I tried the bisoprolol (2.5) for 18 months after my diagnosis of paf
Struggled on it and still got af attacks (very symptomatic). Finally persuaded the medics to swap me to the calcium Chanel blocker. Night and day so much better and thought that this was it 😊😊
But, cycling home on Monday night (only two miles) felt big ectopic but carried on. Fast forward to midnight and bang afib and the usual speed thumping and breathless. Off to A@E 5 hrs later and a Digoxin home still in af but better.
I have only beef on the veramapril for 10 days.
Early days or am I kidding myself that an ablation is the only answer.
As always your thoughts are much appreciated
Rod
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Ablations are not always the answer. I've had three and still have AF.
My EP has discharged me from his care saying some people are not helped by them and I'm one of them. Looking at this forum others on here are like me and continue with heart arrhythmia's despite many ablations.
Have you tried the healthy eating options that are constantly recommended on here? Doing so has helped me greatly.
I also believe that the mind has a great part in promoting AF. Countless times members on this site have worn monitors and found that their hearts behave perfectly for that period, but once it comes off - well back it all comes!
Could the thump you had in your chest while cycling home have set you off mind thinking, am I going to have an AF attack?
Yes, I think most peoples attacks are like that. I remember my heart bouncing around and thinking I would surely not survive the attack and, living on my own, wonder when I'd be found.
Fast forward lots of years and 3 ablations and I don't have attacks like that now. Whether my third ablation helped, or it was my change of diet I really don't know. I have to say that whereas my AF didn't get better after my first two, it did eventually after my third. To be fair my first ablation did stop my heart banging in my chest when I walked up hills. I thought everyone's did that!
Now, I don't let anxiety take over, 15 years of having AF and surviving have taught me that it's not the big deal that I thought it was. I don't keep checking my pulse and do my best to ignore what it's doing. I no longer spend days admitted to hospital.
I can't expect you to be the same right away, it takes time to feel confident and understand that an AF attack is not the big deal we think it is. Being able to control our thoughts and anxiety is another vital learning curve that really helps. Anxiety is like fuel to AF and makes it so much worse. We must remind ourselves that there are far worse conditions we could have. I remember at age 17 coming over faint at the sight of a man with half his face missing. I hope what I've said will help you. Jean
I wouldn't personally do anything strenuous while your heart is racing over say 110ish, or if you feel ill or drained. Saying that when I've had long periods of AF lasting days/weeks/months, as I live on my own and am a little garden proud, I've struggled to mow my lawn and then sat later with a sore heart feeling sorry for myself that I had no one to help me. Many times after I've done this my heart has reverted to normal rhythm. I would/could never push through a wildly racing heart rate and wouldn't recommend that to anyone. Let's not forget too that our hearts can all behave quite differently and what is ok for me, may not be for someone else.
Yes, in my opinion, you can sometimes push through it very gently without falling over. A few times when mine would take off super high I would think I'm going to end up in hospital. I'd start getting ready to go and not feeling like doing so, take a shower and a few times showering has put me back into normal rhythm.
Washing dishes and any gentle chores can still be carried out. Do anything that takes your mind off your heart. If your pulse is high then perhaps sit and watch something interesting on t.v. or the internet. Never ever sit anxiously concentrating on what your heart is doing, because that's a sure way to keep the AF going.
Once, when in AF, I went to a neighbours house for pre Christmas drinks and nibbles. I forgot all about my heart and another neighbour told me I was looking really well. My immediate answer was, I feel it and then It dawned - I was back in sinus rhythm. The fun and laughter there, which had taken my mind off my heart rate, had been my cure.
So if you live on your own and have a friend who can lift your spirits and make you laugh, ask if they'll come around and see you.
It can sometimes be stopped with our minds, I have proved this just once, but it's too long a story to write here. What I think we can do with our minds is reduce the severity of the attacks by remaining calm when AF kicks off. I think this may only be possible after having had lots of AF attacks, coming through them and realising they're not the big deal that we first thought. Also the more episodes you have then eventually the less anxious you become, anxiety feeds AF. I'm convinced that people who go to A&E, only go back into sinus rhythm while there because they feel safe.
So many people who wear heart monitors, for a period of time, will tell you how well they felt while wearing them. I swear I could have climbed mountains when I had mine fitted, but once they were off - back it all came. I believe that happens because once again we feel secure wearing one, we want an attack so that it can be proved how we are suffering. Our anxiety is reduced and we rarely experience a severe attack at his time .
The moment you feel your heart take off, or even if you suspect it's going to happen, get up and move around and try to set your mind thinking about something other than the beats. As I've said this is more easy to do the longer you've had AF episodes. I've had them for 15 years now. To start with I totally tuned into my beats and my anxiety immediately soared. I would get a little thump in my chest and immediately think, oh no it's back and get out my BP and heart rate machine, so I could see what was happening! AF is best ignored, but of course that's not always easy to do in the early years of having it.
I have no idea why my 3 ablations didn't cure my AF. My EP said some people aren't helped by them and I'm one of them. I have to say that my AF experiences are nowhere near a bad as they used to be. My diet has changed drastically and I rarely eat anything that contains artificial additives.
I hope that what I've written is clear to understand, let me know if not.
Jean Ive not found I could or I go dizzy, feel sick & sweaty.....have to stop and preferably lay down.
Am in the same positon each med has to be increased then fails in its effect. Already half way through the permitted dose for the channel blocker and Ive only been taking it ten days & my heart rate hasnt slowed at all....lol.
Am also praying abalation is the answer as though the p-afib is periodic the fast heart rate is constant. This all started when I was gping through chemo over four years ago.
Appointment 3rd April.....fingers crossed.
So all my sympathies to those in the same boat.....
I was diagnosed with P-Afib last July but the racing hear Ive had for 4 and 1/2 years....not that Im counting. 😳🤣 Ive been on cardivilol with ever increasing doses....that did settle the racing for a while. Unfortunately as the dose got higher it interfered with my thyroid treatment and I became really tired and put loads of weight on.....which hasnt helped! Also low thyroid causes palpitations!! On the veramapil I feel far less tired, more alert but hasnt changed my racing heart so am hoping I can loose weight now.
Today by error I took my second dose of the day four hours too early ....and so was worried Id overcooked myself. A nurse reassured me......interesting the 160mg effectively for fours hours made no difference what so ever. Heart still racing just the same.
Am not sure what they will do -abalation or pace maker or no idea what drug they could use next.....
No, if you feel the way you describe you must always stop and rest. Never ever go against what your body is telling you to do. Still try to distract your mind though.
Agree with you Jeanjeannie50 - I have felt very similar to you. For me my bedside radio has been a comfort when af happens in the early hours, put it on loud to help mask a thudding fast heart! I also keep a small case packed along with uptodate list of meds & cardiology reports/blood test results etc "just in case" I need to call paramedics/go to A&E. Like you having had svt, paf, permanent af, af flutter you do learn to luve with it but, the anxiety it causes at the time & the exhaustion afterwards has been very hard to cope with at times. Again, similar to you if I have had a social event planned it has been tempting to cancel but, it certainly helps take your mind off af & yes, you can come away realising you are in nsr.
I find when the AFib kicks in waking me up I feel better if I sit up. And your spot on distraction is the name of the game. An not great yet at this. Can cope with the racing but its the breathelessness that scares me.
Unfortunately Rod I’m one of those that has to work whilst living with symptoms and keep it quiet too.
It sucks, but as much as I want to stay in bed some days and rest, I have to pull myself up and go to work or the bills don’t get paid simple as that.
As Jean said the mind is a powerful ally, but also a weapon. Sometimes it can work against us. It’s the fear that we are going to go into AF and what will that episode bring? Try deep breathing, plenty of posts on here about techniques. Believe it or not some come out of AF by exercising or moving about instead of being sedentary.
It would be beneficial to grasp the classification of different drugs and what they are designed to do so that you are on top of what happens regarding side effects and the drugs' mission - rate or anti-arrhythmic. Bisoprolol is a beta blocker and Verapamil is a nondihydropyridine calcium channel blocker. Verapamil is designed to address rate and not rhythm. In other words , it is supposed to keep your heart rate down and not to get you in rhythm and keep you in rhythm. You would need an antiarrhythmic drug for the latter which a GP cannot prescribe.
My world class EP told me that drugs will hardly solve the problem. You do not say whether you have had a consultation with a cardiologist and preferably an electrophysiologist. It appears that your GP is handling your drugs. I suggest you be referred and discuss whether you want to live in (with) AF or not.
AF begets AF. The more AF you have, the more you will get. If you are considering an ablation , the earlier the better the outcome. Those that have these "failed" ablations have let their AF progress too far. In my case, I have had to have three because my progression was to six months persistent.
Ablation is not a cure because the burning only blocks the rogue electrical signals. Clinicians are hard at work trying to solve the arrhythmia puzzle. The best in my opinion is the French LIRYC institution built solely for research to solve arrhythmia and which brings together experts from all over the world under one roof.
Today ablation still is not a permanent cure, but caught early enough , some experience decades AF free, others with advanced AF need many ablations to achieve that goal. With mapping tools getting better and better, success is increasing annually.
Perhaps you might want to look at your situation whether you just want your heart rate to be kept low and on drugs or whether you consider ablation with the objective to block AF and hopefully off drugs if your AF had not progressed really far.
Hi Rod, I have checked my past replies, and I found that I did reply to your last post, I believe. Thus,the above reply went into more detail.
It is not surprising that Verapamil, did not stop your AF; it's a rate drug. It is not surprising that your AF has become more frequent: AF begets AF.
Older literature promoted rate control as a first line of therapy, and, if I remember correctly, two or more drugs had to have failed before an ablation was offered.
Today, some centres have adopted ablation as the first line of therapy. The CABANA trial examined drug therapy versus ablation. Depending the method used to interpret the results, one can either say they are equal or ablation is better. The current interpretation favors ablation.
You are lucky that you have not gone persistent despite 18 months of PAF. I went persistent one year from diagnosis. My silly GP did the rate control thing allowing me to get worse and worse. The waiting time for an ablation plus having to go out of the country ate up another six months persistent. Result -- three ablations so far.
Your EP sounds as if he is following the older literature. If you do not want to be on meds for the rest of your life, discuss ablation or it is most likely you will find yourself in the same boat switching meds. These meds will just prolong the inevitable -- take you longer to get to the ablation. However, there are situations when AF can be stopped if it is triggered by certain conditions. If sleep apnea triggers AF, then controlling sleep apnea should get rid of the AF, at least that's what I've read.
Also, the longer you stay in AF the greater the result you will still need meds. even after an ablation.
With the experience and the knowledge that I have now, there is no way, if it were me, that I would allow an EP make me live in AF. Mine tried so I went to another country and I am now nine months post ablation and in sinus rather than waiting for my next AF attack. Do keep me posted.
Beta blockers and calcium channel blockers are rate control meds not rhythm control meds. I could not tolerate beta blockers bisoprolol not Atenolol so ended up on verapamil, which I really liked because it had her minor side effects, at the low doses I was taking. However if I did get an afib attack when taking it it did not keep my hr below 130 at the low dose, so I would take another 40mg tab to help with the rate control but i understood it took 4 hours or more to have an effect so it was not much use in keeping the hr low. I always got high rate afib . Consequently after my AF " developed " further I had to move to flecainide rhythm control and diltiazem rate which was horrible in side effects.
So I had an ablation 25 months ago and have been off ALL meds since May 15 2018.
You sound like me. The Veramapril is better but not stopping the Af and I was in A & E again this week. I do not want the Af to 'develope' and dont want the rhytm control. Am I just putting off the inevitable ablation ? I am fit and well 61 year old otherwise.
I am not medically trained and can only tell you what I did and why. My afib got worse, (afib begets afib) , I hated the drug side effects i was on when i had to take Diltiazem and felt I would probably get more over time ( brain fog poor memory exercise intolerance breathlessness) was fed up of going into high rate afib and having to go to A&E. The third last time I went (pre flecaiinde/ diltiazem) i was in 130 to 195 bpm RESTING for 8 days and spent 5 of them in hospital and was only got back into NSR by flecainide infusion in my local hospital CCU! I was asymptomatic in afib which made things worse .(was shattered after 8 days though).
My EP said I was a good candidate for ablation and would come off all drugs if it was succesful. 70% success rate. No brainer to me. I wish I had explored the ablation sooner. But I had no known triggers, or confirmed causes , was fit, and had no co morbidities so felt I was not at any risk with the procedure.(although nothing is risk free, but then neither are the meds!)
Yes well pretty much, but I am less excessive. I don't drink anywhere near as much but I never knew any triggers except maybe stress. Alcohol never kicked off afib, but I don't know what did. I never drank Monday to Thursday anyway except on holiday. I was on decaf everything post afib occurring but again I got afib attacks when on decaf (and having stopped alcohol). so last 12 months after being afib free for 13 months post ablation I drink normal tea and coffee most of the time. I have made an effort to keep below 13.5 stones, (would like to be 12 stone something - a target for this year) and do enough exercise to keep my BP in the normal range and keep a bit fit. . I eat a lot of salads with fish during the week, don't have any fry ups unless away on hols, but did all this since 2013 anyway so was on all this before I developed afib. Post ablation i had a couple of months on 3 day weeks getting back into work, but then changed my hours to 4 day weeks permanently with Wednesday off . I had a 53 mile each way commute and could spend 3 hours plus driving on a bad day, so decided to have a lower stress day and a lie -in mid week, and not get as tired over the week . This was again working on maybe it was stress or tiredness related, but I have no evidence really it was ( 3 of the first 4 afib attacks started on a Thursday, but in converse i have had MUCH more stressful jobs in the past.) Also as needs must at work i worked a few 6 day weeks with longer hours to no detriment during the period after my ablation . But I was getting tired with the commute. I have just gone back to 5 day weeks with a new job, but now my commute is 1 mile each way! So over the week less hours overall and no battling traffic and I don't need to leave home at 6:20 every day. Again i dont know that this was the problem but i am just cutting back on possibilities across a number of areas. Also i am breathing in less fumes and diesel particles by not being in a line of traffic 5 days a week) But it is reducing potentially bad/ unhealthy things not eliminating, as I do not know what caused afib and never had known triggers. Also i am now 5 years older than when afib started (60 this year) so probably was time to reduce (mostly) bad behaviour as I get older!
I had a choice of being referred to Wythenshaw or going to Royal Stoke which is smaller and further away. I chose the latter purely as I had already met the EP when he was a visiting Cardiologist at my local hospital when I first got AFIB, and he seemed to be a good guy. This was before I knew what an EP was!
Neither of my ablation was a problem. The first was a Pulmonary Vein isolation cryo for AFIB. I was under mild sedation except for the local in the groin entry point.
I never felt the groin and I was in a position where I could watch a lot of the screen the screen and could some of what was going on. The actual cryo is four veins having the freezing gas balloon blown up inside the mouth of the vein (there is a medical name for this area but I forget). There is pain but it is relatively minor - the pain is just the brain freeze like you bit into the worlds coldest ice cream. 4 times , That's it last longer than the ice cream but i have had worse at the dentist. The AFIB stopped in the cath lab and so far has no re-appeared. I did get a bit of oesophagus pain immediately afterwards as I left the cath lab, this felt like when you wolf down some food an it sort of gets stuck half way down to your stomache . (one of the pulmonary veins is adjacent to the eoesophagus). That was more uncomfortable than the procedure but I got a glass of water and a few swallows and after half hour that was mostly gone. An hour later I was eating chicken sandwiches! I was in recovery about 4 hours waiting for the groin to heal then I went home (wife driving). Once you go to bed you are not allowed to walk downstairs for 24 hours. I was up and about after 2 days no problem, groin was fine, back at work in a week.
Unfortunately 9 days after I developed rate controlled re-entrant atrial flutter (right atria) and that was very symptomatic, walking lounge to kitchen had me breathing heavily, so I did nothing for 3 weeks waiting for an ablation to stop that. The flutter was not evident on any ECG prior to or after the ablation and as I was asymptomtic in AFIB I am sure that is right. I have been running in afib at 243 BPM and could not tell other than by my Garmin. The EPs registrar advised that it was likely to have been promoted by the flecainide I was taking for the AFIB.
So four weeks after my AFIB ablation I had a flutter ablation. Simpler, less risky ablation, being in right Atria. Shorter procedure done by RF. Mild sedation, local in the groin, still no problem. This was a bit more painful that the cryo , but again I am sure the dentist drill is worse or at least similar. This time the pain is felt in the right shoulder. Each burn only lasts seconds. The flutter stopped during the procedure I took longer to recover from this but not because of the procedure, mainly because my heart rate had been 140 bpm for 3 weeks solid so I was shattered (a lot of marathons that is!) and as I had been lying down mostly for 3 weeks my muscles had wasted. I had a few days rest then started walking. After a week or so I walked round the local park and worked up to 9 miles over the next 3 weeks , 2 or 3 walks a week, then started running some of the walk. After I saw my EP at my follow up in early May I came off the drugs and I was back running 6 miles soon after, and was running almost as quick as previous to AFIB in 3 or 4 months. (PS my running is not very quick i just do it to keep fit - no competitions !)
I have to stress I was running before the AFIB, and during the AFIB , and had no co morbidities so I believed all my issues during my afib period were caused by the drugs, and the 3 weeks with the flutter. So I am lucky at that, as once I got over the flutter exhaustion I felt able to push on to recover. I was not really scared of having any other problems. I was more motivated to get better and get off the drugs.
Other people may have lot more to cope with so may need more time for this - I am NOT advocating anyone uses this as a template for their own recovery. I am not medically trained
No September 2015. I was only diagnosed as some time in july/August 2015 I was in the last 200 yards of a run and I felt a fluttery feeling in my upper chest for a few seconds only. When I downloaded my Garmin data I had a spike from 160 to 195 just before the end of the run . Strange I thought and forgot about it. 2 months later I had had a very busy work day and only got home at 9pm. I had my evening meal ( lasagne with Salad ) and then at 21: 25 I was on my computer looking at personal emails. I got a fluttery feeling for a few seconds upper chest, thought indigestion then remembered the run. As my garmin charges plugged into my pc it was only 30 seconds to put it on and was surprised to find my HR was 165 bpm sat down. By this time the fluttery feeling was gone. Strange i thought again so I got my wife to try it on and she was her usual low 50s bpm. So I kept the chest strap on all night and looked at it on the morning and I had been between 135 to 165 for 5 hours until the battery went flat.
I felt fine so was going to go to work but my wife rang the 111 service and asked should I go to work or hospital, the answer being neither an ambulance is on its way. Very embarrassing as I was perfectly all right. Anyway the ambulance ECG showed 165 bpm and afib, so to A&E I went. I reverted to NSR sometime the following night, after having starved all day so I could have a cardioversion in the morning! I suppose i could have had afib for ages and never noticed as it had never coincided with a run before or I never noticed. . Running generally stopped my afib anyway , a trick I used for 20 months until it stopped working as my afib progressed in July 2017.
I was on Bisopralol and flecanite for over 15 years until I needed 2 stents fitted for angina ,,, I’ve got asthma so they took me of them and put me on verapamil, it was hell at first ,they changed me to slow release verapamil that’s helped but now get low heart rate at times ,,, not tachardia much , but lots of ectopic and mostly long spaces between beats ,,,, I’ve got cardiology next month looking at pacemaker possibly , so possible verapamil will not suit you ,,,but it takes a good while to settle months ,,,,
I had atrial flutter & fibrillation ,,,it got rid of the flutter but not the fibrillation,,,, told me to wait till I was older to do it again ,,, but by then my other heart issues gave me problems too , angina etc ,
I mistakenly took my seco nd dose of the day four hours too early so instead of having 80mg circulating I had a 160mg. I was worried there would be repercussions but spoke to a nurse who checked it out for me and no thank goodness. The 160 over the four hours did not reduce how fast my heart was running at all. Bit surprised by that!!
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Change from Bisoprolol to Diltiazam. 
Coming off Bisoprolol
bisoprolol 
Update - Bisoprolol to Diltiazem
A bit scared of changing from Bisoprolol to Dronedarone.
