I have posted before that I have had paf for about 18 months. On my first Afib the medics put me on Bisop (now 2.5). Since that time I have had probably another 6 attacks. All symptomatic and all self resolved. Since the Bisop my bp is usually about 95/60 and rate of low 50's. I feel too low and making me worse.
All of my attacks have been post meal time, middle of the night and about 7am. I am convince I have vagal Afib.
I have not had alcohol since and now lost 2.5 st in weight. The last short Afib was 7am 3 weeks ago.
The ectopics are becoming more frequent and mostly when I am not doing anything.They are not nice but do pass.
I have read several good studies that say that Bisop should not be used for vagal Afib and could make it worse.
So I would like to get off the Bisop and intend to ask the EP just that.I am leaning toward an ablation as I am feeling lifeless ad can't do anything. I think it is the Bisop but maybe the Afib.
Can I ask have any of you done just that, getting off the Bisop,and what did you do? Did it work ?
once again thanks Rod
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Thought you might ask that ! Answer is nothing. I stopped the lot except 75mg aspirin. Life is great and normal. I recommend you seek medical advice before you
Bisoprolol made me quite ill, very fatigued, like walking through treacle, breathless, cold and tingling feet and hands, the list goes on. There are a lot of people out there who cannot tolerate Bisoprolol so yes, definately raise this with your EP. I came off it and was on Atenolol and Flecainide which was like night and day compared with Bisop. My quality of life improved greatly. I also had an ablation which was successful in alleviating my AF for 2 years but alas I have had a couple of episodes lately, triggered by food so am now thinking of another ablation. Hope this helps.
A number of people have found it very helpful to change from Bisoprolol to Nevibolol (both 'beta blockers') Doing so should help you to distinguish between the effects of the Bisoprolol, which seems to slow many people down to an unacceptable level, and the effects of the AF itself.
Your GP may well be able to make this change for you.
I first had AF 8 years ago and was put on 2.5mg bisoprolol. I suppose I'm one of the lucky ones in that I had no adverse reaction to bisop, or the episodes for that matter. Even though an episode would last anywhere between a couple of hours and 12 or so hours, and I was aware of it, it did not stop me doing what I normally do. It was a feeling I had rather than something debilitating.
With my GPs approval I went down onto 1.25mg bisop because my resting pulse was too low when I went to bed. It would occasionally be mid 40s and even approach the 30s. I realised about this time that my AF was vagal based on videos I'd seen and articles I'd read.
There are a number of triggers that considerably heighten my chance of going into AF, and always late evening or when I'm about to go to bed.
1. Too much alcohol. I'm okay with small amounts that coincide with the drink driving limit, but the more I go over, the bigger the risk of an episode.
2. Big meal. Not good. Shortly after it, I get that feeling, even though my pulse is steady, that I'm likely to have an episode sometime during the night.
3. A cold, sugary drink like J2O out of the fridge. That is most likely to put me IMMEDIATELY into AF.
4. Posture would you believe. There are a number of settees I will not sit in because in the past I've gone into AF as soon as I settled down into them. Crazy, I know. I once very nearly went into AF just stumbling over the doorstep entering the house, but I managed to avoid it through deep breathing, which still works for me.
Anyway, I decided bisop was possibly contributing to my AF because I would wake up in the night with a low pulse, yet still go into AF. Having stopped it, things got no worse. I still got episodes but they were very tolerable and didn't really bother me that much.
I now keep the bisop as a 'pill in pocket'. If I have an episode, and I think my pulse is quickening a bit too much, then I'll pop a bisop.
So, I am in agreement that there is such a thing as vagal AF (my GP won't even talk about that and chooses to ignore me when I use the word vagal) and that bisop is probably not a good medication to be taken if you believe you have that.
Strangely, of late, my episodes have become more regular, but also less noticeable and bothersome, and even revert to NSR in a shorter period of time, which I welcome. This has kind of coincided with me having to take Tamoxifen and so there is a possibility it is a reaction to that, but who knows.
Amazing reading your post especially with the settees, if i sit on a really uncomfortable settee than i will get skipped beats and ectopics its awful as if i go to someones house i have to really work hard to make me as comfortable as possible to try and calm the ectopics happening
I believe it's one of those things that some of them just don't acknowledge for some reason. There's enough medical professionals on board with it though and so I'm not sure why it seems to be such a taboo subject.
Very interesting. I too have had PAF for about 8 years. I also have hypertension for which I take amlodopine which controls BP to around 140/75. I take no other medicine for Afib not even a pill in the pocket.
I found I cold not tolerate beta blockers. My resting pulse is 51 -55.
Like you, I try to limit my alcohol intake and my chance of an attack increases if I go over my limit which seems to be a couple of pints or maybe 2-3 small glasses of wine. I have 3/4 days off alcohol every week.
Overeating or eating late, I mean over filling the stomach, is definitely a trigger, (vagus nerve?). So small meals and early suppers help. I also take pre biotics
I also find that as time has gone on my attacks are far less forceful but more regular. They almost always occur at night when I'm asleep. The worst symptom is that when having an attack, I have to urinate extreme amounts so find myself up and down from bed for hours.
I am going back to my EP soon and know that an ablation is likely to be offered. I have had one for atrial flutter 3years ago which they say was successful. I would prefer not to have another ablation but do not want to get involved with life changing drugs.
In general, its a waste of time discussing the condition with GP's, they are not experts.
There are various tests underway at present using electrical pulses thus " soothing" the vagal nerve. Apparently this method is used with some success in the treatment of other conditions.
We have a number of things in common there. 99% of my episodes happen when I'm in bed, and yes, I do have to go to the toilet when it happens, but recently, less so, maybe only a couple of times. When I get an episode, it find it mild enough that I just go straight back to sleep. I have only had an episode during the day once in the last 5 years, but I think that was because I was slow to react to the signs with my deep breathing. I usually find, I can prevent the episode coming on when I do that. It doesn't always work at night, especially if you wake up already in AF.
I thought ablations would only be offered if your quality of life was severely affected by it. Mine isn't at the moment. When a nightly episode continues into the following day, it doesn't stop me doing what I usually do.
As for AF related medication, all I take is Apixaban, but I think even with an ablation one is expected to continue taking an anti-coagulant.
I think you are right about the deep breathing. One needs to catch the attack before it takes grip which is impossible when you are asleep.
I was offered an ablation 3 years ago for afib but wanted to try to beat it by lifestyle changes. However, whilst on holiday over xmas, I contracted a chest infection which caused me problems with breathing which led to 4 full blown attacks in 8 days. So back to the Consultant EP to see what he says, but EP's do ablations! I just wish they had a higher success rate.
The drugs are life changing but I find the horrible symptomatic Af much worse. It had given me an anxiety that I never had.
Tonight my b/p and pulse were better than the last 18 months as I stopped taking the bisop yesterday in order to start the calcium channel blockers tomorrow but i bottled out and took a bisop. A bit ashamed of my lack of nerve.
Hi in reply to Alan G I have had many AF episodes starting up when i am seated in a half reclined position in my chair. This week my cardio has put me on the waiting list for an Ablation [have had PAF for 8 years} and hope for a positive result. Mentioned Vagal Afib to the cardio and he just ignored my comment, am on 7.5 Bisop and had i seen 7164 post would have mentioned it to the cardio. Am having an Afib episode now which will last 18 to 20 hours.
Thank you for your replies which are very helpful.
Just spoken to my GP who wrote to the EP. The EP agrees that we should stop the Bisop and move to Verapril. I am to stop the low does bisop now and start the Verapril on Sunday morning.
I truly hope this works or its the ablation for me.
I was told by my renowned EP that drugs will hardly fix the problem. You are moving from a beta blocker to a nondihydropyridine calcium channel blocker. In an onlinelibrary.wiley.com, this 2016 article states , " Verapamil may also be be useful in reducing recurrent AF after cardioversion. "
However, since you are paroxysmal time is on your side. Just be cautious that you not get to persistent. You will know that if your episodes get longer and longer. The chances for a successful ablation are much higher for paroxysmal than persistent.
hello 7164 I also think i get vagal afib (indigestion/sleep/resting). i changed from bisoprolol to calcium channel blocker a couple years ago ( because i have an epipen) and I found them much better. I do take a small dose of flecainide and generally it works for me. I do get the odd week or two when I am a bit AF/palpatation prone. I am also considering ablation but currently the tabs work. good luck
The vaginal Afib made me laugh and we should all keep it and when we Afibbers feel down read it😊😊😊
Rod
When you say Vagal Afib, are you meaning the Vagus Nerve? I'm responding because I had serious Afib due to the irritation to my Vagus Nerve. Over 3 1/2 years I suffered horribly. Was in emergency room at least twice a month, and sometimes more.
At the end, it was so bad that my heart started stopping. Anywhere from 3 seconds up to 7 seconds. I would start to black out. The electrophysiologist put a monitor on me and after some days of wearing it, he said I needed a pacemaker asap.
I was being scheduled for the pacemaker, which I dreaded. Prior to having Afib attacks, I had 2 root canals. After which is when the Afib started. Luckily, my new dentist told me he felt that the root canals caused the problem. Just before the appointment for the pacemaker installation, I followed my dentist's advice and found a Holistic Dentist that was very familiar with this type of problem. He removed the two root canals, along with the ligaments too.
Then he seriously cleaned out all of the infections and necrotic tissues, with Ozone!! The only thing that kills ALL of the bacteria.
The moment he was finished, all of my heart issues just totally stopped! I could feel the return to normal within my heartbeats.
That has been almost 2 years ago. To this day I've never had one problem concerning my heart. Yes, the Electrophysiologist, the Cardiologist, and my Primary Care Doctor were astounded.. But I'm living proof that root canals can affect many bodily functions due to Vagus Nerve irritations.
I suggest you find and watch the video on UTube called "Root Cause". You'll be astounded and grateful if you do. Now, most dentists will deny any of this, due to not wanting to have negative effects on their revenue streams. This video was on Netflix, but the dental industry forced them to remove it from their film lineup. Afraid of the $$$ consequences, sadly.
This may not apply to your situation, but I hope it helps if it does.
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