AF Association


I am experiencing difficulty controlling my COPD and am taking a Steroid based inhaler. I have recently had a DDDR implant for SSS, Sinus Pauses, Brady/Tachycardia and Chronotropic Incompetence. I had a 1.25mg Bisoprolol daily... could not tolerate any higher dosage : Since the DDDR implant , I can at last , receive a new dosage of 5mg Bisoprolol... Plus PIP -of up to another 5mg Bisoprolol. I understand that Bisoprolol is contra-indicated for COPD Patients? I am SOB now and keeping to the 5mg Bisoprolol -as prescribed. I am very reluctant to take the PIP extra dosage... I think this may compromise my breathing further? I have seen so many Consultants with differing ideas? I would welcome your comments regarding COPD and Medication to ease A/F ,PSVT and all the other abnormalities I still experience?

May I wish you all a better New Year for 2016

7 Replies

Hi sheppey,

Sorry to read about your medical problems - hopefully someone on this forum, in a similar situation, might be able to "swap notes" and give you some support. I have a friend with COPD and it takes quite some management. Meanwhile, all the very best to you.



Hi Sheppey,

The combination of COPD and AF is horrible. I make a joke of mine, as my COPD was caused by TB as a child - so it seems I like diseases with initials.

Now to some help - I hope. As I am also asthmatic, I cannot take any medication ending in lol. Sotalol gave me first degree heart block so I was put on Diltiazem. I tolerate this fairly well but the side effects of most meds are exaggerated. The Diltiazem gives me painful swollen feet, which is helped by Losartan Potassium.

I am due for ablation at the end of February. I know that things are stacked against me - as my last lung function tests showed I have lungs of a 90 year old.

Like you I have a steroid inhaler but at times I also need oral steroid tablets. Is your steroid inhaler the best one for you, as when mine was "swapped" for a Qvar breath activated inhaler - my asthma improved and is now quite well controlled. Nothing helps much with the breathlessness.

Sometimes I am too breathless to drink a cuppa - but a puff of my Salbutamol helps that a little.

I might add that I am nearly 82 and had the TB when I was 11. I try to be thankful that I still have a good brain and can carry on with my crafting.

Not sure that I have helped - but I know it is always good to read of somebody having similar combination of diseases.

Looks like half of this reply has gone missing. Will press submit and hope for the best. Evelyn


Dear Enjoy, Thank you for your reply: I too have to take Emergency pack of Steroids ,plus antibiotics, for exacerbation. My COPD has presented difficulties- and swapping many medications to try to stabilise it. I waited 20 weeks to see the Hospital Thoracic Team (Urgent referral)- the appointment duly arrived... on the very day I was in another Hospital having the DDDR implanted!

I am due to see the COPD Guys in January and hopefully, my Consultant Cardiologist in January?

Interested to see how this works out.

Your wonderful, positive outlook has certainly inspired me.. I wish you well.


Dear Musetta, I was pleased to receive your reply. COPD is very difficult to manage and combined with heart issues makes diagnosis challenging..... Heart or Chest- signs and symptoms? It has been a long slog to finally get my DDDR implanted. I went into Cardiac Care 16 months age to have it fitted. But ,unfortunately, it was delayed to allow further tests. I wish I had forgone the tests and had it implanted then?

Hopefully ,things will improve... I am looking forward to a better year -next year

All the very best


Which inhaler do you use? My official diagnosis is asthma but I suspect COPD might be more accurate. I use Symbicort which has made huge difference to my lung problems. My cardiologist said he would like to prescribe Bisoprolol but he 'was not allowed to', I now know that is because of asthma. I took Diltiazem until my recent ablation. I have been very wheezy and feel as if I can't take a deep breath since but I'm hoping that will wear off soon.

Don't suppose this is much help to you, however Diltiazem has a bad press but I got on fine with it once the dose had been adjusted (downwards). I think once you have comorbidities (horrible word!) you have accept compromise.

I am interested to know how you get on with the pacemaker which I gather is a fantastic new model! My alternative treatment was a pacemaker but I decided to have one go at ablation first. At the moment I really don't feel I could cope with another one but the EP was confident this one was successful ⛅


Thanks Buffafly, I was up to June 2015- using RELVAR ELLIPTA... Then changed to the new FOSTAIR inhaler : I also use SALBUTAMOL and CARBOCISTEINE.

I have Found the new pacemaker SOR. SORIN REPLY 200 DR ..... DDDR really good. I was so used to a HR of about 43bpm:

I suffer from SSS and could not take the drugs to help control my heart. Recorded at HR 30-289. Brady/Tachycardia.

I had Fast A/F, PSVT, Sinus Pauses and Chronotropic Incompetence.

Since the PM implant, I have a regular HR of 60bpm.... and now increases on demand. I am still trying to get used to the new HR. When I exert myself the HR is very fast and I am SOB ?

I need to find out the settings and interactions with different medications-Which I am sure will be corrected to suit my needs more effectively?

It is a pity I had to wait so long for the PM (was to be fitted August 2014) ?

The PM will not stop my Fast A/F, PSVT episodes continuing..... but, it stops me going into Absolute Bradycardia - and I can accept stronger doses of medications in the future?

From what I have read ,relating to the new PM.... It certainly would appear to be a very good device... I will let you know how I fare with the follow up clinics... RE: the Medication concerns and PM settings.

I have no worry or concern on having a PM implanted.... I had a Implanted Loop Recorder removed and a new PM implanted this time 01 December 2015.... so routine now .

Thanks so much for you reply,


Thank you, very interesting! I was told the purpose of the pacemaker would be to allow a higher dose of medication to control tachycardia when necessary as the dose I was on at the time was causing pauses of up to 5 secs.

I know if I am developing SSS the ablation will not cure that so I am curious about the experience of others. I have no fear of a pacemaker either but I know many people feel they couldn't trust them.

Thanks again for your reply, I hope your medication can be adjusted to improve your QOL,

Best wishes, Julia


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