My appointment was converted to a phone call. He was 1/2hr late. Rang the wrong phone despite me asking for my mobile to be the means. Didn't have the ECG and blood results the GP ran for me a couple of weeks ago and sent directly to the cardiologist's secretary. Apart from that...
I wanted to switch to Nebivolol but he said they are all the same so if Bisoprolol doesn't suit none of them will. So he wants to try a calcium channel blocker. I thought they were a blood pressure pill. Will they keep my rate down? It's in the high 80's or 90's on 2.5mg Bisop. I don't want it higher. I tried to reduce the dose last week and my HR went higher and the anxiety was horrible. Will I get that again by stopping them and switching to a calcium channel blocker?
I wanted to see an EP, but no, I didn't even ask. He was determined to try this different med and then review. Another 6 months of life gone I suppose. He's told me they have tried the cardioversion (we don't know how long I was in NSR before it went back into Afib because I didn't feel it) so we need to find a medication I can cope with. I could have more serious toxic drugs (no thanks) but he didn't advise it. He said the considerable risk of an ablation mean that wasn't wise.
I feel like I got nowhere. Disappointed all round today.
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FancyPants54
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Feel your disappointment. Horrible when that happens. Maybe try to ring the secretary ask them to pass your questions on and could you call back for the answers.
Worth a try. I rang my cardiologist’s secretary everyday then the cardiologist called me. They just so busy all the time but you still deserve your time with them you are after all his patient.
Hope you get sorted soon.
Like ectopic1, I changed from Bisoprolol to Diltiazem several years ago and it worked well for me so all might not be as bad as you think. I know you shouldn’t have to, but could you consider a private appointment to see an EP, should cost less than £300 but be careful about having any tests as these can be expensive. Also make sure it’s clear that any ongoing treatment would be on the NHS.....
My biggest problem is numb toes and balls of feet with excessive stinging and burning feet in bed and a change in gait and horrible plantar facitis. Plus the fatigue and lethargy, but I'm hypothyroid too, and beta blockers can make that worse. If I hoover one room that's it, I'm done for the day. I used to decorate and restore historic plasterwork as well as run a business!
I've had swollen feet on Bisop. I am on a water tablet to reduce that.
I have been on Verapamil from the start. I don’t have high blood pressure at all, so was concerned I might go too low. However, I have had no problems (18 months) and my heart rate is pretty much controlled as long as I avoid known triggers, and I have had no noticeable side effects.
Hi Fancy Pants, I would be inclined to ask to speak to another Cardio. or an EP. which we are all entitled to do. There was a huge change in how I felt and coped when I was changed from Bisop. to Nebivolol. I had an ablation in March so I may not need the meds eventually.
A lot of GPs prefer Bisop as it is so much cheaper, that's the reason it is usually an EP or Cardio. that prescribes it.
This might be a good post to read for you as there is lots of info.
My GP was happy to switch me to Nebivolol, then when I suggested trying to come off Bisop all together he preferred that. He felt we would see if any improvements happened. But I couldn't cope with the withdrawal. Then he said he would wait until I'd seen the cardiologist because my appointment was so close.
I do sympathise that you have been left frustrated by your cardiologist - been there a couple of times too. The point is that he is aware of your full medical history and it sounds as if he is cautiously proceeding in finding the best drug or combination of drugs to help you. I had three changes of medication before finding ones that suit me.
Bisoprolol did not suit me at all and I tolerated the misery for four years before getting changed to Nebivolol. I don't have experience of channel blockers but others seem to be positive about them. As we are all different and react differently, it may be a matter of try it and see. Certainly Nebivolol has worked for me with fewer side effects than Bisoprolol - hopefully, your channel blocker will be an equal success.
I always have a fall-back position to help me through a problem time - and it is calming and reassuring. I would advise following your cardiologist's advice regarding the channel blocker and if things are not what you expect, ring his secretary and explain (make notes first). Failing that, ask for an EP appointment - that might be difficult in the present circumstances or see a cardiologist (or EP) for a private consultation.
Hang in there - it is a frustrating time, especially with this virus mess causing such chaos. Best wishes.
Thank you everyone, for your support and suggestions. I have decided to go with the flow for now and to take whatever calcium channel blocker he suggests in his letter to my GP. Of course, I have to wait for the GP to get the letter, they are never fast.
I would like to see an EP at some point and am prepared to pay. I'll wait until things are more normal though, as I can certainly get on with life at the moment, albeit tired and with very sore feet. As for seeing a second cardiologist, I'm in a rural area and I'm dealt with through Banbury Hospital. It's a great hospital for most things. I think this is the only cardiologist there. I could ask to see someone in Northampton, but that's not a very nice hospital. No one around here has very good things to say about it, so I'll stick where I am for now.
I hope the change of meds will help. I also need to change my thyroid meds, but one thing at a time. And see where this change goes first.
I take diltiazem 120mg every day and have 60mg tablets on hand to take when I have an episode of AF. I can’t take more as I have slight Sick Sinus Syndrome. Depending on where you read the info it is supposed to have some anti arrhythmic properties as well as reducing BP and heart rate. My cardiologist had a sulk because I wouldn’t even try bisoprolol and my GP supported me as I’m asthmatic. I suspect the foot problem is partly caused by AF although the meds get the blame. I hope it works well for you 💜
In terms of calcium channel blockers there are two types: nondihydropyridine and dihydropyridine. The dihydropyridine ones are perscribed for blood pressure whereas the nondihydropyridine for rate. The two common nondihydropyridine calcium channel blockers are verapamil and diltiazem.
You refer to cardioversion so you must have gone persistent at some point. If you are going to be kept in persistent for six months for the review, that would be most problematic because AF begets AF. Your heart will ger further fibrotic and remodelled.
To discourage you by making the comment ". He said the considerable risk of an ablation mean that wasn't wise." is alarming because he is a cardiologist and not an electrophysiologist. I suggest you get a private consultation as soon as possible because persistent AF leads to permanent AF. And if you have been kept persistent for a few months, you will need more than one ablation.
I was already persistent for 11 months before the cardioversion. I don't know when I returned to Afib after the cardioversion, certainly I was still OK about 3-4 weeks after because I have an ECG to test.
He seems to think I could do well just living with it. And if we can find the right meds then I'm sure I probably could. But the beta blockers are making me tired. Thousands of people live with this without even knowing they have it.
I'm not keen on an ablation. Dad had one, it didn't work. He had the Maze procedure too, that didn't work. This runs in the family.
Neither Beta Blockers nor Calcium channel blockers worked for me - I was poorly on both and better off without anything other than anticoagulants. Thankfully cardioversion puts me back into NSR for a decent amount of time - I had my 3rd at the beginning of February and am still in NSR. I am waiting for an ablation which should have been done in April but C19 put paid to that. Don't know when I will get it done.
My cardiologist seems dead set against ablation for me. Perhaps because I am overweight. I hope the change to calcium channel blockers brings my stupid heart rate down and gives me some relief from the side effects.
I do hope the calcium channel blockers work for you. Trying to lose some weight may help you too if you can. Why are you unable to see an EP? Please ask to be referred to one.
An EP has never been mentioned, either by my GP or the cardiologist. If I want to see one it will have to be privately.
I hope the calcium channel blockers work too because right now I can't exercise at all because I have zero spare energy and get such painful legs and feet.
Weight has nothing to do with this. I was slim and fit and very active when I first experienced Afib 7 years ago. I have other issues such as unresponsive hypothyroidism now that also needs to be better treated before I can expect to loose weight. I am seeing a private endo for that side of things. We've tried various options but so far no success. The next logical step for that will really upset the cardiologist.
Thyroid problems are a pain aren't they? My Mum had hyperthyroid and it never really got well balanced on medication and there was no way she could lose weight it was hard for my Dad as she was practically paralysed from other problems and he had to try and move her in and out of the chair bed etc. It's never just one thing is it? Ask your GP to refer you to an EP you don't have to wait until they mention it. You should be able to find out one local to you by googling your local health authority. I didn't even know they existed until I came to this site and I had seen countless cardios in that time - having to go private in the first instance as there was no cardio at my local hospital. The private cardio never mentioned an EP - and they worked at the same hospital. When I moved after only seeing an NHS cardio once in 12 months and a nurse once when put on anticoagulants the brilliant cardio I saw and her nurses at the new hospital were part of a team working with an EP at a different hospital but until I asked about it did not mention an EP. We have to be proactive.
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