Why am I breathless ?

[Bowlingfan]

Symptoms of AF have been fairly mild lately but have been suffering terrible bouts of breathlessness which can last for hours and wondering if this is a symptom of the condition or could it be some of my medication causing it ? I’m on Apixaban 5mg Bisoprolol 5mg Digoxin 125 and 5mg Amlodopine .Only diagnosed in January so all except Amlodopine is new to me .

[Paulbounce]

Yes - afib can make you breathless. It can be part and parcel of the condition. Have you tried the correct breathing technic's ? They can help.

Enjoy your weekend.

Paul

[Bowlingfan in reply to Paulbounce]

Thank you Paulbounce I will look into breathing exercises

[Hidden]

I’m not medically trained, but one of the problems I experienced was that the symptoms of AF we’re almost identical to the side effects of the medication, particularly the beta blocker. Bisoprolol, whilst an effective drug for AF, does have a reputation for causing breathlessness. Whilst there are alternatives unfortunately, I believe it’s the only beta blocker GP’s can prescribe. Apixaban is unlikely to cause breathlessness but I cannot comment on the other medication.

If he hasn’t already, I suggest you ask your GP to refer you to preferably an Electrophysiologist (EP) who is a cardiologist who specialises in arrhythmias. He may suggest alternative medication or treatment which might reduce your current breathlessness.....hope this helps.

[Bowlingfan in reply to Hidden]

Thank you I have been put in touch with a cardiologist and had an echocardiogram and was given a phone number from there so might be worth a call to see if Bisoprolol can be changed as all info I’ve read points to it . Looks like it’s going to be a long haul of trial and error to get back to some sort of normality but browsing on here certainly helps !

[Hidden in reply to Bowlingfan]

You need to make your own enquiries, but Calcium Channel Blockers can be a helpful alternative to beta blockers. Nebivolol is a beta blocker which often gets good reports.....

[Bowlingfan in reply to Hidden]

Thank youn

[DevonHubby1 in reply to Hidden]

Wife had a really bad experience when GP unilaterally switched her from beta blockers to calcium chain inhibitors which massive increased her AF occurances. Consultant was livid and switched her back to beta blockers. We were told CCI was a treatment for AF just way down the pathway when other alternatives had failed to work.

[Hidden in reply to DevonHubby1]

Which is why we make it clear we are not medically trained and only offer suggestions for people to discuss with their doctors.....please see the first line of my initial response.

[Palpman in reply to Hidden]

We do not need to be medically trained to repeat what our cardiologist told us or to give our experience under similar circumstances. If we cannot share knowledge and experience then we must close the site down or talk about our dog.

[Hidden in reply to Palpman]

I am afraid you have got that very wrong. The reason why I and all other responsible contributors make it clear that I am or they are not medically trained is because if I share information about medication or treatment I have no way of knowing if it is appropriate for them because I have no knowledge of their medical history. For example, if I was to suggest to someone that they changed from warfarin to Apixaban and it turned out they had a mechanical heart valve it could have catastrophic consequences. We are not medics therefore we need to be careful and follow the guidance as shown to the right of this page and copied below.

“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.”

However, if you are referring to non medication advice, then you are absolutely right.

[BrotherThomas in reply to Bowlingfan]

Best of luck, my cardiologist doesn't believe that bisoprolol causes breathlessness so won't change my meds. If i say I'm not going to take them anymore, he just says OK that's up to you. My GP won't talk to me about it either.

[Pedroski in reply to BrotherThomas]

I called bisopralol the devil drug to my Cardiologist and told him it was making me more breathless, Because I think it was causing weight gain by retaining fuid...................he said "he disagreed about MY experience with Bisopralol"..........I guess though he has never had to take it...........no more for me

[Nigel2000 in reply to BrotherThomas]

Whoa! I found metoprolol to cause terrible breathlessness and depression, I wonder if bisopralol is similar. I was still using it as a pill in the pocket until my last ablation (2 weeks AFIB free!).

[S11m]

Do you also have Bradycardia? (slows pulse rate).Bradycardia makes me feel faint - but it has been improved by three cardioversions, two catheter ablations and two pacemakers!

[Finvola]

Hi Bowlingfan - Breathlessness and AF are known bedfellows but I notice you are taking Bisoprolol too. Some people (I for one) suffer dreadful breathlessness on Bisoprolol - others have no problems with it. As Paul suggests, try controlled, slow breathing to see if you can lessen the symptoms.

I stuck with the breathlessness and Bisoprolol for 4 years, always being told by my cardiologist that it was the drug of choice. Finally got fed up not being able to carry out normal tasks and asked my GP for help. He changed me to Nebivolol and the difference was startling - almost normal again! Cardiologist was happy with the change.

Both drugs are beta blockers but Bisoprolol is wide brush across heart and lung tissue - hence its ability to cause breathlessness. Nebivolol is cardiac-specific and does not act on lung tissue, so it is usually prescribed for people with asthma and AF.

The other possibilities are - a reduced dose of Bisoprolol or that your system may get used to the dose with time.

Read up as much as you can and discuss it with your doc. Best wishes.

[Bowlingfan in reply to Finvola]

Thank you Finvola don’t think I could suffer this for four years so maybe need to contact GP or Cardiologist at beginning of the week to see if it can be changed and Nebivolol sounds worth a look !

[Finvola in reply to Bowlingfan]

Don't know why I did it either! As far as I remember, Bisoprolol is cheap so therefore attractive to fund managers - Nebivolol 2.5mg is expensive but, strangely enough 5mg tablets of Nebivolol work out at the same price to the NHS as Bisoprolol.

Some forum members get 5mg prescribed by their docs with instructions to cut the tablet in two. Might be worth checking costs to rebut price concerns - my memory is that a few years ago there was a factor of 8 in the comparative costs at the lower doses.

[Auriculaire in reply to Bowlingfan]

Like Finvola I changed from Bisoprolol to Nebivolol and felt better. On 5mg Bisoproplol I felt breathless and extremely lethargic . In fact like death warmed up. I felt a lot better when my GP said to reduce the dose but I don't realy notice any side effects on Nebivolol. What I have noticed is that an increased dose of it does not bring my heartrate down during an afib attack as Bisoprolol does.

[Dollcollector in reply to Finvola]

I agree with you entirely . When l changed from bisoprolol to Nebivolol l felt almost normal.

[CDreamer]

You haven’t said when you are breathless?

Breathlessness on exertion is to be expected, to a certain extent so for example:- I could walk at normal speed without breathlessness when in AF (no meds) but as soon as an incline came along, I was breathless, climbing stairs similar.

If you are breathless at rest then please go see your doctors & don’t hold back from pushing for more testing and an echocardiogram.

When you take heart rate control drugs - they are going to restrict your HR on exertion = oxygen deprivation for your body - hence you need to slow down or pause.

On breathing:- read James Nesbitt - Breath and Patrick McKeown The Oxygen Advantage. Most of us breath through our mouths but nasal, diaphragmatic breathing has many advantages, especially when exercising.

[CDreamer]

PS - I can’t take any HR control drugs.

[Hidden]

I’m puzzled why you are taking digoxin, a beta blocker and a calcium channel antagonist, all of which are rate controlling drugs in AFib.

Since your very prolonged episodes of breathlessness are presumably happening at rest, are you sure they are not associated with underlying tachycardia like AFib?

Have you noticed any wheezing or swollen ankles? Are your kidney tests ok, in which case, the digoxin dose is probably not a problem

My suggestion would be an early review by your GP, press for a full cardio respiratory assessment at the surgery, including peak flow to rule out any asthmatic component. Your GP can organise an up to date chest X-ray and an echocardiogram, the latter to see how well your heart is pumping.

And finally an urgent review of your medication. Given your cocktail of heart drugs, I wonder if you need a beta blocker at all, and if yes, I have found nebivolol has suited me much better than bisoprolol. I should add that I am not a doctor, and none of us can make a diagnosis or give specific advice about medication. Good luck.

[Bowlingfan in reply to Hidden]

Always happens when at rest - usually through the night or early morning! Have blood tests on Monday so that will check the digoxin . Had echocardiogram 2 weeks ago and heart health was good which eased my mind a bit but still need to get this sorted out so will definitely look into my use of Bisoprolol. Thank you all for your advice , I have learned a lot from this site !

[Desanthony in reply to Hidden]

Good tips Badger2021

[Desanthony]

Bisoprolol and other tablets of their ilk made me very breathless with a cough so am not on any of these. Tried about 5 or 6 different types and mixes and various doses of them when first diagnosed before my first CV and they all made me worse rather than better. The crunch came when I couldn't even walk downstairs without getting breathless and my wife called the cardio who said stop taking them straight away. When I next saw my cardio put me on digoxin higher dose but that had the same effect then went down to lower dose and seemed OK but only on it for about a month before having my first successful CV and even when I have gone back into AF - twice in that time they have not put me back on them. I got a tip from a pharmacist friend of mine who recommended using those nasal strips during the night to help with my breathing at night as I was unable to sleep - these worked quite well she had used them with her Dad who had AF. Hope you feel better soon.

[Windlepoons]

I was very breathless on Bisoprolol so my cardiologist changed me to Sotalol. Still get a bit breathless but much better.

[CloudRunner]

I am not medically trained but here are a few thoughts, and I’m sorry if I’m stating the obvious!

We know that, when in AF, our hearts are beating less efficiently. This is likely to mean that our blood oxygen saturation levels are lower than optimal. If this is the case then it’s a bit like breaking into a jog and our body says “Ay oop lad, I need more oxygen if you want me to do this....get puffing!”

Certainly when I go out for a walk the first bit is a short sharp hill and I quickly run out of puff. If I spend some time doing deep breathing exercises before setting out I find it quite a lot easier.

During the night it is likely that your breathing rate is slower and more shallow and perhaps this is leading to lowered blood oxygen levels and your body asking for a bit more puff because of that. I would certainly suggest getting into the habit of doing deep breathing exercises as they also help with more than just the AF.

As a slight complication, Bisoprolol is a rate control drug and can hold your heart rate lower than the ideal. I’m certainly not saying that this is a problem in your case but just be aware of it when you talk to your GP or cardiologist.

[TMeditation]

I’ve been on Bisoprolol since my AVR 2 years ago and have also experienced breathlessness. However I take my meds in the morning and generally the breathlessness passes during the day so I’ve never really thought about changing. Actually I just put my early morning breathlessness down to not liking mornings very much 😄 So I’d be interested to know if Bisoprolol-induced breathlessness would pass or be evident all day? Just be interesting to know.Good luck and do talk to someone soon to improve life for yourself . Sue 🙏

[Palpman]

I had flutter on occasion and now only take Flecainide.My red blood cell count is low so I suspect this is the cause of my breathlessness.

[Ducky2003]

I started off on Bisoprolol but it hot so bad, I couldn't walk 50m or upstairs without struggling for breath. I happened to mention the breathlessness to my pharmacist one day. He explained that, although Bisoprolol is supposed to be cardiac specific, it does sometimes attach to receptors in the lungs as well as the heart, which causes breathlessness. He also said that other meds were available.I then did some research of my own into this and

at my next cardiology appointment a couple of weeks later, I asked the consultant to take me off Bisoprolol and put me on Diltiazem. He was a bit taken aback but agreed to it. Breathlessness improved dramatically. Diltiazem comes with it's own side effects, swollen gums and ankles with me so you need to make yourself aware of the pros and cons. Best of luck.

[Eirecara]

Hi Bowlingfan, I’m sorry your suffering from such awful symptoms. Breathlessness is a scary experience. I would suggest an appointment with your gp to discuss your meds. Specifically question are you over medicated. Best wishes ☘️