He could benefit from increasing his metoprolol dose, however, in the hospital it was noted that he was bradycardic in the morning with a pulse rate down to the 50s, and we were concerned with making this patient bradycardic in the setting of congestive cardiac failure. 
He could benefit from increasing his metoprolol dose , however , in the hospital it was noted that he was bradycardic in the morning with a pulse rate down to the 50s , and we were concerned with making this patient bradycardic in the setting of congestive cardiac failure .