Diltiazem v Bisoprolol & Felodipine

[ChanceyBoy]

Have ongoing (daily episodes) of paroxysmal AF - more palpitations than actual racing heartbeat. Recently prescribed Diltiazem instead of Bisoprolol & Felodipine. Anyone on this or changed to it from a beta blocker??

[Hidden]

After a cardioversion back in 2014, I changed from Bisoprolol to Diltiazem and it suited me well with few side effects.

[KMRobbo]

I was on it for 10 months until 3 months after an ablation. I had tried biprolol and Atenolol beta blockers within 3 weeks of diagnosed and had bad side effects so my GP surmised I was intolerant to beta blockers. I was on Verapamil a calcium channel blocker for 20 months which was great, no side effects but my afib progressed so I to go onto flecainide and diltiazem . I was put onto 200mg of modified release diltiazem.I did have side effects:

Over the months I had breathlessnes, some exercise intolerance ( max hr was quite low) tiredness, poor memory ( forgetfulness) and brain fog, which in hindsight got worse the longer I took it.

I did raise this with a cardiologist who advised the symptoms were probably the diltiazem and dropped me to 120 mg. This did improve the tiredness. However owing to another afib attack putting me in hospital I was put back to 200mg. This was nonsensical as the afib breakthrough was owing to me missing flecainide dose! However I put up with it as I was 2 months until my ablation.

Unfortunately post afib ablation I developed fast reentrant atrial flutter. The diltiazem did it's job and rate controlled me at 140bpm for a month until I was able to have the flutter ablated. I stayed on the diltiazem until 3 months after that ablation and my EP follow up.

Even though I stopped taking the diltiazem it took 4 to 6 weeks before I lost the brain fog and started to feel better. I think I was taking too high a dose of it all along ( but i am not medically trained).

I have mixed feelings about diltiazem . It caused me issues but it also helped reduce a big problem.

The above is not to scare you off taking it, but just for your info if you get similar issues.

I am aware that others on this forum take diltiazem with no issues, and hopefully you will be in that category!

Please also note that there many brands/ specifications of diltiazem. The original one i was taking became difficult to obtain and the cardiologist spent ages trying to specify a replacement that matched the original. I was surprised at the range.

Best wishes.

[Hidden in reply to KMRobbo]

I’ve only ever taken 120 mg so may be why I’ve not experienced your problems, nor swollen feet.......

[BobD Volunteer]

Some of us can't take calcium chanel blockers such as diltiazem if we want to wear shoes and socks due to fluid retention in the lower limbs. The only thing is to try it and see if you are one of us.

[ChanceyBoy]

Thank you all for your kind responses. I've been on 3.5 Bisoprolol & 5mg Felodipine since my heart attack 3 years ago and it does keep my HR down, 60 - 80 resting, even my AF doesn't raise it! So, be interesting to see how Diltiazem works as it is replacing 2 tabs.

[Buffafly]

I take diltiazem 180mg as I can’t take beta blockers. I felt awful when I took it with Propafenone (similar to Flecainide) but on its own I have no problems except swollen ankles in hot weather. 120mmg is the lowest dose I think but the max is much higher. It doesn’t seem to affect my daily average HR but it does seem to act as a ‘limiter’.