I've recently started taking these tablets and I am finding my heart rate is slower and lower. Took my BP today and it was 107 over 73. At one stage a couple of nights ago my pulse was 41. I feel this is too low. I stopped taking bisoprolol because it did a similar thing - though quicker and with alarming regularity. I am also feeling breathless - even when resting, very tired and coughing. I am not sure whether to go to my GP about this. I feel a lot worse over the the last few days than I did before on just the apixaban. Due to a total mess up with medication I was diagnosed back in April and had to pay to see a cardio EP as couldn't get in to see a cardio with the NHS until the end of September! Cardio version was talked about but was taken off apixaban when an ulcer found - this shouldn't have been done as the ulcer was so small - there is just no joined up medicine though and messages from one specialist to another and then to my GP Just didn't get passed on. EP thinks the verapamil may help everything rather than taking the chance with cardioversion. I was willing to take the verapamil to try thus and will have to pay privately to have the cardioversion as local hospital not taking in what they term "minor" procedures when I called the cardio department team. Though now I wonder if I made the right choice? Should I persevere for another couple of weeks? What are other people's experiences with this medication?
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Desanthony
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I took 120 X 2 daily of Verapamil for a few years and with Warfarin.Changed from Warfarin to Apixaban still ok....I never take my blood pressure although my GP does whenever I see him. It is pretty normal 70 over 120 ish. Then I started to feel faint and my GP reduced my Verapamil to 80 X 2 a day..problem solved.I have never been breathless nor had a cardioversion. It was suggested in the early days of my AF but I felt somewhat nervous about it. Long waits to see cardios makes people so anxious which is not what you want with AF but some areas seem better off than others in this respect or so it seems.....And trying to put 'pressure' on GPs or the cardio. dept MAY help.It does depend on how feel able about strongly putting your case.
Thanks,. I am on 120 once a day and apixaban. On bisoprolol I did faint a couple of times. I just could not function at all - better off without it. Not passed out yet on verapamil but the breathlessness is similar to what happened on the bisoprolol as is the tiredness. Apparently the earlier the cardioversion is done the better the result. Anyway, going to stick it out until the end of the week and then go and see the GP if not better. Thanks fir your reply. I have other problems as well and the cardio thought that some of the side effects from the verapamil would sort or help sort these out - I am not yet getting these other more common side effects - typical!
It may be. My brother-in-law and I both had this side effect when on bisoprolol. It just dropped the BP and heart rate too low I mean at one time 90 over 53.
This is a dreadful situation you are in, you are not alone. I totally understand what you are going through . It is bad that we have to pay to get treatment and private treatment is not infallible . Stick to your guns and try to be strong , you know your own body and how you feel . Is your GP helpful or is he too much in awe of cardiologists? I am sure people in the know on this site will have good advice !
Both Bisoprolol and Verapamil are rate control drugs to keep the heart rate down (generally below 100 b.p.m.) but not perscribed to get you back into sinus rhythm. A cardioversion is done to get the heart back into rhythm. You have to be on an anti-coagulant, in your case apixaban (which you were taken off) before a cardioversion can be performed. So, I am a little confused as to what your objective is -- to live with AF or to try and get back to sinus rhythm.
My GP automatically put me on 120 mg Verapamil as I could not tolerate Metropolol., especially 25 mg. Then as I was getting more bouts of AF, he raised the ante to 180 mg. in the "hopes we'd get lucky." To say he was ill informed is an understatement. Since Verapamil is designed for rate, it obviously did not get me back into rythmn, but I could tolerate even the higher dose. The tragedy was he didn't even ask me if I wanted to live in AF and kept me for a whole year until I got the persistent before he would refer me.
Then when Amiodarone was added by my EP after my first ablation, my rate plummeted to the low 40's whereby I asked to be taken off Verapamil as my rate was below the 60 b.p.m.
It seems that you have a system that is sensitive to drugs, so I would remain on top of the situation as you may be prescribed all sorts of drugs that are mot suitable for you.
Thanks for that. I am also on apixaban. He said to try the verapamil for a couple of months to see if it helped. I don't really know why he didn't take me on to do the cardioversion as I would be paying him after all! Not like them to turn down money but he did say he would do the cardioversion if I wanted it. So, may get back to him soon and sort that out. As you say I am sensitive to medication - though not the ones I would like to work better than they do! Certainly beta blockers work too well on me. Hardly slept at all last night as well so if the verapamil does cause insomnia I think I would be better getting off it. Thanks for your reply. It has given me something to think about.
Are you in paroxysmal or persistent atrial fibrillation? If your EP is talking about a cardioversion, then you must be in persistent. If that is the case you might want to read this article by Dr. Haissaguerre:
If you are in persistent, according to the above article, you do not have the luxury of a "couple of months." So, I cannot still see clearly what the objective is. Again, my GP fooled around with Verapamil for a couple of months and I went into persistent. If you are already persistent, Verapamil is a rate control drug, not a rhythm control to get you back to sinus.
I hope I have given you further fodder to think about.
Good luck to you. Time is of the essence when you are in persistent if your objective is to get back to sinus rhythm. Because my GP held me for a year so that I went into persistent, then the hospital referred atrial fibrillation department held me for another 5 months just to see the EP , although I was scheduled for a 7 month appointment, but talked to the manager of the cardiology department to reschedule to the 5 month point.
In any case, the prognosis was that by the time I could get an ablation, one year would have passed getting me to long-standing persistent , so I opted to go to Bordeaux, France, at my expense. Bordeaux, France took me within a month, but I did have the four rotor areas beyoond the pulmonary veins, and I have just had a second ablation to correct the atrial tachycardia. At least I didn't get to one year to long-standing persistent atrial fibrillation where there would be 7 rotar areas and more extensive ablation.
The tragedy was that if I had been sent for an ablation when at the paroxysmal stage, only the pulmonary veins would have to be isolated and I would not have had to have a second ablation.
So, it's not as much what your EP wants as he/she may be tied by the system (in terms of government financed); it is what you want-- do you want to remain in persistent, going onto permanent, for the rest of your life on rate control medication or do you want to try to get back to sinus rhythm? The choice is yours.
First question is are you asthmatic as this affects matters more than anything.
With all these drugs you need to experiment yourself finding the correct dosage for your body. We all have different body weights and metabolisms and I suspect you're on the smaller side. Reduce the dosage to half and let your body stabilise, then increase until you can keep BP at 120/70-ish.
As for the cardioversion, see your GP and insist he/she refers you to a hospital that does do minor procedures.
No I am not asthmatic. I have mild Bronchiectasis after a chest infection which could have been pneumonia - but got to the Doc too late, in one lung but this has never affected me at all also do not cough up any sputum - or at least hen ever a I do it is clear. This breathlessness was what affected me most at the beginning of all this in April and what took me to the GP. My blood count was low at the time which led to the tiny ulcer being found. My GP then took me off the apixaban but shouldn't have. I was put on different medication for the ulcer - as already on some as taking mega pain killers for bad neck and back pain and arthritis. The ulcer was found to be gone in October - though still there in July. I have therefore been back on apixaban since early October. If things do not change for the better in the next couple of days I will contact the cardio. Ankle for your input.
Sorry you’re having so many issues. I would see your doc sooner than later or at least get an appointment made. I take 100mg of Verapamil 2x a day and tolerate it well. I have a Biventricular device implanted and they set it so my heart rate will not go below 60bpm. If they didn’t do that mine would go in the low 50’s. I have heart failure so I also suffer from shortness of breath on exertion. Whenever my docs would try a new medication, they would say let’s see how you do for two weeks. Then we would discuss my reaction to it or lack there of. But if side effects were to disruptive the meds would be stopped and we would try something else. So waiting a few months with negative side effects is too long. Praying you get answers. Maybe consider a second opinion. God Bless.
I am going to give it just another few days - have actually taken the tablet for 8 days so willing to take it to the two week mark. Will make an appointment tomorrow - will probably have to wait a while but my surgery does do walk ins every morning so if it gets worse I can do that.
The only problem i had with verapamil was weight gain. I had 4 cardioversions none of them were successful long term. During this time i was also on warfarin. I then had an ablation nearly 2 years ago and now still in sinus rhythm. I take apixiban and will for the rest of my life with no side effects. Cardioversion only really allows them to see if you can go back into sinus rhythm. I don't think it is a long term solution. Go back to EP/GP if not happy
At what stage were you given cardioversion? I understand that cardioversion does not always work and does not last. Also how long had you had your AF when you had your ablation.
I had my first cardioversion after I had AF nearly a year it lasted 6weeks that time and I felt really good but I went back into AF much to my disappointment I had another cardioversion about 6 months after that which lasted a few days. At that time I was on verapamil and warfarin my INR levels were always low even with increased doses . I was then taken off verapamil and put on dronederone this suited me better but I had another cardioversion and did not go into sinus rhythm at all. My next visit to move EP. resulted in her suggesting I go for an ablation but I was told there would be a long wait. I opted to stay on dronederone until then unlicensed as you could only be on it for 6 months. (That may have changed now) my ablation was done after I had AF for over 3 years that was nearly 2 years ago. I am now in sinus rhythm it's not a cure but it is the nearest there is. I am now back to the level of fitness that I was before AF. I walk 4 miles plus each day, I run, I do keep fit classes and most important I can run after my little grandchildren of 2, 4, and 6 years.
Good look with whatever life brings you there is light at the end of the AF tunnel x
Thanks for that. It is so difficult to get in touch with anyone - especially on a Friday. I have e mailed my cardio's secretary and will hopefully be able to see him soon - I doubt that will be before Christmas. I talked to the pharmacist today and she said she didn't think it was the verapamil that was causing my symptoms - though I don't know what else it can be. So, we shall wait and see what the consultant says or the GP depending on who I see first.
Thanks for your informative reply. Have a good weekend.
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AF query
Verapamil and Bisoprolol
