Newly diagnosed paroxmyl AF

I was captured for the first time in AF in August this year and given bisopropol. The next day the dose was reduced from 2.5 to 1.25 as heart had dropped. A week later I was admitted to coronary care with diagnosis "over beta blocked" and taken off the medication with it just to use as a pill in the pocket. Problem being it takes 12 hrs to get in the system so if I hve an episode I'm relying on my heart to really calm down itself. I'm waiting to see if can have flecainide or alternative is ablation which I'm very nervous about. I wonder if cld take 1.25 alternative days of bisopropol ?

15 Replies

  • Julie , as I understand it, Bisoprolol takes about 15/30 minutes to start working. I know as I have this as a pill in the pocket and also have it administered at AE.

  • I feel it starts to work within the hour for me actually. It's just a Dr told me it's not the most fast acting and takes 12 hrs to work - so doctor advice conflicting with when I too feel it starts working.

  • What dose do you take for PiP?


  • @MarkySmith, I take 2.5mg at the start of a fast AF episode, followed by a further 2.5mg half an hour later. If rate still high, and it usually is, I wait maybe an hour or two, unless I am instructed otherwise , and take a further 2.5mg. I dont take more than 10mg .

  • Is this as a pip? Is this what you were advised to do? Assuming so - I've been told not to take more but one episode I took 2.5 and next day took 1.25.

  • Julie5180 Many of us react differently to Bisoprolol so take whatever dose you have been advised.

    I'm probably not a typical case , in that it is difficult to lower my rate once I am in a fast rhythm,which is why my dose is what it is.

    I usually end up with a DC cardioversion.


  • Hi I take 2.5 as pip. I hve been monitoring my hr using an app. I usually feel the palpitations and if heart goes fast I wait a bit, if fast for about an hr I take pip. It's all new to me trying to control it. I was dizzy most weeks from about last October and I e been tired for a long time. I was diagnosed sinus bradycardia years ago but never any bother until last year/this summer.

  • You really must discuss this with a doctor as we are not qualified to answer than question. I do think you need to see a specialist such as an electrophysiologist as your options seem limited at present. Some people are rally not suited to taking beta blockers so a different approach is vital.

  • I am waiting to see EP - the problem being I have been in and out of A&E over the summer - and everyone I've spoken to (Drs and Cardio) has a different opinion so I actually think it's confusing! I'm signed off work which is frustrating as I have a stressful job but I'm wondering be Use I am just dipping in and out of AF whether I should just return as it seems that will be me in paroxmyl AF for the future now!

  • Hello Julie and welcome to the forum. You are having a rough time of it and it's not made easier by having to go so often to A&E. You don't say how long the waiting list is in your area to see an EP but here I faced a very long wait so decided to go privately and was seen within days. It cost £200 and got my diagnosis and treatment untangled and put on the right path. Might that be an option as I returned to my EP's NHS list after my private visit, so it worked out very well?

    With the correct treatment, it is possible to control PAF and give you back your quality of life.

    Best wishes.

  • Hi thank you for the welcome and reply. I do wonder if the right treatment has to be ablation as I said in very nervous about it!

  • I was told that Bisoprolol typically takes 1 to 6 hours (it varies from person to person and for an individual at different times) to get into the system (yes differing medics have different ideas). I have been on it for two years. For me it takes1 to 1.5 hours after taking it in the morning to receive the boost.

    Also depends on whether you are on it already or are on it as a PIP.

    For most it is at the lower end and some as little as half an hour (from comments on here).

  • Hiya Julie5180,

    you could speak to your pharmacist. They are a more reliable source of information on meds than doctors, and when you see your doctor it will be good to have some background.

    In my experience pharmacists are very happy to answer your questions, and more patient about it.

    (And of course they can see all your meds and consider how they work/don't work together).

    Having that background knowledge when you see your doctors gives you the edge.

    My own recent example may be useful to you:

    I asked the pharmacist could bisoprolol 1.25 tablets be split to form lower doses. Yes, they can, and pharmacy can split them accurately for you. My GP still thinks that is not a suitable option for me (due to an additional condition, in my case, causing positional tachycardia), but it was useful to discuss it. Because she could not answer all my concerns and questions she is willing to refer me to a heart rhythm specialist (aka EP or Electrophysiologist). Result!

    While you are off work, it is a good use of time to find out all you can about AF as you may not feel you have the time, later. It will be less stressful in the long run.

    Best wishes from Boombiddy.

  • Julie, I had one nasty AF episode in June 2012 which was caught on an ecg but stopped before I got to A + E.

    My EP prescribed flecainide as pill in the pocket (not taken a single one yet). This was because whilst I was previously being investigated for 'palpitations' (almost sure they were not AF but ectopics), I was given Bisopropol as a PIP and although only a 1.25 dose, it made me lethargic and gave me bad dreams so I was told to stop taking it. BTW Just one 1.25 dose made me feel like that.

    I've since taken the supplement route and swear by MagnesiumCitrate(800mg daily) along with others. I've been very lucky since and even my ectopics have been very few (Oh how I struggled writing that in case sod's law steps in now!)

    If you are paroxysmal and have only had one AF episode, why don't you try the supplement route for now.


  • I take 10mg bisoprolol a day and was told this is the max but once went to Ed with AF and they gave me another 2.5 mg did not bring hr down so had a cv

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