Jared replied: "Metoprolol is nothing special. I really don't understand all the fuss about such a medication. It works with the Beta1 receptors. It is very predictable -- Aside from a secondary use of performance anxiety reduction, it is used primarily for hypertension. Not Atrial Fibrillation -- You said your heart rhythm went back on its own and stabilizes (I assume) in that you are no longer in atrial fib at the moment or have been. Regardless, this medication does little if anything at preventing or stopping the fibrillation. It works by reducing cardiac output, reducing heart rate (pulse), and heart contractility. These effects contribute to its blood pressure lowering abilities. It has a short half life, meaning you need to dose it several times a day to prevent rebound effects and just as importantly allow it to stay at balanced serum levels for maximum effect. Which is why you are given the slow release version .. for convenience. :) This isn't the king of beta blockers, but in the preparation you have it isn't a bad choice for HYPERTENSION. They dosed you with betablockers during your afib in the hospital more because of your tachycardia - fast heart rate.. In lowering such a high rate, .. it helps with the sinal impulses in that particular heart node to mediate atrial fibrillation. The medications of choice for Atrial Fibrillation would be (and I'm sure you got this..in the hospital) is - anti arrhythmic. Such examples are: Cordarone, Norpace, Tikosyn, Tambocor, Rythmol.. etc. There are quite a few. These work by slowing your heart rate, and working on the sinus node as referred to before. Some really concentrating on the A/V node. Basically without explaining why this happens (because you probably know all of it already) -- they work on the heart tissues and the electrical impulse action and reactions in the heart to reestablish normal rhythm. Sort of like a liquid pacemaker until the heart 'switches back on its own to this rhythm'. Often people with atrial fib never switch back. In these cases they will either opt for a pace maker or depending on the severity of the afib, age, and other co-morbid factors they will opt for medication. Anti arrhythmic meds as explained before. If these work,.. then they are preferred over such a device implant. I have seen both kinds of patients whose heart will regulate with simply medications, and others whom rhythm will flip flop constantly with tachy and brady occuring concurrently -- that medications just have zero effect on. Some of these people don't have any negative effects from their afib and we just monitor.. most are fitted for some type of device or allowed to continue to try various AA meds to see if things will improve over time. With you -- the only thing that worrys me slightly is the Sinus node occaisonally getting out of wack. IE: You developing transient atrial fibrillation. The elevated heart rate is highly common in afib,.. with the combination of the emergency room, people acting fast and moving about, your own nervousness , and so on. The heart is trying to restablish normal rhythm .. believe it or not the high heart beat is part of the body's own built in reaction to reestablish this rhythm. But the body over compensates, naturally,.. But you say your rhythm like the other few times it has occurred goes back to a normal rhythm and stays there. *if* your rhythm has stayed non afib for years at a time.. then this is what I would do. You are most likely getting a dose of 150-400mg's daily. You cannot (or shouldn't) reduce the medication suddenly , or cold-turkey shall we say. You will need to reduce it slowly over several weeks. A titration downard. If you have some of the non time released version it would be somewhat easier.. but you can break the time released versions of this medication and not lose the time released action. I would recommend starting by breaking it into quarters -- Reducing a quarter the first week. (Taking 3/4's dose for a week). 2nd week, reduce another quarter -- stay on half a pill. 3rd week, stay on the half.. 4th week, reduce to one quarter -- 5th week -- Stop completely. Sounds tedious but needs to be done. There is rebound hypertension, elevated heart rate, increased contractility and so on that can and likely will occur because your body has adapted to the medication. What is key during all of this -- Have an accurate Blood pressure monitor. -- Monitor several times a day every day. Use a legal pad, or some sort of log, to write down your readings each time... note the date, the time of day, the systolic and diastolic readings.. and in your case note the pulse (heart rate). If at any time your blood pressure exceeds 140/90 continue to retake the pressure in a seated or laying down position. If it does not go down re-up your dose slightly to stabliize the pressure. if it is reading 141/92 or so... it isn't anything major.."