I'm really hoping for some help from anyone who has experienced this problem.
I have been having what I now know was AF on exercise for a few years (though I was just unfit), but a month ago one came on strong after I bent down to pull a couple of weeds up. Ended up in the hospital for 2 days and diagnosed with paroxysmal AF and came home with Bisoprolol 5mg and Apixaban.
Within a day of coming home I started to get strong tremors coming up through my torso when I start falling asleep. Sometimes also mildly when I'm just resting. A month on its still happening which is very unpleasant and frightening. Several GP's and the cardio nurse, and a private cardiologist I managed to get a call with have all said its not something they have heard of which is making me even more worried and upset by it. One came on strong the other night and it caused my heart to race and triggered an AF which resolved its self after about 30 mins, but my BP went up by 20 after that and it's still up.
After the last AF a few days ago I spoke to a GP and he suggested I move my Bisoprolol to evening to give me more protection through the night, but I'm still getting the shaking just as bad. And I'm feeling really really anxious and queasy for the first half of my day. This wears off a bit after lunchtime.
I have had my Apixaban swapped for Riveroxaban to see if that would help, and it seemed to slightly ease the tremor I could feel when relaxing, but not the strong one that comes on when I start falling asleep. I suspect that was just a coincidence maybe.
I can't believe I'm the only/first person to have this and I'm hoping someone somewhere can relate and tell me if they managed to get it resolved.
Thank you so much for reading this.
Written by
KG70
To view profiles and participate in discussions please or .
Hi. I'm on Amiodarone again following a relapse into AF but have been having these trembling episodes in bed at night with a surge in pulse rate. When I had the AF originally, I wouldn't get the trembling just the rvr and anytime during the day. Now, it seems to be a problem in the middle of the night like last night I was awoken at 2am with the tremor and a pulse of 147.
I was going to pose the question on here, particularly as to why it seems to be a problem in the early hours.
Be interesting to see if anyone else has the same issues.
Hi Ducky, thanks for responding, and I'm sorry to hear you're having this problem too. Fingers crossed we hear from someone who has resolved it. Some interesting points in CDreamers reply below. I may try upping my protein and trying some magnesium. I can only cope with a small amount of magnesium though and only the Bluebonnet liquid so will be a few days to get some delivered.
I have switched my Bisoprolol to taking it with my evening meal so its stronger during the night and my HR has been more stable through the night for 2 nights, but the trembling persists and I'm waking up multiple times a night.
I often have restless leg syndrome at night due to a neurological condition in which it is common but I have also had - to a very mild degree - the sorts of symptoms you describe, sometimes during the day. I have always understood that this is the ANS autonomic nervous system kicking in for some reason and it is usually because I have overdone things and not had enough rest - I have to be VERY careful to pace myself, I am dehydrated. Or sometimes lacking in some nutrition, for me it is a warning I need more proteins.
Magnesium spray usually sorts out the RLS and so I now associate that type of symptom with nutrition/hydration/electrolyte imbalance.
I think I would be far more tempted to blame Bisoprolol than the anticoagulants - but I am very biased against Bisoprolol - which is a Beta Blocker & adrenaline blocker - which massively affects ANS.
Investigate Magnesium supplementation - I can’t take oral Magnesium but many here do find it helps tremendously. Be aware of postural changes - bending down, lying prone etc and if you find symptom onset after change of position + higher HR or onset of AF then investigate Vagal AF. Bisoprolol should not be prescribed if you have vagal AF but you may find some Doctors won’t even acknowledge there is such a thing.
I seem to remember that Dr Gupta did a video on Vagal AF?
Thank you so much for the response. Lots of interesting info there and things to think about. I'll have a look at the video's thanks. As my first major event was after bending down to pull weeds I suspect mine may be vagal. I read something a while ago that resonated with that idea.
I also struggle with magnesium as the pills seem harsh and too high a dose, but I got on ok with a small dose of bluebonnets liquid magnesium so may try that again after reading up a bit more.
I'm almost certain its the bisoprolol as its making me feel horribly unwell. I think its also making me very depressed and anxious as I'm really finding my anxiety levels have gone through the roof and its hard to cope with. But I don't know if that's just a bit of PTDS and fearfullness from my new diagnosis. I'm hoping that seeing a cardiologist next week will bring me some relief and things settle down.
Thanks again for your reply, I really appreciate it.
If you go on YouTube and research York Cardiology you will find a series of videos by Dr Gupta (UK cardiologist not the US media doctor) with good explanations of many AF associated things - including another on Vasovagal and palpitations which you may find useful.
It is the bisoprolol. It can produce apneoa like symptoms, which can intensify as the dose increases. Also the bending down could induce af, I get that, also from the change in pressure from the bisoprolol. Its no doubt the bisoprolol has changed your patterns. It's a strong drug. Change it if you can!
Hi Phil, Thank you very much for that. More confirmation of what I already suspected. I have asked several GP's to change it and they are having none of it, saying Bisoprolol is the 'gold standard' and gives me the best protection possible. Hope to see a private cardiologist this week so will have the conversation with her to see what she suggests.
I struggled to walk more than 50m and getting upstairs was a nightmare on Bisoprolol. After about 3 months of this, I did my own research and begged the cardiologist to put me on Diltiazem instead, which he did. Felt much better, although I ended up with swollen feet and gums but at least I could breathe. My pharmacist explained that Bisoprolol can attach to receptors in the lungs as well as the heart and this is what causes the issues, even though it's supposed to be heart specific.
Best thing to get advice from consultant. Unusually your GP is correct about bisoprolol. Its a horrible drug if you're unfortunate enough to have the side effects and I generally stand alone with its total usefulness for me.
Wouldn't go without it.
I had a terrible time working out which meds were best for me.
I had electrolyte imbalance, sodium low due to putting myself on a low sodium diet. Level went so low but didn’t know it so went to emergency twice. Yes, during Covid. Dumb ! Anyway, docs don’t check this lab often enough, maybe ask for an electrolyte value ? At least to rule out something you could be low in ? Best of luck to you. Sarah from San Diego
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
should I take extra bisoprolol? 
When Bisoprolol doesnt work?
Do I ask GP to increase bisoprolol?
