Stopping betablocker s: I have been having... - AF Association

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Stopping betablocker s


I have been having problems with bisoprolol,awful heavy legs,with lots of muscle pain.Saw my GP yesterday and as I am actually feeling 70%,improved in terms of AT episodes,said Sean yourself off bisoprolol,told me how,halfway for so many dayscetc..

But as have don't often get fast AT to use bisoprolol as a Pill in pocket approach.

I was pleased but now reading Suzs post a bit concerned!!! I know none of us can give medical opinion,but has anyone else done the same as me? And how did you get on please?I do take flecanaide 100 mg day.


42 Replies

Bisoprolol is a beta blocker for rate control. Flecainde is a rhythm control drug. Whilst it is common to take a beta blocker with flecianide many people do not so it your doctor has agreed it I would not worry.

wilsond in reply to BobD

Cheers,my slight concern is that I do get Aflutter at times,caused by flecanaide I was told.However,having betablocker as a quick fix PiP will I hope be better.Think might ring Arrythmia nurse just in case....wanted to chat to EP anyway about my ablation,whether its still necessary...thanks

Wilsond I had muscle pain and aching legs, well still do. So hoping this will improve. I admitted to the doctor that I had started to wean myself off Bisoprolol. He said “ I’ve had patients who have stopped altogether as they can’t cope with the side affects of beta blockers. They have come bouncing back to the surgery a couple of weeks later feeling wonderful. What can I say “


wilsond in reply to Suzy1954

Oh thats reassuring! Thank you for that,and hope you get on ok yourself.This forum is invaluable to me. X

Suzy1954 in reply to wilsond

Read your profile wilsond and it looks like you attend the same hospital as me. I only ever saw an EP once and he said an ablation wouldn’t work for me. (Which I tend to agree with) but I’ve never seen an arrhythmia nurse. Is that at the hospital or GP surgery?

wilsond in reply to Suzy1954

Hi Suzy,Walsgrave? Also was at George Eliot until I was referred to Walsgrave.

I dont have an arrthymia nurse at the GPs,and wasnt specifically assigned to one at hospital,but had a query before and looked it up,and there are 2 there,who can be contacted by phone,and I think you can request an appointment.Number is 02476965668 xx

Suzy1954 in reply to wilsond

Thank you. Yes it is Walsgrave.

Bertiedette in reply to wilsond

Hello Wilson you mention Mr Osman your E.P?

wilsond in reply to Bertiedette

Yes he is!

Suzy1954 in reply to Bertiedette

I saw Mr Osman too. He said an ablation wouldn’t work for me as I’ve got too much scar tissue from 3 previous ops. He never mentioned seeing him again, so just go to cardiologist Dr Been once a year.

Jes59 in reply to wilsond

I’m at the George Eliot so that’s interesting info, thanks!

Savi18 in reply to wilsond

Hi Wilsond, i'm at Warwick

wilsond in reply to Savi18

Hello! Maybe all us Warwickshire people could meet up sometime?best wishes,Dawn x

Thank you Happyjo,no other heart issues apart from a biscuspid aortic valve,which is still working ok.i think I might ring the arrthymia nurse today as a double check!

I would be inclined to check this out with an EP or cardiologist, wilsond as you are having runs of AFlutter from your Flecainide. My Flec dose is 200mg daily and I too get runs of Flutter. My EP specifically told me that a beta blocker was essential (in my case) to prevent 1:1 conduction of flutter signals and that I couldn’t use it as a PIP as the AFlutter would be underway before the dose kicked in. His words were ‘too dangerous’. I was on the dreaded Bisoprolol and endured it for that reason.

After more than three months on Nebivolol, my breathing is normal, legs don’t feel like lead and I can walk uphill.

Sorry to sound negative about stopping a beta blocker with Flec but I wanted to share my particular experience. There are many posters here who take Flecainide without a beta blocker, so my EP may have other reasons for his advice in my case.

I will ring his arrythmia nurse now,thanks.I havent stopped yet,reduced but not stopped.Ill let you know....xx

Finvola in reply to wilsond

Forgot to say, EP was happy with lowest dose (1.25) but even that I found intolerable. Would like to hear how you get on. xx

Spoke to Helen the arrythmia nurse and she said as i hadnt got a 'life threatening arrythmia' (what is classed as that Im not sure) I could stop the biso,see if it made a difference,if not continue with it on 2.5, If I come off it I can add in extra flecanaide if things kicked off.Said take my 50 mg flec in the morning, then ,if AF or Afl start,take 100mg straight away,wait an hour or so.If settles,just take evening dose,if not can take an extra 100mg.

Well,she then said,if you cant tolerate one type of betablockers its likely you wont tolerate the rest,but did mention dialezpam (dont know if Ive spelt it right) She is going to speak to my EP about it.

I might end up just putting up with the elephant legs and weariness...?!!Im going to have to think about this.I agree,its the flutter which is the concern ....

Confused? You will be!

I will let you know what EP says.

Off to get sugar substitute for my sugarfree chutney,shall be busy this afternoon in a nice way,kind regards Dawn x

Diltiazem? I take it instead of betablocker because of asthma, no probs at low dose.

wilsond in reply to Buffafly

Thank you! X

Aprilbday in reply to Buffafly

Buffafly- can you tell me what dosage you are on. I am on 240mg and I am starting to get a little more short on breath. It does keep my heart rate nice and low at 60-61. But maybe I need a lower dosage.

Buffafly in reply to Aprilbday

I am on 120mg. My cardiologist suggested Bisoprolol but my GP refused to prescribe it because of my asthma as she would be blamed if things went pearshaped. She wanted to prescribe the standard dose which is 240mg but I pointed out that my previous cardiologist had said that was too much unless I had a pacemaker so we are trying 120mg. My resting HR is quite variable between 55 and 68 and my HR generally is quite variable so I am very interested to see what happens when I have the next bad episode of AF, not hoping for it of course! Before I had an ablation I was taking Propafenone (similar to Flecainide) and Diltiazem and my HR was about 50 which made me feel very sluggish and I retained a lot of fluid but I feel fine now - most of the time. Somebody complained recently of feeling as if they had a chronic cold on a high dose of Diltiazem and I do wonder whether the higher dose causes a bit of congestion - it certainly affects my ears! Do you get swollen ankles?

Sorry, this is probably far too much information! I would think the lower dose would be worth trying, good luck!

Aprilbday in reply to Buffafly

I am actually grateful for your response! I woke up early here and happy to get your detailed response. I also feel like I have a cold (sniffles, thickness in throat, etc) on diltiazem! I am more convinced that this is a reaction to the drug. Also itchy legs/arms at times. I do not get the swollen ankles. Earlier this evening, I sent my doctor a note to inquire about reducing my dosage. Hopefully will hear back by Tuesday. In my digging online for side affects of diltiazem, I was surprised to find that some doctors precsribe it for anxiety. I thought it was only a heart rhythm and blood pressure drug. Hopefully you wont have anymore bad episodes to discover anything on heart rate change. It works beautifully on keeping my heart rate steady.... but I guess I want my cake and get to eat it too!

Buffafly in reply to Aprilbday

Effective for angina which I have during episodes and also for IBS and diverticulitis though it is not officially prescribed for the latter two 🙁 I believe it is for heart rate, not rhythm, which is why Bisoprolol is preferred as it also has a small effect on rhythm - probably someone will contradict me in a minute as there is some argument about that.

Aprilbday in reply to Buffafly

IBS? Wow. I’ve got some reading to do. Thanks for mentioning rythym vs rate!!! I enjoy learning things such as this.

Grace4291 in reply to Buffafly

what is considered a low dose

Buffafly in reply to Grace4291

120mg a day - I take an extended release capsule.

I have reduced my Bisoporal from 5mg to 2.5 mg by cutting the tablets in half, its now been a couple of weeks and all appears fine at the moment.


Hi Wilsond

Yes I have stopped bisoprolol completely I am feeling better than I did on them so far so good with the AF I fully expected and my gp said I'd go straight into AF when I stopped but I haven't and it's been a few weeks now about 6 I think but I'd need to look it up. I'm not suggesting you do the same I'm just saying my experience. Good luck.

wilsond in reply to Hidden

Thank you hope you continue to do well xx

It really isn't true that if you cant tolerate one betablocker you won't tolerate others. Nebivolol was so much better for me than Bisop and I see lots of posts saying the same - but it is more expensive and that's the real issue I suspect.

wilsond in reply to songbird74

That's interesting,Finvola on here also swooped to that.Ringing back Monday,thank you x

I started weaning myself off bisopropol at 3.75 was OK but 2.5 my bp went up so my GP wants me to stay on 3

75 untill my cardiologist can advise me

wilsond in reply to Denise-

I'll keep eye on bp then,thank you x

Yes I did exactly the same since bisoprolol made me fee just so awful, far worse than the A fib itself. All the beta blockers and the calcium channel blockers they tried me on made me feel like death warmed up

Stopping the drugs worked for me, but everyone is different.

Thank you,glad you feel better now xx

Hello you mention heavy legs and muscle pain. I have had this for ages but, until recently, the only tablets I have been taking are metformin, rivoroxaban and statins. I am on amiodarone now prior to a cardioversion next month. I'm guessing you are referring to side effects of a particular drug but I thought I would ask as I've never been able to work out why I have the heavy legs and aching muscles for so long. Is there a connection between AF and these symptoms?

wilsond in reply to G1703

Not sure,but my GP said any of my drugs might cause it,but bisoprolol probably number 1! I take Atorvastatin,Flecanaide,Losartan and Apixaban too.

Hope you find wishes

I sympathise as I coulb not tolerate even 1.25 bisop.

I am not medically trained but have had recent experience of flecainide 2 x 50 mg for rythm control with 200 mg diltiazem rate control daily. I think the 200mg was too high for me and was better on 120mg but that is another story.

My main concern is your flecainide

I was on flecainide from July 17 to the 24 th April 18.

I had a cryo PVI ablation on 29th January which was succesful. I was back at work in a week still on the flecainide and the diltiazem. 2 days later I got an arrhythmia which was different to the af I had previously which was fast but asymptomatic. The resurgent arrhythmia was very symptomatic. I was breathless just walking into the kitchen to get a brew. I contacted my EP who said don't worry early days, but if it gets worse go to a&e. 24 hours later it was worse so I went to a&e. They took an ecg and decided it was a fib and then contacted my ep and decided to increase the flec to 100mg x 2 to try to cardiovert me. This slowed my heart rate but made me much more arrhythmic and breathless, a bag of ferrets in my chest. A second look at my ecg and a second ecg showed I had flutter which I did not have previously. A week later I was lucky to get an appointment with my EP's registrar. He confirmed I had flutter but also confirmed I did not have this prior or during my ablation. He advised me that flecainide Promotes atrial flutter. So I think when I got rid of the a fib at the PVI ablation it helped to start the flutter (I am not sure of this mechanism.) When the flecainide was increased to stop the assumed resurgent afib it made the flutter worse. The flecainide was reduced back to 50 mg x 2 which put me back to permanent a flutter at 140 bpm but much less arrhythmic which was terrible but better than the bag of ferrets! The 140bpm was only so slow owing to the rate control of the ditiazem. Fortunately I was given a second ablation on the 26th February for right atria re-entrant flutter. This stopped it immediately.

My concern for you is you already have some flutter and you are considering taking away the rate control. For me in my experience this would have probably been a disaster as without the diltiazem rate control I could have had a much higher heart rate - maybe double or worse ! Flutter works in 1:1, 2:1 and 3:1 ratios. It maybe you do not have the same type of flutter as I had but you need to be cautious.

Please look at Dr john Mandrola website for good information /description of flutter.

Wilson D this is the link to Dr john Mandrola flutter facts

Thank you for your detailed reply.I am waiting for opinion of my EP,hopefully Monday regard ing the Flutter and biso.Meantime I am holding fire.So fed up with aching,heavy legs,but stay safe too!

I do appreciate your time,will look at the link tomorrow as it's late now.

Thanks x

And flecanaide induced flutter in me too!

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