop it and go back to Tirz.

 

[Garbo]

(...) and ramping Reta with a slow titration (2mg 4w, 3mg 4w and now at 4mg). My average heart rate for Jan/Feb/Mar was 80 and RHR has been in the 65-67 range for the past 4 months. So far, Reta has not increased my HR any more than Tirz.

If you are switching from Tirz to Reta I recommend you follow a low and slow titration schedule and closely monitor your HR. If you find it is increasing too much (or you fall out of sinus rhythm) you can alway stop it and go back to Tirz.

Yes. This is the way : ))

 

[raw_oyster_eater]

i think the survo elevates too but to a much lesser extent.

 

[Garbo]

如果不介意的话，能问问您之前心脏方面的情况吗？我去年得过一次持续性房颤，先是做了电复律“治好”，后来又做了消融术，似乎彻底“治愈”了。之后我靠Tirz（加上饮食控制和高强度运动）减掉了50磅，并且在过去六周左右的时间里一直保持着这个体重。我现在身体状态也非常好。我对Reta作为辅助维持体重的药物很感兴趣（目前我正在尝试不同的Tirz剂量，从停药三周到每天服用5毫克，以及介于两者之间的各种剂量）。考虑到之前有报道称Reta会引起心脏问题，我当然对它有所顾虑。鉴于我现在处于维持期，我会从微剂量开始并保持这个剂量。

请原谅，但我这次严重的心脏紧急情况非常罕见，如果在这里说出来，几乎会让所有可能在这个网站上的人都认出我。

（我的用户名反映了我极度注重隐私……如果你年纪够大，能理解这个梗，哈哈。）

再次声明，我并不是想吓唬你，Reta。我分享我的经历只是想提醒你注意自己的心率变化，并在必要时采取行动。

你很可能没事的！——因为你不仅身体健康，而且几乎可以肯定你不会像我一样被那些乱七八糟的想法蒙蔽双眼。

 

[raw_oyster_eater]

人们可以服用奈比维多来抑制它。

 

[Cantthinkofauserna]

请原谅，但我这次严重的心脏紧急情况非常罕见，如果在这里说出来，几乎会让所有可能在这个网站上的人都认出我。

（我的用户名反映了我极度注重隐私……如果你年纪够大，能理解这个梗，哈哈。）

再次声明，我并不是想吓唬你，Reta。我分享我的经历只是想提醒你注意自己的心率变化，并在必要时采取行动。

你很可能没事的！——因为你不仅身体健康，而且几乎可以肯定你不会像我一样被那些乱七八糟的想法蒙蔽双眼。

没问题。所以我想应该不是你之前有房颤，治好之后Reta又让你复发的情况吧！这正是我最主要的疑问/担忧。

 

[Garbo]

没问题。所以我想应该不是你之前有房颤，治好之后Reta又让你复发的情况吧！这正是我最主要的疑问/担忧。

不，如果真是那样，我肯定会告诉你的，我保证

 

[raw_oyster_eater]

随身携带一套球拍？

插到墙上的插座里就行了。搞定。

 

[chmuse]

我的情况也类似，我没发现任何迹象表明这是一个问题，你发现过吗？

我是女生，他们说是焦虑症。 症状没到需要担心的程度，所以我觉得应该在正常范围内。

 

[raw_oyster_eater]

我是女生，他们说是焦虑症。 症状没到需要担心的程度，所以我觉得应该在正常范围内。

请尽快服用一些让人心情愉悦的药物！

 

[GimmeABreak]

人们可以服用奈比维多来抑制它。

请注意，我没有任何医学背景，但Primum Non Nocere是一位医生，他在The Roundtable论坛上就此主题发表了一系列文章。以下内容是对他文章的概括。Reta

的胰高血糖素样作用会提高心率。奈必洛尔是一种β受体阻滞剂，作用于不同的通道。胰高血糖素是急诊室可用于治疗β受体阻滞剂和钙通道阻滞剂过量的药物之一。虽然这些药物可以降低基础心率，但Reta的胰高血糖素样作用实际上可能会抵消这些药物降低心率的效果。

我知道肯定有人会问有没有参考文献，所以这里列出来：（他总是会提供）

胰高血糖素的作用机制 https://www.vumc.org/poison-control...why-do-we-give-glucagon-beta-blocker-overdose

β受体阻滞剂和钙通道阻滞剂的毒性及治疗方案 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767195/

​ [archived internal link]

 

[raw_oyster_eater]

是的，所以我才说它能抑制症状，但不能缓解症状。

我服用的是20毫克奈必洛尔。

 

[GimmeABreak]

是的，所以我才说它能抑制症状，但不能缓解症状。

我服用的是20毫克奈必洛尔。

Damn!

I was on 2.5mg 2x and my BP was borderline low (90/60) so I couldn't really increase my dosage. A month or two ago I switched to metoprolol 25mg 2x and I am experimenting with substituting 20mg of propranolol for my morning dose every few days. The propranolol works great and better than the other two, but I don't think I want to switch to it 100% because of the side effects and I think its pretty hard on the liver.

I make the changes and let my cardiologist and electrophysiologist know when I have appointments with them. They are both like, "whatever works".

 

[raw_oyster_eater]

so i wonder and believe that heart rate has to go up to get energy burning and fat burning effect.

so if i take reta and a bunch of beta blockers what's the advantage of reta?

 

[GimmeABreak]

so i wonder and believe that heart rate has to go up to get energy burning and fat burning effect.

so if i take reta and a bunch of beta blockers what's the advantage of reta?

I don't know for sure, but I don't think is how it works.

If your heart rate sitting on the couch is 60 and mine is 90, I don't think I am burning more calories than you (other than the minuscule amount of calories burned by my heart muscles to incrementally beat more than yours).

 

[raw_oyster_eater]

if my heart rate goes from 60 to 90 i think i have to be burning more energy.

can't break the laws of physics. captin.

but maybe its not that much. a good subject to research further.