New to AF and meds

[Abseil]

Hi, I have only recently been diagnosed with AF following the flu (3 weeks ago in A&E) and have been put on bisoprolol (and other meds). It's been less than a week on the meds, can anybody advise please, should it work straight away? I am still getting AF everyday and didn't know if I should contact my CHD nurse. My next appointment is 3 weeks away yet - I don't know if I could put up with it all that time unless the meds are progressive and will get better over the next few days. My HR still fluctuates (when not in AF) around the 75-85 mark which I believe is still high for being on beta blockers? Thanks in advance for any advice.

[Hidden]

Bisoprolol won’t stop the episodes recurring , only slow them down. What other meds are you on?

[Abseil in reply to Hidden]

isosorbide mononitrate, rivaroxaban (and lansoprazole and diabetes meds)

[Hidden in reply to Abseil]

How fast is the AF when it comes? Are the episodes associated with any symptoms?

[Abseil in reply to Hidden]

Between 90-110 and only last a short while as in a minute or two, sometimes up to 15 mins. Usually happens in the afternoon or after about 15 mins of pottering around. I am 57 and have been off work for 3 weeks with the flu. The flu has gone but this AF still bothers me, especially now I am started to get back to normal household activities. I am due back at my desk job on Wednesday and feel a little nervous that I will be getting episodes of AF whilst trying to run meetings or concentrating. Thank you for replying and your advice.

[Hidden in reply to Abseil]

In your position, I would book a one off private appointment with an electrophysiologist (EP). It sounds like you need medication to prevent the episodes (rhythm control).

It will cost around £200 for the consultation, then you can revert to the NHS for further investigation. Only a cardiologist/EP can prescribe a rhythm control med and the NHS route can be very slow. But yes also ring the CHD nurse who may be able to expedite a cardiology appointment, or possibly get your NHS consultant to approve a prescription.

[Abseil in reply to Hidden]

Thank you very much.

[Tantaanna in reply to Hidden]

I would agree to the appointment especially since you go back to work

[Buffafly in reply to Abseil]

I have had a nasty virus which lasted at least 4 weeks and my heart was very wobbly with spells of running faster than usual but it's fine now. You may find that the AF is much less troublesome when you are fully recovered. It would be good if you could have another week off work, and don't even think about exercising until you have had more heart investigations (don't know what you've had so far). Usually you can't be prescribed antiarrhythmic medication until you have had tests to show they would be safe for you. I'm sorry to say it's a slow process usually but on the upside there are people who have had AF after an operation or a drinking binge and not had it again so far so if you look after yourself there's hope. As no one else has mentioned and you did say 'any advice' the usual lifestyle advice is no smoking, alcohol, caffeine, chocolate, over eating, overstressing or overexercising 😖 As you are diabetic a lot of this will already apply. Sorry 💜

[Abseil in reply to Buffafly]

Thank you for replying and your advice 😊

[jedimasterlincoln]

Bisoprolol is rate control, and ideally it shouldn't be letting your heart beat too fast. However, it does not control rhythm which, when irregular, can feel or indeed run fast.

[Abseil in reply to jedimasterlincoln]

Thank you for your reply and information. My GP said that a lot of people don't even feel the AF but I am of an age group that do. I guess I will get used to it over time. It just makes me feel unwell. They have told me it won't kill me, but it can't be good for the heart to have AF going on!

[jedimasterlincoln in reply to Abseil]

Directly no it can't kill you, but it does carry a risk of stroke as your heart is being inefficient. My Dad has AF constantly. No symptoms, only detected by accident, but still needs anticoagulation.

I only get AF in short sharp bursts which knock the wind out of me and leave me unable to climb a flight of stairs before I get a HR of up and around 190.

[Abseil in reply to jedimasterlincoln]

I am on anticoagulants. I was up in the 180s when I was in A&E not it tends to peak at a little less than that. Guess it is early days and I just have to get used to it. I'm not looking forward to exercising again! Oh well, I am grateful to be here and monitored; it is better than some. Thank you for your help.

[jedimasterlincoln in reply to Abseil]

Your body is usually pretty good at telling you when you're pushing or overdoing it..... just be sensible

I used to be washed out and debilitated at 120, now I can go upstairs and get dressed etc at that rate and it's only 150+ I have a problem with so there has been progress.

[Abseil in reply to jedimasterlincoln]

Good to hear. Thank you

[RichMert in reply to Abseil]

Yes some are totally unaware but I feel every missed beat or flutter. Those of us that suffered AF for a long time and had an ablation become sensitive to any change in beat. You can lose your confidence to do anything energetic but do not beat yourself up about that. My consultant told me it may take 18 months or more to regain my confidence after the ablation. That was 5 years ago and my reason for mot jumping on my bike more often.....the tyres are flat. LOL. Seriously, I used to go for a walk during my AF episodes as I found that it reduced the duration. AF can also be stopped due to any form of inertia, if you drive, try a break test on a quiet road.

[Maril1 in reply to RichMert]

Yes same here always go for a walk HR through the roof 180+ but AF lasts 15 min to 1.5 hrs instead of 4to 8 hrs. I would be very interested in more information on forms of inertia?

[RichMert in reply to Maril1]

Maril1. This will make you laugh. We discovered this when the Ambulance driver had to break hard to avoid an idiot. The crew member flew through the cabin and my bed shunted the support hard sending me sliding only to be stopped rapidly by the belt. My heart went back to normal instantly and from that point on the Ambulance crew would try the same method but it failed to work. I think it is more effective when you are not expecting it to happen. Mine started on one occasion through breaking hard whilst I was driving. It's a long way back from Honiton to Cornwall with a 140bpm AF. Plus there are not enough loo's on the way. Abseil, that is another thing that is normal with AF, needing to pee every 15 minutes whilst in AF.

[Maril1 in reply to RichMert]

Yes I always have to go for a pee during my walks in AF . I have tried many shock methods including ice cold water but they have not worked as yet . Another one that has worked for me is couple of pints of ice cold lager maybe 3 or 4 to be on the safe side.

[RichMert in reply to Maril1]

No, definitely comes down to sudden movements which is why turning over in bed or standing up can trigger them, likewise, stop them

[Abseil in reply to RichMert]

Hi Maril1 and RichMert - I can relate to some of the comments you have made and have taken the others on board. Thank you for your replies.

[Hidden]

The pharmacist said it would take 2-3 weeks for the meds to be working properly. I was also recently diagnosed so still learning. Aiming for below 80 but to contact them if regularlyover 90. I have found the pharmacist at the surgery to be very helpful, might be worth you asking yours.

[Abseil in reply to Hidden]

Hi Rayswife. Thank you for replying. You message came through just as I was sitting in the Drs. I called the CHD nurse at my Drs yesterday and she thought that maybe my meds needed to be reviewed given the symptoms I was describing, and booked me into the GP today. He has doubled the dosage of the beta blocker as, understandably, he has put me on the lowest dose, and we will review in a couple of weeks. I agree, the pharmacist was very helpful when I had a chat with him, after I received your message. Thank you

[Pointysticks in reply to Abseil]

My GP has been brilliant and has let me manage my medication myself to a certain extent - started me low and said I could double that dose if the symotoms didn't go. I did have to increase and now have permission to increase again. So I know the maximum I can go to and if I do need to do an increase then I can do that first and then call him.

However he knows me well and that I am sensible!!

[Abseil in reply to Pointysticks]

Excellent relationship Pointysticks. Thank you for replying to my post. I go to a surgery with about 8 drs - they are all good but I made sure I got an appointment with the one that specialises in CHD and will try to make sure I only get appointments with him so I can build a relationship; nothing more tedious (or slightly worrying that you’ve forgotten something) than having to explain the same condition to several drs.

[Pointysticks in reply to Abseil]

I go to a small practice. Just three and an occasional locum, so I do try to see the same one for this, or if it's just to discuss a dose change a telephone appointment will do.

[RichMert]

Hello Abseil,

I am not sure Bisoprolol will prevent the AF. It will however lower your heart rate by 10bpm or more depending on dose. You have the start of PAF and once your Heart settles down (you are completely over the Flu bug). You may see the episodes are less frequent. It does come down to finding the right drug but I would avoid Amiodarone or Flecanide unless the episodes start to get longer (hours) and it becomes persistent as opposed to Paroxysmal.

[Abseil in reply to RichMert]

Hi RichMert, thank you for your reply and advice. The 10 pbm reduction is interesting. As you may see from my reply to Raywife, the GP has increased me dosage so hopefully that will have the desired effect for my current symptoms. I've taken your other it on board - I shall keep it in mind

[RichMert in reply to Abseil]

Just to say, when you stop taking Bisoprolol, unless you are swapped to another Beta Blocker, you will need to come off of Bisoprolol slowly (over a course of a week or 2). Do this by halving then quartering the tablet and taking them a day apart towards the end. I mention this as I and many others found that you will feel anxious and keyed up if you come off of Bisoprolol instantly.

[Abseil in reply to RichMert]

Oh! Good advice. Thank you. I thought I would be on it forever so it's good to hear that there is a chance I won't and I will keep your advice in mind.

[Atriljohn]

Hi I was diagnosed 2011 heart failure and AF.

Given bisoprolol spironolactone ramipril warfarin and others but kept AF even after 3 ablations. You can live a long life with AF my dad had this over 15 years my heart is 110 over 70 90 bpm

Yes get puffy some exercises but doable my ejection factor now 35% normal is 50% I think feel ok

[Abseil]

Hi Atriljohn. Thank you for your reply - that is very interesting and reassuring. I feel like I am rattling with all the meds I am on and feel a little astonished by it all as I am only 57 and have tried to stay fit and healthy but, alas, as I joke with my three older siblings, I appear to be the runt of the litter and, despite my efforts, seem to get everything! But, as I said, your reply has been reassuring that I can live with this condition for some time yet, and can resume some exercise if managed carefully. Thank you

[007talullah]

Hi, lots of good advice and comments here. Just wanted to add: it’s a good sign that your AF is self limiting (you say it only lasts up to 15 min and you’re not taking anti-arrhythmic drugs) and that you know your trigger (exertion). I would feel confident you will find a combination of drugs that work well for you. You’ll know within a few days if they’re doing the trick. If they’re not working go back and ask to try something different. The best way to help yourself is to learn about AF (via this and similar forums) and be your own advocate. Good luck!

[Abseil in reply to 007talullah]

Thank you 007talullah

[Aquataine]

Hi

It took my husband's a good 2 month to settle down and he is still not what I would call well, he is on Bisoprolol as well and his pulse is very erratic and much higher than yours.Do not be afraid to go to your GP's it maybe that your medication needs adjusting. Good luck!

[Abseil in reply to Aquataine]

Thank you Aquataine.

[Sim22]

As with all illness it takes time, I’m a year in and I’m still acclimatising Relax you’ll be fine

[Abseil in reply to Sim22]

Oh boy! A year?! I’m going back to work on Monday and am a little worried about it. Had a CT angiogram 10 days ago and haven’t had the follow up appointment yet - I’m assuming that if anything was serious, they would have contacted me by now. Guess, like you’ve said, it just will take time to get used to this change in life’s path! Thank you for your reply