Loss of confidence after ablation procedure... - AF Association

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Loss of confidence after ablation procedures—bisoprolol and fatigue.


I take Lixiana 60 mls after 4 ablation procedures and 125 bisoprolol.

I know bisoprolol is very small dose but it think does impact my energy....I came down from a much bigger dose post 4 ablation procedures. Does anyone have experience of bisoprolol and fatigue—and or, biting the bullet and stopping taking it altogether?

I found the whole AF thing really scarey and part of me is still in the shock of that and the procedures. Doctor left me to wean myself off the bisoprolol and said if I felt safer with the low dose then just keep taking it.....

I do occasionally feel my heart skips and starts but only occasionally and not for long. I think my hypersensitivity and anxiety is not helping me move forward.

Has anyone anything helpful to contribute re loss of confidence and fatigue related to ablation and/or low dose bisoprolol. (Re the drug my doc says I am unusually sensitive to meds and had to be swapped about a lot before tolerating bisoprolol better than anything else.)

28 Replies

"Has anyone anything helpful to contribute re loss of confidence and fatigue related to ablation and/or low dose bisoprolol. "

Short answer yes, I'm on 10mg Bisoprolol and I've been constantly tired, no energy, loss of motivation about many things!


I've stopped taking Bisoprolol as even a low dose contributes to loss of energy. I use it as a Pip but even then it is pretty useless. I took a total of 15mg in 4hrs followed by a further 5mg 8 hrs later when I slipped into fast AF. It did nothing much at all and I had dc cardioversion later in the day.

jeanjeannie50 in reply to Hidden

Bisoprolol doesn't work for me either, but Metoprolol does.


Hidden in reply to jeanjeannie50

I've looked into this and apparently it should not be taken with my drug Disopyramide

jeanjeannie50 in reply to Hidden

Oh right.

opal11uk in reply to Hidden

Mmmmmm well I have been taken the two together now for 3 years..........

Hidden in reply to opal11uk

Well it obviously works ok for you then, which is good.

I looked up the interaction on the BNF website and it shows severe interaction....predicted to increase risk of cardiovascular side effects...advised caution or avoid.

As far as I'm concerned I don't want to take any unnecessary risks. I am already on enough drugs to sink a battleship and would be more likely to be affected being elderly. ( How I hate that word...think I'm still 30 ish..sometimes 😉)


P.S.....am talking about interaction between Disopyramide and Metoprolol here !

opal11uk in reply to Hidden

your post re 'elderly' made me smile, I am still 21 several times round hahaha

A known side effect - just do a post search on Bisoprolol - probably the. It’s common subject. I did take it, really felt I had no quality of life so refused it, best thing I ever did! I can cope with AF but not the affects of the meds but it does work for some.

I don’t get anxious when in AF, I feel ill and fatigued - and there will be some degree of anxiety/stress in my body - but I don’t worry about it.

I use slow breathing and meditation and vasovagal maneuvers and if nothing else works - I go to bed and listen to audio books and distract myself and usually I convert to NSR within a few (up to 24) hours but I know that doesn’t happen for everyone.

Everyone is different and reacts differently but finding coping mechanisms for when AF strikes or ectopics or palpitations is, in my view, essential.

lilyj54 in reply to CDreamer

I find that it has been meditation and breath practices have helped enormously....that’s for sure....

Very helpful doctor in hospital reminded me that when your heart races or AF it mimics the biochemistry of anxiety, and so it is no wonder to feel that way!

It has just seemed such a long road to normal, whatever that was!!

I have not had an ablation but I do take 1.25 mg bisoprolol a day for PAF and palpitations. I had the same issues as you are having which really surprised me given the low dose that I am on, yet my palpitations are bad enough that I did not want to go off of the medication. Someone in this board mentioned that taking the med at night (before going to bed in my case) rather than in the morning would help. That seems to be the case. I have had far fewer symptoms of random fatigue and dizziness since I started taking bisoprolol at night. Perhaps it is because the maximum dose is in my body when I am sleeping g rather than during the day ? If you are not already taking the med at nighttime, give it a try perhaps to see if it it helps. Best of luck to you. I know very well what you mean when you talk about the fear and anxiety that feeling unwell brings. It is a very unsettling feeling.

lilyj54 in reply to castanes

Yes I do take it at night...

Unsettling is the word...

Having had the ablations I would just like to experiment with not taking the bisoprolol and see how my energy is

Thanks for your understanding

Oh, I sympathise with you. At my latest cardiac appointment the cardiologist told me to stop taking Bisoprolol immediately as it was reducing my heart rate to dangerously low levels (34). I was on 1.25mg daily, so the lowest dose as far as I know. This beta-blocker left me feeling very tired with several episodes of ectopic beats resulting in dizziness and the occasional episodes of rapid, irregular heartbeats lasting from minutes to hours. I see your doctor told you to wean yourself off them. I do wish these medics would all sing from the same song sheet. Anxiety does not help, but when these episodes happen it is hard to be blasé about them. I worry too. I have been off Bisoprolol for a month now and I no longer feel so lethargic. I still have ectopics, interestingly without the dizziness, but no racing episodes so far. I am just waiting to see, really. I do not have any experience of ablation, so I cannot help with that I'm afraid. Have you discusses a PIP (pill in pocket) with him? That might suit you better. Keep well.

I am on 3.75mg and I am constantly exhausted.

Last week I tried taking it at night and I had more energy during the day but my BP got higher so I have gone back to taking it early morning.My heart rate is usually 40-45,is this too low?I have GP appointment next week when I shall ask if I can change to some thing else. I wonder which drug will be better for me?

I take Apixaban and bendroflumethezide also thyroid replacement.

Thank you for this excellent site.

You mention taking Bisoprolol at night and feeling more energised during the day but your heart rate was higher. Might I suggest that your heart rate which at around 40-45 bpm is too low reverts to a more normal level during the day and that is why you feel better then. It should be around 60-100 bpm. Have you taken your heart rate? I have just been taken off this beta-blocker and all heart medication due to a daytime heart rate of 45ish and a night time rate of 34 and I am feeling better than I have in ages. Have a word with your GP next week. Pin him against the wall if necessary, but get some answers. Good luck.

lilyj54 in reply to sarniacherie

Thanks for this...I too have a low heart rate....certainly exercise helps....but can tend to feel like a car with the hand break on continually. I do take bisoprolol at night and rarely feel bright and breezy in the morning.

I have been willing to just live with it as quality of life is better post ablation and on low dose....BUT STILL NOT OK.....and as I get older other things kick in. I feel I need to be as strong as I can be crossing 65 and counting.

Hi Sarniacherie.

Good to know you are feeling so much better and thank you for your reply.

I stopped taking the bisoprolol at night as although I felt a better during the day my HR was around 40 and I realise this was way too low so due to this and rise in BP

I went back to taking it early morning again.

My appointment is next Wednesday when I will 'pin him against the wall'. Love it!

This would be an amazing thing as he is quite chunky and I'm a little old lady but I shall let you know how it goes.

I have recently got a new BP machine which records HR and lets me know that I am constantly in AF.

I shall indeed make sure I get off Bisoprolol.

Thank you all so much.

I shall be thinking of you. There is so much medication out there that anyone getting exactly the right one for them, first time, is very fortunate.

Good luck. X.

Let us know how it goes.

Speak to your Cardiologist and ask to change from Bisoprolol, its an awful drug for some people, me included. I take Atenolol (due to come of this after first ablation) which changed my life. Bisoprolol made me so lethargic and hardly able to take a few steps without sitting down every few seconds. There are lots of other drugs which would help you. Good luck. Get off Bisoprolol.

Hi Lily, I have suffered from PA/F for many many years and just after my first and only ablation my world turned upside down and I lost confidence and ofcourse the anxiety accompanied it. For me ablation was not a success and left me worse than I was, so much so that I thought the end was nigh lol but it wasn't, they fitted me with a pacemaker because apparently during the procedure the doctor 'must have touched something', what I don't know or can't remember, so anyway the Pacemaker has been in place now for 3 years and with that I take Bisoporal and Disopyramide so didn't get to come off the drugs and I also take Pradaxa to thin my blood. A/F is a complicated condition, some people manage without drugs after ablation but others don't so you really need to work with your doctor on this to decide just what is best for your particular A/F, and if you read the posts of others on here you will see that most of us are different with different sets of problems so a very difficult choice regarding drugs.

Bisoprolol 1.25 mg puts me to sleep in 40 minutes. I also felt terrible with arm and chest pain and fekt drugged. Atenolol was better but not good still very tired. My GP decided i was intolerant to beta blockers and put me on 120mg verapamil a calcium channel blocker instead. 95% of the problems went away.

Hi. lilyj54

I was diagnosed with PAF about 3/4 months ago and it was quite a shock and scary as you say. I was put on exactly the same dose and

medication as you and immediately felt different.Even at 1.25 Bisoprolol I did notice the tiredness for a while but after a few weeks it did wear off a bit. My problem is breatheless ness when walking., which sent me to the Dr in the first place but one of the side effects of this drug is exactly that and fatigue so it

doesn’t make a lot of sense.

Anxiety plays a big part and I find the best way to get over this is to distract yourself, have a conversation with someone, read a book, listen to music, suck a sweet, watch something amusing on TV.

Some daysI wake up with a fuzzy head and have this jittery feeling in my chest, it can go on for hours and is unsettling and scary, especially as I live my own. This is when I have to find a distraction .

Try to relax more and stick with it a little longer. I have found that things settle down more with time


Hello lilyj54

I haven't had any ablations yet but I decided with my GPS knowledge to come off bisoprolol because of fatigue and anxiety. I am still on lixiana 60 and doxazosin 8mg and losartan 100mg I am still having side effect problems but I'm so much better for stopping bisoprolol. In some people it can cross the blood brain barrier and cause these side effects I was told that be an eminent cardiologist at London Bridge Hospital. Good luck. X

Get your doctor to prescribe an alternative to Bisopropol asap.


One thing's for sure, we all react differently. My experience of Bisoprol is of fatigue, lethargy, depression, moaning "I can't live like this." One doctor at my practice looked at me blankly, said: "but we always prescribe Bisoprol." Reluctantly, she pulled down her Mimms, or whatever their drug book is these days, and prescribed first Corvedilol and then Atenolol. Same results: with added almost-hallucinations on Atenolol - seeing shadows apparently moving around the bedroom at night and the white wardrobe doors seeming to come towards me. Cardiologist, whom I pushed to see, prescribed Nebivolol 2.5 mg with Digoxin.

I know some people don't fancy Digoxin but now my life is worth living again, after six months of feeling like a zombie. This is of course my experience, and might not work for other people. I'm not medically qualified in any way.

Cardiologist said he had considered electrical cardioversion but thinks I am better - maybe because I'm in my late 60s - to go on what he called chemical conversion. I am going to investigate what he actually meant by that, and long-term effects, but at least now I have the mental energy to do more pushing.

And last night I sat outside in the cool of the evening with my husband and we shared a bottle of nicely-chilled NZ Chardonnay, following which I slept like a baby.

I am on Bisoprolol and did have terrible fatigue but it is better now after following advice on this site, I now take it in the evening instead of the morning, feeling much better for the change

Hi ,Itake bisoprolol and didn't realise I'm 1 of thousands with the same symptoms the dose I'm on is 10mg which seems very high .I have PAF and do have a pacemaker .and have had an ablation I am tired out most of the time on a bad day totally exhausted.I get severe back pain which mimics a burning sensation .breathlessness is a big issue .my walking is very limited .I have always been active and find it all very frustrating Poppy Storey.

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