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Paroxysmal AF.

I was diagnosed very recently (beginning of this month May)with paroxysmal AF.

I had few heart palpitations for 3 years but given the green light after seeing a cardiologist. He said it was few ectopic and nothing to worry about.

But in Early May this year the palpitation became annoying and my GP done an ecg and found AF.

Had a 24 holster ECG after seeing my cardiologist and I was perfectly OK with a rest echo and an echo after running the tread mill.

I insisted on having a 72 hours holter(ECG)which showed 101 abnormal (AF) waves in 72 hours.

Was put on Apixaban to prevent strokes , and Bisoprolol 1.25 mg to lower my pulse in case it shoots.

I am a very fit active 73 year lady ,but after being put on these medications ,I feel “weird” depressed and unsteady. I am limiting my activities now and trying to be patient to give my body a chance to get used to the drugs.

I just wonder how many people with “ paroxysmal” AF have been given the clear because they were not lucky enough to be given the chance for more diagnostic. And in my case (this was a private consultation!)

15 Replies

Firstly welcome to our world and weirdness and anxiety are part of it. Lets all panic there is something wrong with our heart! We have all been there believe me. Anxiety and AF are common bedfellows is an oft repeated expression.

Then consider the bisoprolol which being a beta blocker has the power to suck energy and life out of us. Being a Harry Potter fan I call it the drug dementor. Some people are lucky and not much affected but lots are. Maybe if the feelings do not go in the next couple of weeks as your body aclimatises it would be a good idea to discuss with your doctor to see if there is an alternative. There are but not being medically trained I can't offer advice.

The Apixaban I am sure you will have been told is an antcioagulant for stroke prevention and should be your best friend although again there are alternatives. I am not aware of anticoagulants causing the feelings you describe though.

Lastly for now, knowledge is power so go to AF Association website and read all the booklets and fact sheets so that you educate yourself about this mongrel condition and will be able to have meaningful discussion with your doctors.

Ask any questions here and I am sure somebody will be able to help.


Thank you so much BobD for your kind advice. I am trying To be patient and give the Bisoprolol a chance to work It has been only 4 days since I used it( I even asked my GP to reduce the dose from 2.5 mg a day to 1.25 mg ) as the higher dose turned me into a zombie! The issue here is that I get terribly anxious when I feel “weird” with the medication and this brings the AF on. ( my AF is paroxysmal i.e. only happens from time to time , but when ? it is unclear).

I am physically very active, no other serious medical problems but had a long period of stress .


Question is, how high does your HR 'shoot' and for how long? What I am thinking is that if you were feeling fit and well before diagnosis and your tests are fine why are you taking medication apart from anticoagulation to prevent stroke? Probably the stress you were/are suffering from affected your heart so if Bisoprolol is making you feel more stressed it doesn't seem helpful. I wouldn't give up yet but if you feel the same in a couple of months there are alternatives if you really need medication. Best wishes 💜


Thank you Buffalo. I went to see my GP as I had unpleasant palpitation. She found after doing an ECG ( at that moment I was with her) that I had AFib. She has done a very small tracing so could not read the heart rate.

2nd day I have seen a cardiologist who has done 24 hours ECG ,and Echo at rest and after exercise. He found my heart to be perfectly normal ,and NO arrythmias ,and That I reached my target heart rate and no” shootings”

When I insisted that I have a 72 hours ECG ,then the cardiologist found that I had “ paroxysmal AFib( which happens only sometimes because of some triggers! But the maximum heart rate was 128/m.

He put me on Apixaban ( anticoagulant) only.

Then when I saw my GP she added Bisoprolol to “ deal” with any “ heart rate shooting” in the future as she said.

I shall give it a month and then I shall decide what I want to do, surely I do not want to be invalid with a medication I probably do not need. Thank you again for your empathy.


If the cardiologist thought that all you needed was an anticoagulant then I would ignore the GP and ditch the Bisoprolol before your body gets used to it. Then you would have to wean off slowly. After all he is the specialist not the GP. Buy a Kardia so you can track the heart rate during attacks of afib. You could also try cutting the dose in half again. Many people cannot tolerate even small doses of Bisoprolol. You could also look into taking magnesium as many people find this helps. Dr Gupta has a good video on this.


I was told to stop taking Bisoprolol 1.25mg daily after only three days as it was bringing my heart rate down too low- I asked the pharmacist as I was feeling so tired and he rang the doctor immediately after taking my pulse! The doctor saw me straight away (a first!) and agreed I should stop taking it. Drug dosages are based on the average male so we women are at a disadvantage! I only take it now following taking flecainide as a PIP if my heart rate is over 140 twenty minutes after taking the flecainide but we are all very different and sadly, it is taking forever for doctors to realise this!


Hi I'm on the same tablets as you for the same thing Sept 2018 and I felt so tired no life but now getting much better getting my life back it takes time take care


Thank you Redbull 45 .that what I am doing at the moment. Wait and see ,with a month time limit on my side. I want to be good again.


Awe four days isn’t long with bisoprolol....it takes a while to settle in, as in over a month ,

Took me ages, seemedto affect my vision too which also settle down..and I bit dizzy all settled......energy does seem to get zapped on each as bob says.........if I’m honest I’ve not been quite the same person since this all happened, a year ago, I think the fact it’s our heart it makes us so much more aware of every blip and twitch.....you aren’t alone it’s very early days with the tablets and also the diagnosis , I think being told you have afib knocks the stuffing out of you just to be told youhav e something......it will settle down and won’t seem such a big thing as time goes on....life can be normal and you won’t be thinking about it all the time, We’ve all been there on this forum. It took over my life when it started, but not now . Try not to get anxious, ( hmm says me who frets at things!)......as for the apixaban, as bob says, it’s your friend. I’m pleased I’m on it, as it helps prevents strokes and that’s what we all need.....I haven’t heard anyone have trouble with that, it’s a silent friend. Don’t worry give the tablets time to settle in.


Thank you Morzine you have put your case in a very humane way.

I sincerely think it was the diagnoses that shocked me!!

Till now I cannot believe it! I am a professional lady( was) in a very delicate job position, worked very hard for 35 years, and when I retired I had big dreams to travel, read, socialised catch up on what I have missed on while working.

Then “BOOOM”, voilà.

Today I am starting to reorganise my life as if nothing happened.


It is such a huge shock mine happened on holiday in Spain and they were so nice in hospital,we then drive back to France and saw cardio who I’ve been under ever since......initially you feel as if life’s over...it’s such a shock....but gradually it gets to sink in life can be normal......the tablets are kind of the regulators that are behind the scenes keeping everything good.....it’s just thst bisoprolol is a tricky one to settle down it takes time........when I came home from Spain I thought that’s it bang goes my holidays.....I felt rather like a wounded bird under a bush....but thanks to this forum I’ve found out others do holidays, and even long haul flights ....I’ve since been to it’al y, Spain, and U.K., and now am goung to Australia in the autum....must admit I do think oh heck why did we book flights to Australia.....that’s when I have asilly fret about the heart...then the other me says look come on don’t be silly....anyway looks like I’m goung.....must admit the first trip to Italy I was nervous about it.....but then Spain I wasn’t...I think it’s about getting your confidence back....as it’s a huge dent in your confidence in your body.....anyway minouche I hope this all helps......you aren’t alone in this the forum helped me sooooooo much....

Chin up!


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You mentioned 101 strange waves over 72 hours, it doesnt sound like sustained AFib which I understood is a continuous or sustained Arrythmia which last a few seconds or minutes to hours. Did the doctor state it was Atrial Fibrillation?


Yes definitely F-M-C-MM , the cardiologist stated it was definitely AFib, but Paroxismal I.e it happens erratically ,May be once only, and may be few times and may be turn into a persistent AFib,but he took precautionary measures!!

So all the treatments I am having is to avoid “ stroke” and becoming a persistent one.


Really important to read about AF. If your cardiologist didn't prescribe a rate control med. then it may be worth going back to discuss with them as it's their area of expertise.

Some people with PAF are prescribed a pill in the pocket med so just take it when they have an episode. That's why you'll find it helpful to read around the topic here and as Bob says the AFA has lots of info.

Re the anxiety that's common and one of the strategies people recommend is breathing control. Again there's info on that here. Yoga helps too. I do different cycles. For example breath in for 3, hold for 4 out for 5. Or in for 7-out for 11.

Also be worth thinking what your personal triggers may be common ones are, alcohol, dehydrated, stress, certain foods, caffeine, even lying on their left hand side for some people.

Good luck


1 like

Make sure you take your resting pulse rate several times a day, if it drops low ( mine went down to only 40) your plan to stay on Bisoprolol for a month before checking back with your GP would not be wise, as it could cause dizziness / fainting. This also applies to BP, if yours is usually normal, the Bisoprolol can drop it too low.

Some of us on here with paroxysmal AF respond better to rhythm control drugs rather than rate control as our heart rates only rise when in AF.

Pat x


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