I was diagnosed with AF about 4 years ago, am on Warfarin, & Bisoprolol 1.25mg but still go into AF about every 3 to 4 weeks,

[brianfer]

I have been on various drugs but none of them stop me going into AF which always start sometime during the night so I wake up with the problem they last most of the day, Bisoprolol i have been on about 3 months

[Hidden]

Hi Brian, beta-blockers don't work on me and quite a few other people as I understand it. Maybe you need rhythm control drugs instead? Are you seeing an EP or cardio, as I think these can only be prescribed by them if you're in the UK.

Koll

[Hidden]

Hi brianfer,as nobody mentioned ablation to you if you,ve had af on and off for 4 years.Are you just under your Dr or have you seen a cardiologist or an EP

[brianfer in reply to Hidden]

When I was in hospital about a year ago a Doctor on the A&E team suggest I should have ablation, he discribed it as having 2 wires soldered together in the heart, so far the consultant I've seen some type of drug, could be down to my age 73 but quite fit, thanks

[CDreamer]

Hi Brianfer well the Bisoprolol is obviously not keeping you in NSR, you are taking the minimum dose. You say that you have also tried other drugs which have also failed so I would agree with the others, ensure you are seeing an EP, if not ask for a referral and ask about other treatment options such as ablation.

[rosyG]

If your AF always starts a night it may be vagal AF and if so Beta blockers and Digoxin shouldn't be taken as they make it worse.

Please get an appointment with an EP as suggested by others and get the correct treatment

A study reported in the ESC in 2008 found that 73% of the vagal AF patients were given incorrect medication and 19%were in a much worse position at the end of 1 year and none of the ones with correct treatment were, so it's very important to look into this as soon as you can- do let us know how you gt on

[RobertELee in reply to rosyG]

"If your AF always starts at night it may be vagal AF" You may well be right Rosy but what is your understanding of the basis for that comment? Just curious....

[rosyG in reply to RobertELee]

I discovered this through researching all the cardiology journals leelec as my GP put me on the wrong medication! I have been involved in the new AF pathway our CCG are designing ( as patient rep)and the cardiologist at our local hospital has this information on his web-site- ie betablockers and digoxin are contra-indicated with vagal AF.

Some people have a mixture of both types but vagal AF typically starts during the night/ on change of position when lying down/ getting up and also is linked to meals as the vagus nerve runs through near the heart and oesophagus etc

The cardiologist is going to design a triage sheet asking patients if they have noticed AF starting at night or after meals so we are getting somewhere at last!!

[RobertELee in reply to rosyG]

Interesting, thank you Rosy. Me to a tee. Though I haven't had an episode for a little while they always came after a meal or more often, when lying down to sleep at night.

[rosyG in reply to RobertELee]

PS Leelec- this is from one study- it's the type of information I used to diagnose mine!! EP then agreed with me at the Brompton!

Patients were considered to have vagal AF if they met the following clinical criteria: (1) most attacks occurred at rest or during sleep, and generally terminated with exercise or in the morning; and (2) if available, typical electrocardiographic findings (preceding sinus bradycardia and a slow ventricular response during AF) were present. Ten patients fulfilled these clinical criteria (vagal AF group); eight men, mean (SD) age 59 (12) year......... O

[steve60]

Warf and bisp won't stop afib. Something like flecanide will do that. Plus you must have some other heart condition or be over 65 to have been prescribed those ?.

[Beancounter Volunteer]

Hi Brianfer, Steve is right that warfarin and Bisoprolol will not stop A Fib, but I regret mistaken when he says you must have another heart condition or be over 65 to be prescribed them.

Bisoprolol is a rate control drug, it will reduce your heart rate and to some extent your blood pressure, meaning that if and when you have an A F incident usually the heart rate will be lower. It's probably the most commonly prescribed combination usually after first diagnosis at any age, and your EP when you see him will review what you should be taking and possibly change your drugs.

You mentioned being on other drugs, were they rhythm control such as Flecanaide?, that sometimes is prescribed to supress incidents, but only usually by your Cardio/EP not by a doctor.

I agree with everyone else, get in front of an EP as soon as you can, and have your drugs reviewed.

Be well

Ian

[brianfer in reply to Beancounter]

Hi Ian, I'm 73 not sure what other drugs I've been on, most of them so far have quite bad side effects for me, I saw my GP yeterday to get checked re being in AF that day, he going to refer me to the heart consultant at JR hospital Oxford, I live in Milton Keynes, having a bit of a problem finding my round this web site? but thanks for the info/help

[Beancounter Volunteer in reply to brianfer]

Hi Brianfer,

Well that's the best possible result, the JR has an excellent cardiology department, but do ring your doctor and ask to be referred to an ElectroPhysiologist, (EP) they are the specialists in heart rhythm disorders which of course are electrical, whereas most Cardiologists deal with the heart itself. We often describe it as the difference between plumbers and electricians, and you need an electrician.

Good luck and let us know how it goes

Ian

[POUNDING2]

Hi Beancounter

I have had AF for a number of years and I have seen a cardiologist twice but never an EP. Does that matter/

[POUNDING2]

Sorry, pressed the wrong button. Just wondering if I should be seeing an electrician?

Thank you