Greetings AFibbers. Diagnosed paf a few years ago after a pre op check for another procedure. Had no idea and no symptoms. Been a Runner since age 16. Have been taking 5mg daily and apixiban to keep me safe. However i was persistently tired despite walking for at least an hour a day. Recently I tried to get back into Jogging but felt like I was dragging a tractor. 4 weeks ago decided to wean myself off of Bisoprolol and have gradually got it down to 1.25. Was wondering if anyone else here has:
Come off the Beta Blockers ?
Are you still Off. (using alternative meds?)
How are the energy levels better/worse ?
I am not convinced the Bisoprolol has improved my quality of life and I want off of them.
Would welcome comments without judging.
Thanks
Written by
scottyland
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Hi Scotty and welcome to the forum. Bisoprolol is nearly always the first drug prescribed to reduce heart rate certainly here in the UK and that's largely because it can be prescribed by GP's whereas most alternatives are initiated by specialist cardiologists. There are a number of alternative betablockers available and some work slightly differently than Bisoprolol and may be easier to tolerate. That said, it is true that there are a large number of AF patients who take Bisoprolol very successfully and do not experience any significant side effects. There are also Calcium Channel Blockers such as Diltiazem which also control heart rate so it is very much a case of trial and error to find out which medication is the best for you.
Patients are advised not to come of Betablockers unless told to do so by their doctor. If it's under the instruction of your doctor, you should wean yourself off the medication over a period of several weeks and months if you are on a higher dose. I ought to point out that we are not medically trained but this is only repeating what is freely available in the leaflet accompanying the medication.
Impossible to answer whether or not energy levels improve or get worse primarily because we are all different. Also, the medication is designed to modify the hearts function to compensate for the inefficiencies caused by AF. The symptoms for AF can be identical to the side effects caused by the medication so for those in persistent AF it seems logical that stopping medication causes the heart to become more inefficient thereby potentially increasing the symptoms. Because the heart is having to work significantly harder it puts it under a lot more strain leading potential to enlargement and other more serious heart conditions. Hence it should only be stopped under medical supervision.
I hope you don't see this long reply as judging because that is not what is intended. Clearly you consider there is an intolerance with Bisoprolol so why not consider seeing an EP to discuss alternatives or even the possibility of an ablation which if successful, could lead to a partial or total reduction in medication with the exception of anticoagulation. Bit long winded, but hope it helps!
Hello Scottyland I seem to be one of the lucky ones having been prescribed the beta blocker Nebivolol which doesn't appear to cause the same problems many taking Bisoprolol experience. Maybe discuss trying another form of medication with your GP.
My doctor has just reduced my 2.5mg dose to 1.25. I wouldn’t do it without his say so but I hope this will reduce the problems I’ve faced since my ablation in early June.
If I were you, I would keep a check on my heart rate and blood pressure as the beta blocker is used to keep these down.
I am a poor typer so will use note form and these are just personal comments.
I found beta blockers knocked me flat, felt much worse than i really was, even after a year of lifestyle adjustments and accepting the slowing down. It takes a different toll on different people it seems. They are more if the heart rate is rapid though and my cardiologist was in full agreement with reducing then stopping them if that was what i wanted. I have gradually regained physical strength, which i don't think was possible on the blockers, for me that is.
In Australia they use Sotalol first quite often, as it also has an antiarrythmic effect which was noticable initially then disappeared.
Do you have fibrillation or flutter?
You also need to consider your youthfull running days are definitly over but if you can regain some physical strength its worth looking into.
I was on Bisoprolol some time ago and felt very breathless and tired, eventually changed to Nebivolol same dose. Within two weeks I was feeling loads better and less breathless. I do however have a terrible cough now not sure if that is a side affect of pills or something else going on.
Hope all gets sorted for you soon , it can all get very frustrating.
Hi -- it's been about a year since I had my cardiac arrests and was dx with afib and heart failure. One of the drugs they gave me was Bis. I had a very slow recovery, I was too weak to do much at all. But over the year I got better in most ways. But I still had periods when I was just good for nothing, so weak. Last month my doctor cut my Bis to half of what it was -- I had been taking 2.5 a day, but it was cut to 1.25. Within a couple days I felt better. It really made a difference for me. In addition to my having a tad more energy, it also totally eliminated the labored breathing I would have when I first got into my recliner for a nap. I do want to stay on it, however, I believe it is helping me. My CAT Tigger was dx with Hypertrophic Cardiomyopathy when he was a baby, and has been on a beta blocker (Atenolol) for almost 15 years now. You can't even tell that he's sick. The kitty cardiologist explained that a beta blocker slows the heart just a tiny bit, so the heart has a tiny bit more time to rest between beats. That sounds good to me.
Hello scottyland, yes I weaned off Bisoprolol more than a year ago. Just could not live with it
Cycling is my pastime and bisop is not compatible with this activity; at least not with me it isn't. 75mg aspirin is all I take now daily this stops the platelets sticking and prevents clotting hopefully.
Qol is vastly improved now.
Must say this is my experience and would strongly advise you to take medical advice before making deciding what is best for you.
Thanks. GP Advice is keep taking the pills. I am but have cut down to 1.25 daily. Been on this for two weeks and no problems. In fact I have more energy.
I experienced the same fatigue as you on 5 mg a day. I reduced to 2.5 mg and eventually to 1.25 mg with my cardiologist’s consent. I feel so much better and have normal levels of energy again. I would love to give it up completely but I have a fear of an AF episode which I found very stressful and upsetting. It’s like a safety net for me psychologically- best wishes
No the GP's would not be pleased. However side effects of medication lead to even more medication and before you know it you're on a fistful of drugs. I have friends on 16 or more drugs daily. Just think of that soup lying in your gut, not a pretty thought is it. So I made it very clear I am not a "pill popper", thank you very much Doctor, I shall let you know how I get on, and continue to cycle 200 miles weekly and am knocking on to 80 years of age. Seriously though being subdued by medication is not the QOL I had in mind so put them to one side. Right or wrong I shall discover later maybe !
I have CHD so this may be different but I came off the bisoporol as I felt the same. I’m back on it now as I’ve just had an ablation but I’ll be looking to come off it if it happens again. My cardiologist says that I know my body and trusts me to make the decision. I’ve found it useful to take it at night since I’ve been back on it.
Or if you take it for AF I normally take it as a pill in the pocket when I get symptoms.
I’d speak to your team and explain how you feel.
The first time I stopped mine a few years ago I did it myself and told them after I’d been off about a year but that’s not recommended obviously.
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I seem to be one of the lucky ones having been prescribed the beta blocker Nebivolol which doesn't appear to cause the same problems many taking Bisoprolol experience. Maybe discuss trying another form of medication with your GP. 
Bisoprolol Weaning 
Coming off Bisoprolol
Coming of Bisoprolol.
Bisoprolol 1.25 mg
