Changing beta blocker

[Reena09]

Hi there - my episodes of AF predominantly kick off at night when sleeping or at 9.30pm. I am not aware of it and can only tell from the Apple Watch readings as it is very clear when I’m in AF. I’m on 2.5mg of bisoprolol and 150 mg flecainide (100mg at night, 50mg in the day). I spoke with a different consultant today for a second opinion and he suggested that I could have Vagal AF and has suggested changing from bisoprolol to something like adizem. Has anyone experienced a similar situation. Thanks

[CDreamer]

I had most of my episodes during sleep so was sent for a sleep test and yes I had sleep apnea which when treated with CPAP, put an end to most of my nocturnal episodes. I still had AF though but CPAP improved my QOL generally.

The 2 treatments that helped me were CPAP and Pacemaker, all the drugs only made life a lot worse for me but that was because I had an undiagnosed condition which was exacerbated by Beta Blocker especially.

If you put vagal AF into the search box you will find a lot of posts about this and if you research some more, that anyone with vagal AF shouldn’t be on Beta Blockers.

The 2 reasons I am aware for only nocturnal AF are Sleep Apnea and Vagal.

[Reena09 in reply to CDreamer]

Thank you. I’ve spoken to a respiratory consultant and EP and they have both said that only deemed necessary to have a SA test if I have symptoms. Did you have any symptoms? I tend to have a lunch time nap but that makes me feel refreshed and then get back to my generally active self for a 72 year old and apart from that not sure what else I should be looking out for?

[Rubymurray25]

Hi, To cut a long story short I posted a similar question a couple of years ago and someone asked if I had been checked for Sleep Apnea. I hadn't ever really heard of SA but read up on it and realised the waking up, fluttering heart and the increased blood pressure might and the link between SA and AF was proven! I went to my doctors and was asked the standard questions then sent for a night sleep test and it was discovered I was having 68 episodes an hour , the acceptable limit is 5. I was put on CPAP ( controlled airways ) and have never looked back. My cardiologist is convinced my AF was brought on by the SA , I am not overweight so not a usual suspect for SA. Even if this doesn't apply to you hopefully someone else can read it and make a connection. I am forever grateful to the person on this site who suggested I might have SA as they probably saved my life. Kind regards. PS I was on Sotalol at the time.

[Reena09 in reply to Rubymurray25]

Thank you. I’ve spoken to a respiratory consultant and EP and they have both said that only deemed necessary to have a SA test if I have symptoms. Did you have any symptoms? I tend to have a lunch time nap but that makes me feel refreshed and then get back to my generally active self for a 72 year old and apart from that not sure what else I should be looking out for? Thoughts appreciated - thanks

[Rubymurray25 in reply to Reena09]

Hi , Below is a short video I did for the sister site last year, probably explains it better. If you look up the NHS Sleep Apnea questionnaire it will help you have a clearer idea of what to expect ; from memory there are 8 questions with three levels of answers and if you score over 18 I think they have to take it seriously, I think I scored 21. I have been married for 42 years and my wife used to say my snoring was so bad even in the early days where I would stop and gasp for breathe, so I guess I had it for years. There is a definite reluctance with doctors to accept a patience has SA, which was actually rubber stamped by Dr.Sanja Gupta on his website.

youtube.com/watch?v=vwPBmE8...(Not working as expected?)

[irene75359 in reply to Rubymurray25]

Thank you for that; worthwhile to know.

[Reena09 in reply to Rubymurray25]

Thank you very much for your post. I dont score very highly and possibly max 8 and at most 10. So prob not an issue relating to SA and think it is likely to be related to the Vagal nerve which is much harder to resolve.

[Hidden]

Hi,Once I established,(some years ago) that my paroxysmal AF kicked off by food I consulted a Nutritionist and we reviewed my diet ( food intake). That seems to have done the trick. Prior to this my GP had me checked out IBS and Coeliac Disease - which were all clear. So, for me food was upsetting the vagal nerve, either causing it to be dysfunctional in some weird way or causing some levels of inflammation.

John

[MargaretWendy]

Luckily I went to a nutritionist, June Butlin ner Bristol, who told me if I changed my diet to foods that my body could digest easily such as goats milk cheese and butter instead of cowand I ate my evening meal at 7 instead of 9 and didn't eat fruit after 4pm etc etc, I might be all right to stop taking my bisoprolol. So it was for me,, also the blood thinner Rivaroxaban (although my gp really didn't want me to do that) I developed drug induced lichenplanus from the drugs so I had the incentive. Also I was happy to drink very very little ascohol which many would not be prepared to do. I feel I am no longer an invalid now I have been able to give up the pharmaceuticals and changed to blood thinners like celery, garlic, vitamin E cinnamon etc. I do not take much turmeric as June felt it did not suit me. As stressed before, we are all different - but worth everyone consulting a nutritionish whatever you do!

[Gerihope]

I seem to have many episodes of AF overnight too. I am now using a C Pap due to mild sleep apnea, which is something I was not aware of. My physician has me scheduled for ablation due to persistent AF. That will be in mid December.

[Reena09 in reply to Gerihope]

Thank you. Do you know whether you demonstrated any of the typical signs of sleep apnea?

[Gerihope in reply to Reena09]

I was not aware and my husband says he has never heard me snore!