I've just seen a private cardiologist in Sheffield. Told him that Bisoprolol does not agree with me, makes me very depressed, even suicidal. Cardiologist is steering me towards catheter ablation but I'm not keen and don't want to be bullied into this. I would prefer a pacemaker but my cardiologist says no. I'm in a quandary and getting to the point I just don't know what to do anymore. What happens if I just stop taking the bisoprolol?

24 Replies

  • Hi Deeferdi

    I certainly agree that you should not be bullied into anything, almost all of our options are elective ones and need your permission, and in most cases there are alternatives.

    Usual proviso is that I am not medially trained in any way

    So let's start with alternatives to Bisoprolol, there are at least 5 by my reckoning, although I am aware that most cardios seem to find Bisoprolol their first choice, as I understand it has an element of rhythm control as well as rate. But lots of other beta blockers, and calcium channel blockers available.

    I wouldn't stop taking any drug, simply because it is controlling your heart rate, and the last thing you want to is be ill by withdrawal, all of these drugs are powerful and therefore often a planned withdrawal or changeover is necessary. I would probably in your shoes perhaps see another EP and get their opinion, you said you were private so that should be relatively straight forward I would think.

    As for pacemakers, you do know they control the ventria and not the atria?. So the A Fib remains I understand, so not sure what you would gain by that, but perhaps in your particular circumstances it might be an option.

    Main thing is you need to trust the doctor you are seeing, and it sounds like that has broken down, so simply go and see someone else.

    Be well


  • Can I just add a little comment about Bisoprolol being the beta blocker of choice. I have recently been put onto Bisoprolol . Fortunately up to now i have been ok taking it the doctor just had to adjust my dosage down.I wasn't put on a beta blocker because of AF, my AF only diagnosed about 5 years ago and I am warfarin and Digoxin for it and have stayed under control ever since I was taking the beta blocker after having had two coronary artery bi-pass surgeries with 18 years in between them. I was on Atenolol for all these years and thought I was ok. I have Asthma and have inhalers for it. The nurse who does my asthma checks was going to change my inhalers . I got the new prescription only to have the doctors ring me the next day to say they had had a discussion about my medication and that they had decided to leave my inhalers alone and change my beta blocker. I was told after my last heart attack and surgery 14 years ago that Atenolol can actually cause you to become Asthmatic and that is what happened to me but the lesser of two evils was to give to me as none of the other drugs at the time suited me. What no one told me until I developed breathing problems again that the way the Atenolol works all through your body also works the same way on your lungs and breathing tubes and that is to slow them down. This put me in danger of going into respiratory arrest and they said although Bisoprolol works in the same way it doesn't have the same effect on your lungs so this is why i was prescribed it. Im sorry this is long winded and not exactly related to the original post but thought it may make everyone aware that there is no norm in AF or any other illnesses actually so just get a doctor you can trust ( and no I personally wouldn't go private as they do it for the money ) ask questions all the time about your own condition. Sorry once again for the long tale it was the only way i could highlight how the beta blockers work in my own case.

  • Hi

    My cardiologist mentioned ablation early on in my experience of AF and I was horrified. He said he was just telling me my treatment options and at that stage I couldn't believe I would be symptomatic enough to consider it. However since my symptomatic episodes of fast AF (and several trips to A&E), 6 months down the line, I am now booked in for an ablation as it seems my best chance of getting symptom and drug free.

    I don't see why you can't try another drug, if you want to go down a drug strategy for now. I've been through Sotalol, Bisoprolol, Metoprolol, Flecainide and am currently on Propafenone. Folks on this site also mention loads of other drugs I've never heard of.

    Maybe ask why your cardiologist doesn't think alternatives are suitable for you. It's your health and you shouldn't be afraid to try and optimise treatment to suit you nor be pushed into anything you are not ready for or happy with.

    Take care.


  • In my own long standing experiences, the ony drug that stopped AF is amiodarone. That worked very well for about 2 years. No problems while taking it, but did have a Thyroid issue when it was stopped.

    But thyroid has settled since then (10 years ago)

    Since then I have been on Sotalol and currently Bisoprolol 2.5mg/day.

    I have not really noticed any difference between Bisop and Sot. either in the way they control HR or any other side effects (my main issue seems to be in clarity of thought, decision making, but of course that could be down to other issues non heart related.

    I was offered AF and ablate 12 years ago, and turned it down, as it was clear that it would not stop AF and is irreversible. I had assumed back then that the drug companies would come up with a safe drug to stop AF. I still think that will happen sometime in the future as the incidence of AF increases.

  • Prof Camm was talking about new drugs that are being developed at the cardiology conference I attended last week - not available in the UK yet- so I think attempts are continuing,

  • Hi

    I saw an EP in Sheffield privately too who rather bullied me ............a long story, but later I saw one privately in Birmingham for a second opinion and was delighted by the options and support and care...and have now had two ablations there, and so far so good!! Bisoprolol makes many people feel did me too and now glad to be off it post ablation.

    I did see another EP in NHS in Sheffield who was more supportive but did not work in the private sector.


  • Thank you for all your replies.

  • I agree you should not be bullied into anything but I have to say that many EPs feel early intervention by ablation is the best approach thus saving you from a lifetime on quite nasty drugs. Steering is hardly bullying from what you say. Personally I have never had a problem with ablation having had three before I was "cured" and always tell people I would rather have that than dentistry!. Those here who found their way down that route often agree.

    Regarding Pace and Ablate this should be a very last resort and you would be dependent on a machine whilst not stopping the very problem you want to. Because the pacemaker only controls the ventricle you would have a steady heart beat yet still be able to feel the atria fibrillating.

    Do not stop any drug except under supervision as you can have nasty rebound effects

    You need to read all the fact sheets available on the main AFA website so that you are better informed and can have meaningful discussions with your doctors as knowledge is power.

    Good luck whatever you decide and do make any decision informed and not emotive.


  • Agree with everything Bob has said, if I had been lucky enough to have been offered an ablation in the early stages I wouldn't have gone through nearly as much anxiety and ill health for nearly 6 years. AF is normally progressive and the efficacy of early ablations procedures raises the success rate.

    What appalls you? It is a well researched procedure with few risks and a fantastic success rate. You are in hospital for less than 24 hours and have a good chance the of not having to take any drugs which are possibly going to give you long term side affects which are often more serious than AF.

    I didn't like taking Bisoprolol either, had breathlessness and tiredness to a ridiculous degree and never got used to it so it is truly great to not have to take anything as no AF after 2 ablations.

    And you should never allow yourself to be bullied into anything you don't want. sounds to me as though this person is a tad over enthusiastic without the ability to relate to people. That doesn't mean he isn't correct though.

  • I'm not in the early stages, I've had AF for just over 10 years now.

  • Your experience sounds very much like my own. Eventually I'm free of bisoprolol after going down to 1.25 tabs twice daily. I saw an EP about four years ago who suggested trying a cardio version and wrote to the cardiologist to put me on Flecanide. The cardio version worked but at that time was still on 2.5 tabs of bisoprolol twice a day. They made me feel bad and had horrible effects. The doctor eventually said I was allergic to them and only take in an emergency but would prefer me to go to AandE if I start an attack ( I'm loath to do this). I think they infuse Flecanide which acts quickly. A different cardiologist added Ibersartan and I'm feeling good, I've also been taking sodium tabs for the last two weeks and have blood tests to keep an Eye on the kidney and liver etc...

    All NHS and arrived at together with my doctor who is a very listening man. I've also had to argue about how I felt with cardios and the EP who wouldn't do an ablation when I wanted one (I was in tears) but he said He would see me again anytime I wanted. My heart isn't enlarged and everything else seems to be working ok. I do so wish you well in your quest. The main pages have loads on them ,you've probably read them , there are people on the site who all have different experiences but we are all hoping for the same outcome . Keep well good luck. Terjo.

  • Would you like me to give you details of the EP I am under in Birmingham? By private email? Ann

  • Hi Deeferdi

    Have you seen a cardiologist or an electrophysiologist? I assume the later given that they have suggested ablation but could be wrong. I agree with Beancounter that a pacemaker would not do the job for all the reasons he mentioned (please note I am not medically trained in any medical discipline). The cardiologist would have suggested it as an option if it was useful to you.

    Please do not be bullied. A second opinion may be useful to you.


  • Take it easy with yourself. I've had the same with one brand of propafenone (Accord). I took it, and within days I felt awful, end of the world. I was ready to pack everything up and being suicidal would have been next. Stopped the drugs, back to normal quickly, tried them again, down I went. The other brand of propapefone (Arythmol) did not affect me at all like this although it made my sense of time go skew-wiff.

    I felt dreadful on Bisoprolol as well, but not actually depressed.

    Isn't there something else you can try whilst waiting for an ablation? My EP tried 4 on me to get one that worked without horrible side-effects.


  • Have to say when I meet my EP in December if he offers me an ablation I would take it straightaway. In fact I would bite his hand off!

  • Yes there are several beta blocker medications out there for use. Each may react differently for different people and produce different side effects. Dont lose hope, obviously that one is not for you. Do not cease taking it, just go and request to try an alternative. Some doctors prefer to use only a certain type/s of meds but they lose sight of the fact that everybody is different and there is not a single wonder pill that will work well for everybody.

    Chin up, this is just a setback in your journey to get this thing sorted as there are other alternatives to make your quality of life better. Act today. :)

  • I was on Bisoprolol for 2 weeks when first diagnosed with AF. Brought me out in a rash all over my body, but mainly across my chest and arms. Has anyone else experienced this?

  • Hi Deeferdi, sorry a bit late in responding as been on holiday.

    I note the usual team have responded with what seems to me good quality advice. Generally, responses to other queries indicate that there is a number of different drug options to try as soon as problems occur. I am Lone AF with suspected vagal nerve trigger and Flecainide works well. I don't often see mention of lifestyle changes. I think these should always be introduced as part of the treatment….it's a pain but for a quiet life so far alcohol is out and avoiding 90% of Gluten/grains and low sugar has made a big difference from Day 2.

    I'm afraid my experience with doctors is you have to box clever and tough and stay in control and hope you find a cardio to trust, which I have. Still working on the EP.

  • I have a very similar problem with bisoprolol it is making me feel very depressed and very negative feelings and struggling to carry on normal life,my specialist took me off of warfarin and suggested keep taking the bisoprolol as I have only had the one episode of AF to my knowledge whilst under anesthtic have any others had similar effects with bisoprolol and are there better tablets, I am feeling very down and feel I do not want to continue feeling this way..

  • Hi Steve112 I now take my bisoprolol 2.5mg as and when. If I go into AF then I take one rather than have one every day. This seems to work for me. I am in no way medically trained so am just saying what I have done for myself and it seems to be working. Please don't lose hope, I have maybe two episodes per week but I am seeming to manage doing what I'm doing. I feel a lot better for not taking it everyday, much more like my normal self. I am not in warfarin so cannot comment on that drug. Take care of your self and speak to your EP or Cardiologist

  • Dear Deeferdi,

    I am interested in your answer, I take it you know exactly when you are in AF because of symptoms or do you take your BP every day and then see the "irregular heartbeat" on your monitor. I am on bisoprolol and would like to take the same approach as you.

    Kind Regards


  • Hi Barry I can feel my heart start beating fast but I also wear a Polar FT4 watch and chest strap daily which gives a current heart rate. It also gives an average and maximum heart rate for the time you start and stop it. It also gives me confidence. I know some people don't think they're very accurate but it gives a reading compatible with my AliveCor device, so I trust it. Sometimes the fast heartbeat is SVT but most of the time it's AF, but whenever it starts being high I take a bisoprolol and just try to sit quietly until it passes but it can last up to 10hours for me and can come and go over a few days then I can go a couple of weeks without any episodes at all. When taking bisoprolol daily I was exhausted and a different person, I didn't want to speak with anyone or do anything, I just felt so down all the time.

    Hope you manage to sort yourself out!

    Here's a link to the Polar watch I wear, it doesn't show the chest strap but I find it comfortable to wear.

  • Dear Deeferdi,

    Many thanks for your help in this matter - most kind.

    Best Wishes


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