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I was put on Toprol XL and it just didn't work for me. It is a Beta Blocker and this type of drug I understand is a typical starting point for cardiologists. I started getting heart palpatations after a few months on it so my cardiologist referred me to an arythmia and electrophysiologist since they specialize more on this stuff. They took me off the Toprol and tried Proamatine - I have low blood pressure. This has caused high blood pressure so we keep cutting back the dose and added Effexor. Hopefully something will work. I have a heart monitor on for a month to see if we can capture something but I'm thinking the Pace Maker is the only thing that may help.