AF Association
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Ask your doctor: can I swap betablockers for calcium channel blockers

Just a suggestion to anyone with AF. I've had Permanent AF for around 5 years but, thank God, I'm asymptomatic (at least for now), so it really has very little impact on my life.

One thing that I've learned and been surprised by how few people do it is that my doctor (the sainted Ben Brown at Wythenshawe) suggested that I switch from betablockers to calcium channel blockers. I cannot tell you how much of a difference it made to my life.

It's only my opinion but I think betablockers were leaving me with very cold extremities, listless, impacting on my ability to react to any situation and I think were making me depressed. Calcium channel blockers do none of that but they still control my rate (rhythm might best be described as Jazzy:)

If you feel that betablockers are draining you then have a chat with your cardiologist and ask about whether it's appropriate for you to have a trial of switching to CCBs.

The common reaction seems to be that many cardiologists don't really know about them. It also might not be appropriate for you - BB help with rhythm control, I'm only interested in rate control. But it's like night and day comparing the two drugs.

Best wishes for your health.

10 Replies

I should also say that if your doctor doesn't know about CCBs then you should start looking for a new cardiologist who has read some research post 1990.


I take bisoprolol. It's not perfect but the 2.5 dose reduces my heart rate from 80 to about 65. I was tried on a calcium channel blocker (Tildium?) several years ago. It gave me swollen ankles. If I remember correctly Bob also had this problem.

We're all different and we may well benefit by trying alternatives.


Absolutely. I know I sound like I'm on commission for CCBs but they really made a significant difference to me.

Might be worth speaking to your cardio about whether any of the newer CCBs are worth a try. If it's rate control you want I think they give all the benefits of the BB and fewer of the less appealing side-effects. I take Zemret.


Calcium channel blockers are fine if you can take them. I can't , not if I want to wear shoes and socks anyway. Never took beta blockers after the first six months anyway as I was always on rhythm control drugs for AF. The CCBs were originally for BP but there are alternatives for that as well. Great if they suit you but to me they are the devil's spawn.


We're all different and have differing side effects and while CCBs and BBs are both used for rate control, here is one study that indicated a slightly higher efficacy for BBs, but of course you may not be one of the ones to benefit!


I can't take beta-blockers either, at least not Bisoprolol. Slows my heart down far too much, even on a low dose, and makes me feel very old.

My EP put me on sodium channel blockers which are working well so far ( a few years).

Fingers crossed 🤞 this will continue.


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I can't take Bisoplorol I just couldn't function on them cardiologist put me on channel blockers....Slozem...what a difference in me


I was on beta blockers and channel blockers together for several years until a Registrar at Bart's earlier this year said I shouldn't be taking both and cut out the beta blocker (Bisoprolol). Just on Diltiazem now and feel so much better. I'd queried with successive drs, including a consultant, why I was taking both and they said since I was living 'a normal life', they didn't want to change anything. Hoorah for the Registrar! Glad it's working well for you.


The quality of care I've experienced within the NHS ranges from Outstanding to Wouldn't Trust Them With My Cat. One thing that patients have to wake up about is that if they're even slightly concerned about the level of care that they're getting then they should get referred somewhere else. It's within your rights and you can radically change your life by getting proper support.

I think this is especially true with AF, where the NICE guidance is often out-dated and poorly applied, in my experience.


Dr Sarma, also of Wythenshawe, put me on calcium blockers (Verapamil) after a terrible reaction to bisoprolol. They worked very well but their effectiveness wore off over three years and eventually I changed to nebivolol, a beta blocker with a more cardio-specific action.

I solved the swollen leg issue by raising the bottom of my bed so that the fluid drained away in the night. I did need a diruetic every three months or so just to clear me out properly but for me it wasn't an issue.


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