An unnecessary comment: As I have said many... - AF Association

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An unnecessary comment

SteelHeart profile image

As I have said many times until now, I am on no medication for AF but also on no medication for BP, though it is permanently increased (140/90 to 150/100). For that reason, I maybe should not comment on what I am going to, but, looking from the distance, I can not remain blind about the following.

Bisoprolol is very often prescribed drug after a serious bout of AF and people, to say the least, are not happy with this drug (low HR, dizziness, poor sleep,...you name it). So many side effects and so intense, that people can hardly find the right words to describe it. So, here is the question.

AF is known as a condition that comes and goes, without any regularity. Bouts can even be as far as years apart. Someone has reported to be still AF free after seven years from the first bout. Why, on Earth for, would you have to take Bisoprolol permanently!? If it is used to keep the BPM in lower range and not to let your heart get in overdrive, why not use it only when in vicinity of AF, meaning during and shortly after an AF bout...?

If, when driving your car downhill, it starts to accelerate, you may carefully pull the handbrake to slow it down, right. But after you get on a level ground and drive on such a ground for a long time, why to continue to pull the handbrake "just for the case"...? Makes no sense to me...

Would be interested in other people's views and experiences...

149 Replies

I agree with you.

I don't comment very often and I may have missed your previous posts. Taking your 3rd paragraph ....... so, what if an AF'er is asymptomatic, either some of the time or on some other irregular basis, and combine that with paroxysmal AF. Surely that scenario makes it worth while taking Bisoprolol for life, aided and abetted by some sort of anticoagulant too. One strike from a stroke and in one way shape or form its goodnight vienna.

I tend to agree.

However - it works for a lot of people without causing symptoms.

It’s doctors’ 1st ‘go to’ drug.

Fear - that’s what doctor told me to do.

It’s effective in lowering BP & reducing HR.

I remember a story in video form on an AF website talking about ablation (early days - 20 years ago) and it wasn’t until his doctor put him on Bisoprolol that he had any idea on what he was putting his patients through when he prescribed Bisoprolol. He had the ablation & stopped Bisoprolol.

We have all been brainwashed to believe drugs help and sometimes they do but ALL have affects. We are also so desperate to find something help & so if an expert says take this - we do. Include myself in accepting without questioning.

I now always focus on Risk:Benefit assessment of my own - will the benefits outweigh the risks of destroying my QOL? However, I’m told I’m very ‘unusual’ in my attitude to health.

Another problem is that many people find it difficult to withdraw.

Another that Bisoprolol does lower BP and studies show that alone in AFers reduces stroke risk.

You may be happy with your BP but many doctors would want you to reduce it.

I think your statements will be controversial but let’s hope very a polite and reasoned discussion.

SteelHeart profile image
SteelHeart in reply to CDreamer

Thanks for your kind reply, CD! My intention was not to stir, but I really was in a doubt why people so often grumble agains Bisoprolol, and still take it. Yes, many people are so impressed by MDs, that they take the medication believing that there is no other way. But, also, there are a lot of others, often asking about alternative ways of treating AF and other health issues. Thanks again!

Bawdy profile image
Bawdy in reply to SteelHeart

I get you SteelHeat, Metoprolol and flecainide and a couple of others that I can't recall, made me very sluggish without any get up and go. Because of covid I took myself off all of them, in an appropriate way , well, I couldn't see a doctor, and feel so much better for it, still taking xarelto after developing PE's 2 years ago. For me it's about quality and this suits me. Take care .

Maggimunro profile image
Maggimunro in reply to Bawdy

Exactly what I did Bawdy. The medics tried several different drugs and they all made me feel that life wasn’t worth living. But then I-had my ablations and have been Afib free for 4 years now. Iam happy taking my Apixiban twice daily after watching both parents stroke out.m

Part of the problem is that doctors often refuse point blank to recognise or admit to the undesirable side effects that many medicines can provoke. They say the patients are imagining it or that drug X does not give rise to symptom Y ( even if listed in the literature! ). If they do acknowledge side effects they say it has to be put up with for the benefit of the drug. Most patients just do not have the means ( intellectual and emotional) to combat these attitudes which in my opinion often stem from paternalism and in the case of women chauvinism. It is bad enough feeling like crap because of your illness and on top of that drugs that make you feel even worse without having to argue with a doctor who brings out the TINA argument. I am lucky with my cardiologist. He has an unfortunate manner BUT above all else is not a drug pusher, has never even asked for my cholesterol results and followed the ESC latest recommendations of not mandating an anticoagulant till my CHADSVASC score was 3. He was fine with me coming off Bisoprolol altogether after my first afib attack and after afib returned 3 years later changed me to Nebivolol when I requested it.

Janith profile image
Janith in reply to SteelHeart

My blood pressure goes soooo high when l am stressed … l must take blood pressure meds and have since l was a young adult … l held out and refused to take anticoagulants until my afib started occurring more frequently and l became concerned and started taking Eliquis … (brings peace of mind) … l loathe taking this stuff but l have no side effects from sotalol or Eliquis … zero.

SteelHeart profile image
SteelHeart in reply to Janith

Hello! In general, people do not know enough about blood pressure in our body, so readily accept the opinion of the doctor that their BP is "high" and that they should take medication. But the question is, what is high! I was caught at 190/120 in one occasion, MD was worried, but I said that I am not and that this value is something that will last for short, and so it was. My BP is increased, but I feel perfectly well and will start taking the medication when I start feeling any of the symptoms that would indicate that I am in a problem. Until than, pharmaceutical industry will have to sell the drugs to somebody else, lol! What was your BP when you first started taking drugs and how old were you?

Janith profile image
Janith in reply to SteelHeart

Yes but high blood pressure is the silent killer. I have zero symptoms and mine goes higher than yours when l visit my doctor. I have something called labile blood pressure. It shoots up when stressed then returns to normal most of the time … there is a risk with that type of high blood pressure … l wore some kind of monitor and that’s how they diagnosed it.

SteelHeart profile image
SteelHeart in reply to Janith

Hi! I know well that high BP is a "silent killer", but I am sure that many of the medications are with more certainty "silent killers". BP changes during the day in very broad limits. It can vary in the span 90/60 to 400/200 (someone in the forum gave these numbers, though a little high IMO). My uncle suffered three strokes in a single day, at the level of 260/170, but he was 66 at the time). My best friend started having slightly increased BP at the age of 45, and so did I. She decided to follow the advise of the MD and started taking medication, while I refused them. Can you imagine how much of chemicals she has put through her kidneys in these past 25 years (she was taking Monopril). And, she got used to the drugs and could not do without them. I strongly believe to have done what's better for the body. Of course, many people would not gamble with the health in the way I do, but I like researching and experimenting...

I don't think you're unusual in your approach to your health, however I do find it's unusual for a GP to listen and not just prescribe willy nilly

Not all have and I’ve had 2 cardiologists refuse to see me because of refusing to take Bisoprolol. Thankfully now only work with doctors who do and I found that’s because I informed myself.

I’m also incredibly lucky in that one of our GPs is dual trained in Lifestyle Medicine & informed all the other GPs so they are quite discriminating - try getting antibiotics out of them unless it’s immediately life threatening! They’re all into gut micro biome and value of fermentation etc. Quite Dr Chaterjee like.

GrannyE profile image
GrannyE in reply to CDreamer

Lucky you having gps who understand. Not all do yet but i suspect it is just a question of time. They will understand in about 15 years when it will be mainstream. Don’t forget when they were trained no-one knew about microbiomes and the gut brain connection etc. They did not have the electron microscopes etc to look at what happens inside cells.

I wish I had your Gp, I am fed up of feeling ill and I have long lasting pain/issues from upper abdomen as well and everything I'm taking does not get rid and I do feel there is some type of infection.

Sim22 profile image
Sim22 in reply to CDreamer

Hi CD, do remember it's your body and you have a right to comment and get the right treatment for you.I'm on Bisprolol and in the beginning the side effects were awful, my cardiologist asked me if I would stick with it for a while (I was a consultant in the same hospital) . In combination with my pacemaker things have settled but I still feel knackered now and again.

When I was first diagnosed my cardiologist asked me I had any questions, I told him that I had done my academic research and that he was the Dr so you look after me.😆😆😆😆 if you get an infection ill do the same

Lucky you CDreamer! If only.............

Bucerias profile image
Bucerias in reply to CDreamer

Same here , diagnosed with AF in 2010 but had for years before that. 3 Ablations 2010-2017. I still have daily episodes that last only a few minutes, 20 minutes maximum. Never stop me from doing anything, even though I’m in and out of AF constantly. Tried meds, they make me feel terrible. I only take Xeralta. Bisoprolol made me feel suicidal. Lol

Big problem is Too many Drs nowadays don't listen. They follow a program that the insurance companies (here in the USA) decree and they are afraid to go against the insurance companies even if one happens to be a decent Dr. I was hollered at by the cardio Dr and had a finger shook at me just for asking to be tested for any nutrient deficiencies. I left that Dr. It's become profit over patient and all the Drs do is push pills and do procedures. How is that helping the patient. It's the easy way out for those Drs to me. Just follow the program on the computer screen to treat the patient. If I had continued to follow the first cardio Drs finger pointing "program" I can tell you I would be pushing lillies. I went downhill fast after being put on Eliquis and metoprolol which both seem to be one size fits all here. I had to stop both of them and I know the metoprolol has caused damage to me. Same thing happened to my partner. He is messed up from these drugs. Drs don't care anymore and the ones who do won't fight the insurance companies. Won't try and look for the cause. Just treat the symptoms and send you home. I have lost a lot of faith in the medical system. It's not what it used to be when I was younger. And I find that disheartening and a travesty. And because of the approach to patients nowadays treating the symptoms only, too many patients are being harmed and sad to say, dying.

Dee5165 profile image
Dee5165 in reply to belindalore

I must agree with all you stated. I too was placed on meds that made me feel sicker with no QOL. Doctors are not trained in alternative natural methods and therefore push only pharma drugs. Having a health science background, I did my own research. I now take supplements for Afib and although they take 8-10 weeks to enjoy those benefits, I am now Afib free for over two months after having Afib for 6 months 24/7. Even having a Cardioversion procedure only lasted 2 weeks!

Ablation7 profile image
Ablation7 in reply to Dee5165

Wow, what supplements do you take?

Dee5165 profile image
Dee5165 in reply to Ablation7

Hi,

These are the supplements I take. Many of these supplements work to regulate heart arrhythmias. I take them at 9 a.m., 3 p.m., and 9 p.m. when it states 3 times per day. Please be aware it takes 8-10 weeks to realize the benefits.

Magnesium combo, Taurate, Glycinate, Malate - 250 mgs. 3 times a day (called Triple Calm on Amazon) plus additional 100 mgs. of Magnesium Glycinate added to above before bedtime. Dr's Best 100% Chelated only for GI tolerance.

CO-Q10 - 10 mgs. 2 times a day

L-Carnitine Fumerate - 250 2 times per day

Vitamin C - 50 mgs. 3 X a day

Vitamin D3 - 50 Mcg. 2 times per day

B 12 - 1000 Mcg. 1 per day

Wild Alaskan Fish Oil - 630 mgs. 3 times per day

Hawthorn Berry - 565 Mgs. 3 times per day

Good luck if you try the natural methods. If in doubt, please look into Dr. Steve Ryan, PhD on Natural Supplements for a Healthy Heart. Or you may research Dr. Frank Shallenberger in "REAL CURES" newsletter on Second Opinion

Ablation7 profile image
Ablation7 in reply to Dee5165

Thank you so much!!!!

Hi would love to know what the supplements are too if you don’t mind , if it works naturally, why not.

Hi,

These are the supplements I take. Many of these supplements work to regulate heart arrhythmias. I take them at 9 a.m., 3 p.m., and 9 p.m. when it states 3 times per day. Please be aware it takes 8-10 weeks to realize the benefits.

Magnesium combo, Taurate, Glycinate, Malate - 250 mgs. 3 times a day (called Triple Calm on Amazon) plus additional 100 mgs. of Magnesium Glycinate added to above before bedtime. Dr's Best 100% Chelated only for GI tolerance.

CO-Q10 - 10 mgs. 2 times a day

L-Carnitine Fumerate - 250 2 times per day

Vitamin C - 50 mgs. 3 X a day

Vitamin D3 - 50 Mcg. 2 times per day

B 12 - 1000 Mcg. 1 per day

Wild Alaskan Fish Oil - 630 mgs. 3 times per day

Hawthorn Berry - 565 Mgs. 3 times per day

Good luck if you try the natural methods. If in doubt, please look into Dr. Steve Ryan, PhD on Natural Supplements for a Healthy Heart. Or you may research Dr. Frank Shallenberger in "REAL CURES" newsletter on Second Opinion

Thank you, I will look in to it.😊

belindalore profile image
belindalore in reply to Dee5165

Thank you Dee. No Drs are not trained to use alternative treatments. But I have had Drs in the past who were fine with me using supplements for different things. I get angry at Drs now because they won't and don't listen to the patient. I and my siblings and our late father are and were all sensitive to these pharma drugs. I'm treated like I'm some kind of nut when I tell the Drs I am super sensitive to pharma meds. Or just tuned out by them. Yet there are MANY people like us. It's very frustrating and it makes me feel like my life doesn't matter. I really believe if Drs would (and if the insurance companies would butt out and allow Drs to doctor) look for the causes of afib fewer people would be getting the procedures. Procedures that have to be done over and over for some. And I wonder if so many of these procedures fail because the Drs aren't looking for deficiencies of nutrients in their patients. Or looking at the vagus nerve. Looking for a cause. In fact when I told my first cardio Dr how I was doing so poorly on the meds he immediately wanted to do an ablation. Told him no way. I was so weak and unwell it would have killed me for sure. Wouldn't have bothered him in the least. Disgusting. I too did my research and with advice from a few people in this forum and reading all I could , I went to the supplements. I may not be even close to 100% and don't expect to be, but I'm not lying on the floor like I was when taking the pharma meds. I can function as a human being. I hope someday medicine and healthcare can get back to really taking care of the patient and Drs worry less about padding their pockets and the insurance companies quit ruling over healthcare. Thank you for your reply. Take care.

Dee5165 profile image
Dee5165 in reply to belindalore

Belindalore,I couldn't agree with you more. When diagnosed with Afib, my Cardiologist went the pharmaceutical med route. I explained how I never react well to meds and side effects are worse than medical issue. When placed on Beta Blockers I was suffering from Anaphylaxis and other bad side effects. That's when they pushed Ablation. My former brother-in-law died during an Ablation when catheter pierced his heart and he went into a coma and bled to death. So ablation was definitely out for me! Tried Cardioversion and lasted almost two weeks. My options were now limited. Supplements were my only way to go. I actually believe I may have had a mineral deficiency. It appears only 40% of magnesium is absorbed and 60% is lost in urine. This deficiency is only found in special blood tests, not provided with regular blood work. So I replaced these supplements in my body. I agree with you that finding the cause of Afib is the most important factor in finding the treatment. Wishing you good health!

belindalore profile image
belindalore in reply to Dee5165

So sorry that happened to your brother in law. It's a risky procedure and not many discuss the risks. I agree with you that many cases of Afib can be some deficiency. Just regular blood work won't show it. It has to be intracellular and probably most Drs don't even know what that is, let alone do those tests. There is a cardiologist in Arizona. Dr. Jack Wolfson. He became a holistic cardiologist after meeting his wife to be who is a chiropractor. She told him he was not treating the whole person as conventional cardio Dr. He realized she was right. And married her. He'd already realized he wasn't really helping his patients that much by only passing out pills and doing the procedures. Maybe you've heard of him. He wrote a book "The Paleo Cardiologist." He delves into lifestyle changes and the importance of testing for deficiencies of nutrients. Some people call him a quack but he still believes there are some people who do have to go the route of meds and procedures. I would love to be able to see him but I can't afford him. Of course since he's holistic insurance isn't going to pay. But his book is full of good info. Also Dr Sanjay Gupta in the UK affiliated with the London University, is also good. He's a cardiologist and believes too that Afib is helped by taking supplements. He has many good videos online talking about different things. Also Drs don't seem to understand the possibility of Afib being caused by the vagus nerve. ( Dr Gupta has videos about that too.) I asked my first cardio Dr about that and he said we don't deal with the vagus nerve. I was dumbfounded. How could you not consider the vagus nerve being related to Afib? I think too many of these Drs, as I said before, just want to take the easy route with pills and procedures. They have no desire to do any thing further and they don't want to fight the insurance companies. It truly is disgusting. I have Humana insurance and they have a TV commercial talking about how "human" their insurance plans are. Yeah right. I wish you good health also. We have been in trying times with this pandemic. The world is a mess.

😥

Dee5165 profile image
Dee5165 in reply to belindalore

Thank you for your kind words. Agreed again. We have the same mindset. I’m located in NY where there are some of the best doctors. Since Afib is mostly affected by nerve impulses, I went to a Chiropractor who was educated on natural supplements. I trusted him more than these doctors who receive samples of meds from Pharmacy Salesmen and then push these meds. One size does not fit all. But I did the research and read there aren’t enough studies with supplements to advise people to take them. The info scares off most people in taking them stating there could be conflicts with other meds, but enough studies were not conducted. I seem to be a valid study and it worked for me. I have already been fired by one Cardiologist for not following his advice. Glad I was fired!! LOL

Could not agree more! Kind regards!

RaraAvis profile image
RaraAvis in reply to CDreamer

" that Bisoprolol does lower BP and studies show that alone in AFers reduces stroke risk." Did not know this. Where can I find these studies? Thanks.

I take Bispoprolol with no adverse effects and I'm happy to carry on with it, I don't know when I'm getting Afib so it's useless me having a PIP and I would rather take a regular med to prevent any issues than rely on a PIP working fast enough to prevent a potentially serious problem caused by Afib. Each to their own but I'm not sure how your question is helpful ?!

SteelHeart profile image
SteelHeart in reply to bantam12

It was not my intention to help, but to get to know something more...

bantam12 profile image
bantam12 in reply to SteelHeart

Your post seems to be questioning the sanity of those of us taking "Bispoprolol permanently" and that we don't have the intelligence to do things differently "makes no sense" Just my interpretation 🤷‍♀️

Hi Bantam, the way I see it Steelheart is asking why, when Bisoprolol makes some people feel so dreadful, can't they take it just when they have an AF attack. If it suits you that's good, but we sometimes get posts on this forum saying how it makes people feel so tired etc. So his question is, is it possible to take it as a pill in the pocket? I'm sure he also values your opinion saying you get on well with it.

It all depends how the post is interpreted, we obviously read it differently which is fine.

SteelHeart profile image
SteelHeart in reply to bantam12

Sorry if I have offended anyone! It was not my intention at all! Maybe my language skills make my writing sound a little strange and unusual... And, maybe my comment really was unnecessary, lol!

CDreamer profile image
CDreamer in reply to SteelHeart

You do really well and I completely understood your query, I’ve made similar observations.

Singwell profile image
Singwell in reply to SteelHeart

I'm glad you raised this question and I thought the meaning was clear. It's a good thread!

I value you your comment, communication is good. We can all interpret differently

You have every right to post your comment.

I find it harder to explain than to do. I’m not a writer or academic so my langue is poor and comprehension a little suspect especially together with impatience, so I too may be ‘read’ not as I intended.I personally have been taking Bi for over a year now and the greatest problem is not the side effect of the drugs but the mental detriment of having AFib. It’s only recently when I stepped up out of my AFib-slumbering mood and thought, hey Dave! Get of your bum and stop feeling sorry for yourself and do what you can, push until you find your ‘new’ limits and live life.

My greatest pal dropped dead this last Monday and I have lots of very special fun memories of him and us.

So do what you can while you can.

No one will learn anything as a talker, be a listener. But… someone has to start the conversation.

Love you all, whether I do or don’t agree.

I take Bisoprolol as a PIP .When I used it daily it drained .I've had an ablation and 18 months later I have AF occasionally .My EP and I discussed medication on my recent review and he agreed in my case there was no benefit to taking it daily but as a PIP at the onset of AF it was beneficial. Anticoagulants were much more important as a daily medication to lower the risk of stroke with no side effects other than the risk of a large bleed .We are all different but from everything I've read and experienced the prescribing of Bisoprolol seems to be the first go to for GPS and cardiologists but doesn't suit everybody and only time and personal experience Informs the individual of its benefits .

majjic profile image
majjic in reply to jeanjeannie50

It made me feel so ill i came off it and the doctor replaced it with Atenalol which is brilliant.

Beta blockers are also used so drugs like flecanide can be taken more safely so a blanket approach can’t be taken. Drugs need to be prescribed individually ( although I agree this isn’t always done)

Prevention, rather than cure.

I agree with you Steelheart, why take Bisoprolol or indeed any other drug, if it makes you feel so dreadful, but I must just add the following comments

You say your AF attacks are mild, so I'm guessing you've never experienced a bad one? Some people get the most dreadful ones, during one of mine I had to fight to keep conscious because my heart rate was so high. I have a friend who when she has her attacks quite often drifts in and out of consciousness. These more severe attacks can leave you feeling drained for days. For this reason some people will take whatever tablets their doctor has prescribed if they prevent these major attacks. They may feel a little more tired, but it's worth it.

Jean

Thanks, Jean, makes a lot of sense what you are talking about! I wonder how many people have tested a "pill in the pocket approach" and how it has worked for them...

Byke profile image
Byke in reply to SteelHeart

I was given Bisoprolol following my first bad AF episode, but I felt very ill and faint using it. I was re admitted to hospital following another bad episode of AF where I was taken off daily use of it as it is too strong for me, and I was told to use Bisoprolol as pill in the pocket, which I did, unfortunately I was returned to hospital via ambulance when I used it as pill in the pocket as my reaction to it was so bad, following tests in the hospital I was told never to take Bisoprolol again , and not to let doctors give it to me as I am allergic to it. So it did not work at all for me.

SteelHeart profile image
SteelHeart in reply to Byke

So sorry to hear it. Many people have reported unpleasant side effects, but you are the first one who is allergic to Bisoprolol. All the best! Peter

brit1 profile image
brit1 in reply to SteelHeart

I was put on Metoprolol and after a short while I decided I did not want to be on this drug so weaned off and now take it PIP when I go into AF. I do take Eliquis. I also take herbs/supplements that help the heart stay strong (Hawhorn/CoQ10/Taurine etc) plus walk daily and stay slim and eat plant based diet. This way I am doing the best for my heart so when it goes into AF it has a better chance of dealing with it.

SteelHeart profile image
SteelHeart in reply to brit1

I like your approach! Really impressive! Nowadays, where the MDs have no time for the patients, we all have to be well informed and proactive!

Lbeat796 profile image
Lbeat796 in reply to brit1

Thats roughly my approach, i walk every day, am vegetarian, take extra vitamins and magnesium but unfortunately i am a chocoholic which is the worst thing for heart arrythmias!

Until recently I took a PiP which worked really well for a few years. I have a few health problems now and my AF and tachycardia has increased has increased but I am keeping it under control with tablets I cut in half (half the dose) which seems to be working.

Do you mind if I ask about your health problems...? You can send me a PM, so that it will remain among us. I am researching, so every personal story can be used for testing the hypothesis...

Alphakiwi profile image
Alphakiwi in reply to SteelHeart

I am taking diltiazem 30mg as needed to help me through the toughest times. I was taking 120mg once a day and that put me in the hospital . The same thing with other drugs. My doc came up with pill in the pocket approach. I still have to do this with caution as if i take 4 a day i am shattered with bad nausea and weakness. I am going the pace and ablate and already have the PM.

Hi , I stated with the odd AFIB attack but then it got worse and I ended up in hospital so often and felt so ill I had no choice but to go on medication.

BobD profile image
BobDVolunteer

I have often said that any and all treatment for AF is only about quality of life (QOL). I have also often commented that if a drug makes QOL worse then change the drug or go have an ablation.

I really don't think there is anything new in your thoughts but always useful to raise your head above the parapet occasionally to see how others feel.

I do feel, however, that you maybe need to re-view your approach to your BP , Fifty years ago it may have been common but we do know a little more about it these days and you are at some risk. One does not always need drugs to control BP and I have dropped mine 25/15 by weight loss and diet alone.

SteelHeart profile image
SteelHeart in reply to BobD

Thank you for the reply, BobD! I try not to stir much, but am reading our forum regularly (about 10.-20 times a day, lol), so noticed a lot of complaints, hence my post.As for the increased BP, I believe that I am doing the right thing avoiding the BP medication. I feel perfectly well when at 150/100, so do not see the reason to take drugs. I posted something about it in our forums and got the reply of a man, who said that he has done the same - at first, he took the drugs, his BP went down, and he felt dreadful. he decided to stop the medication, his BP went up to 145/95, and he feels perfectly well. Not recommending it to all the others, but it is my small experiment...

Ppiman profile image
Ppiman in reply to SteelHeart

I used to work in the pharmaceutical industry and well remember its being said back then that no one can know what a safe long-term blood pressure for an individual would be since it is unlikely that that individual's "normal" blood pressure (indeed, I also recall similar arguments were used back then regarding blood sugar and thyroid measurements and treatments).

However, since those days, many international studies have shown correlations between raised blood pressure and poor long-term health outcomes, most especially regarding the prevalence of stroke. Raised blood pressure has also been shown to affect many organs and body systems negatively. I've become convinced that we all do need to keep our blood pressure down to recommended levels. My own cardiologist, for example, thinks I would benefit from taking losartan long term even though my blood pressure is normal.

I would, however, be very surprised if "over-prescribing" didn't go on given the pressures doctors face from various sources. In the end, I suppose we must trust our doctors and our healthcare systems, as well as keep our fingers crossed.

Steve

BobD profile image
BobDVolunteer in reply to Ppiman

Hi Steve and thanks for your input.

What I would note is that each time I reached a good target number , the target was lowered, first 145/90, then 135/80 then 125/70. I know from speaking to doctor friends that in some way this is a result of the QOFS set up by the Blair administration which regulated doctor's pay. They need to tick the box that they have discussed such things with patients in order to gather points which affect their salary. Blood pressure and statins are just two such QOFS (Quality Outcome Framework ) so it is possible that over prescribing takes place. My own GP tells me it is sufficient that she has had the conversation with me and that I am old and ugly enough to make my own mind up but I do wonder is some patients are over prescribed. Out of interest I just took my BP which is 116/65 so either I'm doing something right or my heart is failing!

On such a lovely day who cares?

Ppiman profile image
Ppiman in reply to BobD

You’re definitely doing something right. Mind you, I gather that as we age our hearts do naturally “fail”. My brain seems to be in a race with it to do that - and I’m sure it’s winning!

Out of interest, my slim and generally healthy wife just had her cholesterol result measured at 7.2 but our GP told her that he felt that her risk of developing heart disease was too low to bother with statins.

Back in the day, it was generally only the lower diastolic blood pressure measurement that seemed to be regarded as important, but I see that has now changed. I would want to be more than 135/85 myself - but that’s pure psychology as I’m a bit neurotic about health!

Steve

brit1 profile image
brit1 in reply to Ppiman

cholesterol is easily managed by diet vs statins

Ppiman profile image
Ppiman in reply to brit1

You might be right, but I’ve read that only a very small proportion of the cholesterol in the blood comes from the food we eat.

Statins seem to have general acceptance now as being useful but I’m on your side in terms of trying to avoid drugs where possible

Steve

Ronnieboy profile image
Ronnieboy in reply to BobD

I agree on the BP point mine was always high 150/80 plus ,I have lost 20kg in 2 years and BP is now normal ,I've ditched bisolprolol and ramipril .

I believe that as well as lowering BP and HR bisoprolol has a mild anti arrhythmic effect hence its popularity with doctors. We know that many people arrive on this forum in panic and distress because they have been diagnosed with AF - usually paroxysmal because it has more frightening symptoms. If the doctor says ‘don’t worry, it’s common and won’t kill you’ patients aren’t likely to believe it and they expect to be ‘fixed’ so the doctor prescribes the ‘mildest’ medication - bisoprolol or diltiazem . It may be that the patient may not have another episode for years but they assume it’s because of their medication and nobody can say either way.

So, worst case scenario, the doctors prescribe in response to patient demand and patients take as a security blanket. Best case is that the patient does benefit from lower BP and HR and a ‘brake’ on strenuous activity.

I take Diltiazem and it seems to work for me so in the absence of bad side effects I’m continuing to take it. Once I have an episode I would have to take a much higher dose to bring my HR down so it seems better to prevent it.

Hope that answers your question? I totally agree that we should consider carefully whether we really need the medication we are taking as there is sometimes a ‘cascade effect’ where one medication leads to others.

SteelHeart profile image
SteelHeart in reply to Buffafly

Thank you! I can only learn from your reply! Kind regards!

beach_bum profile image
beach_bum in reply to Buffafly

I agree. Some trust their doctors, and some not as much. Some have had had regular checkups all their lives, and some only enter the healthcare system after something goes wrong. And like you said, some...to the chagrin of Doctors everywhere...tend to consult "Dr. Google" first and then tell their GP or Cardio what they think they should do or prescribe. It's the modern parable of ..."what did Dr Google have to say about your sore elbow? ...cancer,,of course." 😏

I so agree! They put me on 10mg (10mg!) of bisoprolol and a blood thinner (sorry - anti-coagulant) daily for life (even though I typically had a resting heartrate of 55) after I had a bout of AF. Long story but basically I don't take any drugs now and hopefully long may it last. Great comment!

SteelHeart profile image
SteelHeart in reply to Paul0208

Thanks for the reply! Glad you liked it! All of us are too inclined to obey whatever the MDs say, but in my country it is well known fact that they have a deal with drug producers and that they gladly prescribe the drugs for life. If the goal is to preserve the health, and it definitely is, than we ought to be careful with taking the drugs, especially such like Bisoprolol

Belle11 profile image
Belle11 in reply to Paul0208

Interesting to read Paul and thanks for raising the issue SteelHeart. What sort of BP readings do you get Paul?

When I was diagnosed with PAF back in February my BPM was 80 (in an episode, otherwise 60). Was prescribed Bisoprolol 2,5 mg and this did not change. Same with BP (130/90). Although no obvious side effects I am considering stopping it because less pills better. It is interesting to note that there are quite a lot of people who take it, in low doses, just as a mean of "calming down". Stage fright, for example.

SteelHeart profile image
SteelHeart in reply to RaraAvis

Thanks for your reply! I can fully understand that, after a debilitating attack of AF, people would accept to take any drug in the course to avoid it. But, Jesus, look at the number of people complaining! Few of them can stand this drug... I know that there is some time period necessary in the course to feel the effect of Bisopriolol, so taking it as a pill in the pocket, when AF attack has already started, may not be a satisfactory solution. But why not test it...? And, one more, our kidneys remember all the chemicals we put down our throat, that's for sure!

I don't think it's an unnecessary comment at all. This is what NICE recommends. This is what my doctor told me to take. When I had an ECG at the surgery where my hr was 159 another doctor told me to double the dose to 2.5mg.

What does this drug do? As far as I can see, it reduces the hr by 10 bpm. So 140 AF and 80 NSR becomes 130 and 70. The trouble comes when the NSR is 60 or below and it goes down to an average of 50, so the patient feels more tired. I don't think it should be given to people like me with a resting hr of 59. I know that because I've recorded it every day for the last year on my apple watch!

In the doctor's surgery my hr could well be nearer 80 but that is deceptive. When I was in hospital in 2018 I was told I had AF and I had to take bisoprolol daily. I refused because, by mistake, I had been given Atenol for a week and at the end of it I just couldn't do anything, I had no energy. I said I didn't want to take a beta-blocker because my hr was low. Then later on the consultant turned up to try and persuade me and I explained how I felt to him. He then went and said to my daughter "your mother seems a bit confused" and she replied airily "oh, she's always like that!"

SteelHeart profile image
SteelHeart in reply to Physalis

Thanks for the reply, you made me laugh at the end! You are so right about people with naturally low HR and further lowering it with the "help" of beta blockers. I see, some people are satisfied with the lowering of BP which comes with lowering the HR via beta-blockers. But, at the same time, the blood circulation goes down and the tissues remain poorly fed by oxygen etc. Long term, it may have tragic consequences... We should be very careful with any drug, it is still something artificial getting into our body...

CDreamer profile image
CDreamer in reply to Physalis

Me thinks he may be the confused one Physalis - I’ve disagreed with you on some things but never have you come over as confused!

Hi, have just read your text. Up until my 5 day stint in hospital recently my last A.F occurance was 2014. Interestingly I am on Bisoprolol and axiphan now. After reading your text will ask my doc in a month's time how long I need to stay on Bisoprolol and see what he says and what justification he gives if need to continue on it. I do find HR is lower than has ever been and do get tired when it comes to evenings but apart from that no obvious difference to day to day life in how it affects me

SteelHeart profile image
SteelHeart in reply to Falco1

Hi, Falco! My first serious bout of arrhythmia was at my age of 55. Had long lasting and intense bout of PVCs and was ready to take anything, despite being against drugs in general, just to stop it. I do not remember the name of the drug, I took only a couple of pills, but it made me feel dreadful! I was not able to think properly, not to mention the talking, I was muttering... Stopped it at once, without consulting the MD. Us, the patients, are the ones who know best what effect the drug has on us, so we bring the decision! Maybe the more serious case is if a patient takes the unnecessary drug, which causes no side effects, but long term causes the problems with kidneys or liver... I hate the idea of taking Warfarin or similar for the rest of my life! It must cause some problems, for sure! Of course, the decision must be all yours! Wishing you well!

P.S. Just noticed the coincidence - you may be the one I mentioned in my post, with 7 years pause after the first AF bout! I have a habit not to forget, if I see some interesting data in other peoples' posts. I have a small red lamp, which lights up when there is something of significant importance, and it remains in my head forever (I mean the data, not the lamp, lol). Cheers!

DGET1 profile image
DGET1 in reply to SteelHeart

I don't like taking drugs myself, but feel I have to if I want to live longer.I use Bisoprolol as a PIP for my PAF, and it does make me feel tired and I have very vivid dreams after taking it.

I also take Apixaban, as I had TIA few years ago, BP meds and a statin.

My point is take the meds or risk having a stroke !!!

As a practicing nurse I have looked after many people who have had strokes, and believe me you wouldn't want one !

My biggest fear !

Also, I do think your BP is too high, and if you can't reduce it yourself I.e. diet and lifestyle, then you should bite the bullet and take meds for it.

None of us like taking g drugs but sometimes you just have to.

Falco1 profile image
Falco1 in reply to SteelHeart

Hi SteelHeart thanks for your message. To be honest I wouldn't have questioned the continuation of the meds I am on going forward if I wouldn't have read your first message on the topic. As it was the first episode of A.F. in 7 years, no recurrence since discharge on 12th July and being 46 years of age may work in my favour, to not need life long continuation, who knows. Without having much knowledge or experience on this topic as a lot of people on this forum, I only had fast A.F,where I read some people's A F.is less beats per minute.. Throughout it's 5 day occurance it started at 186bpm and averaged 140-150 until normal rhythm kicked back in. I am not anti-meds in any shape or form and I'm happy to be taking what I am on now, but agree we should review what we are taking a certain stages going forward to see if we need to continue with it. So 'touch wood' if no repeat episode I will ask my doctor in a month's time if continuation is still needed

I have P/A/F for 20+ years, it caused a stroke in 2000, ive had an unsuccessful ablation 4 years ago, I now have a Pacemaker and I am also taking drugs for control namely Bisoporal (reduced my dose with no ill effect), Disopyramide (again reduced dose) and anti coags. Do I like taking drugs, no I don't, before A/F I wouldn't take anything, I hated the very thought, Why do I take them, because I like to feel well and be free of the constant battle with my heart, it has taken 20 years of my life and also my career, enough is enough lol. I take a very analytical look at life and I enjoy freedom of choice, I've tried the P/P route and yes ok it worked to a fashion, maybe 2/3 hours after taking but I prefer this route because it keeps my heart stable and I am lucky that, for the moment, my heart acts just like it should and that gives me peace, As for arguments, my Mother used to say that some people could start an argument in an empty room......don't you just love the old sayings 😘

Billblue profile image
Billblue in reply to opal11uk

Good answer

I agree with you whole heartedly I have talked to my doctor about what you are saying why ,? She just looks at me as if I am the crazy one how dare I question her treatment I think the problem is GPs haven't studied or experienced afib not interesting enough is my belief. I've told her I'm not taking bisoprodol and that's that. Up to you was the reply. Conversely I have a private doctor who does have afib he said she is wrong and cannot believe she prescribed a daily dose when it was clearly not needed. He has had two ablations too that haven't worked either. These GPs just don't listen just go by your instincts you know your body and what's best FOR YOU.

I'm so glad you liked it! I come from the country where we have been lied to and manipulated with for the past 30 years, so we are inclined not to trust to anyone, especially not to MDs, who are known to be very corrupt (my country!). I believe they all obey some protocols, not having the time to deal with every of the patients separately. For that reason I believe that at least adjusting the individual dose would be god for the patients.

You've got to be from the USA. I am and I totally agree with you. I said how I feel about the Drs here in my other post to you. Money over patients.

Hello, Belinda! Just want to thank you for your likes and the active participation in discussion! I am from Serbia. We, here, are rebellious people, very suspicious when Drs and the medications are in question. It is so true: "Money over patients". The Drs are greedy and ready to sell their own soul for the handful of Dollars, what this plandemic has shown in the best way! I do not trust medical profession and will not again for the long time. Wishing you all the best, Petar

You may as well be living in the USA. The exact mindset of the health care system here anymore. It was different when I was younger. Drs cared back then (I am pushing 70) and tried to find a cause of your illness. Were they always successful? No. But they looked at you, not at a computer screen. They asked questions and looked at your face, your eyes and your skin. I feel like I'm in an assembly line now. Here's some pills or whatever. And on to the next patient. See you in 3 months. The insurance companies tell the Drs how much time they can spend with each patient. 15 minutes with your primary care physician and 25 with a specialist. What a joke. Here when you have an appointment you sit and wait til your appt. for 30 to 45 minutes. Then the nurse or assistant takes your vitals and then you're lucky if you get 7 minutes with the Dr after all that. And there's no compassion anymore. Medical care has truly gone downhill over the years and I believe that, even with all the new treatments and technology, so has the care of the patient. In the USA so much care depends on the insurance plan you can afford. The more expensive insurance, the better care. And if things continue as they are under the present government administration, it will get worse. As they are pushing a socialist agenda. But that's another story. And you're right about the pandemic. It's really brought out the true colors of many Drs. So sad. And so tragic for the patients. Are you familiar with the old movie "Soylent Green" from the early 1970's with Charleston Heston? You can Google it to see. I tease my friends and younger people that what the movie was about could become the future one day. I think sometimes it's not far from a possibility. Wishing you the best and take care. Belinda

Was offline the whole morning... Thank you for your reply and sincerity! We are fuc..d up in Serbia, but you, in USA, also! We are living in dishonest and turbulent times, which many of us will not survive. It was always like that - the good people were the first to go away. Nothing much to be sorry about, but I feel for the younger ones - my son is only 40 and, in normal times, he would have another 40 to live. But, they will not be that lucky... A handful of lunatics is trying to take the planet for themselves. I will try to find the movie, many things have been announced in advance, it makes them feel good if they say what they have prepared for us, the sheeple. But, the game is not over as yet, there is still much that can be done. We will have to fight, we will never surrender! Take care! Petar

We need so many more like us to voice what is happening all over the world. Here in the USA the politicians who say they are fighting for us are only mouthing the words. They have nothing to lose themselves. Or maybe they do. When China makes their play to take over, those politicians may find themselves wearing the little gray suits like everyone else. Between them and Russia and whoever else becomes their allies the USA will not stand a chance. Nor will any other countries who oppose them. It will be a war like none other. If you know of the book written by a socialist, George Orwell titled "1984" , you will see what he wrote is happening around the world. And sadly at a very fast pace here in the USA. History is being rewritten and destroyed. The young people being brainwashed into believing socialism is the way to go. I may not be the most intelligent person, but it's common sense to see what's happening. I myself had no children. But I fear for those like you who have children and maybe grandchildren. It's going to be a different world for them unless something happens to reverse the course the planet is on now. I'm not a religious person but I'm spiritual. I believe that God exists. So I can only pray. Because the other pandemic is that people have gone insane. I'm sorry to say I don't know much about Serbia. Is English the language there? I'm embarrassed to ask that. But I do know your English is much better than mine. 😁

You take care also!

Belinda, you bought me with your compliments about my English! I have spent my working ages as University professor, teaching Hydraulics and Civil Engineering Machines, but in parallel, I was working as an interpreter for English and German, translating mostly technical Operating Manuals for different machines. I must admit that my English has improved largely while reading thousands of posts in this forum and in different other forums. I liked the languages from my childhood, they do not divide us, they connect us. English has become a way of worldwide communication - every young person speaks English nowadays and it is sooo good! I envy you for being spiritual... I am not religious and know no gods - us, the people, have created Gods during the history. I like to say that I belong to a species who was once so powerful, that it was creating Gods, and it really was so. On this planet, people have invented above 10.000 Gods of different caliber, but only a few have survived - Jesus, Allah, Budha, Crishna,... maybe some more... I believe in good people, like the two of us and billions more! The evil is in a war with us, but us are more, we will conquer and lead this planet in the future, there is no alternative! May God bless you, you good soul! Cyber hugs from Serbia!

Thank you so much! I know if there were many more millions like yourself, the world would not suffer from so much turmoil. My hope is that we and the next generation can fight against the evil in the world or at least keep it at bay. There has always been and will always be evil. It just cannot gain complete control. If it gains control all we know will be lost. I enjoy your belief about us creating Gods. I suppose no one really knows for sure until we leave this life how this world and the universe was created. Or perhaps we never will know. I can tell though you have a good heart and are a caring soul. It is 10:30 a.m. now in Florida where I live. And I had better as we say here, "get my rear in gear" and get some things done. 😂Do take care and be safe. Your loved ones too. And cyber hugs to you too!

P.S. You have led a very interesting life. I envy people who are able to speak other languages. I'm an old gal from a farm community in Kansas. A world of difference between the two of us. But it doesn't make a difference when you have a good soul where we come from. 😔

Thank you, too! Actually, there is not much difference between the two of us - I grew up in a village, in contact with the nature, the land and the animals. My education is something that has changed my view of the world, but my best friend is a truck driver and I would not trade him for anything! The education is important, but there are so many perfect, very intelligent and valuable people without education. Also, I know a lot of people who did not get better through the education. They simply gathered (technical) knowledge, but it did not make them to be better persons. Kind regards!Petar

🤗

Do you. I’ll worry about me and handle it my way.

I had a 4 year gap between my first PAF and the next. I suffered from ectopics very regularly though. I was put on 5mg of Bisoprolol straight away .

I would take some blood pressure meds though, as your readings are high is and this can cause other problems, such as kidney damage as well as heart problems.

My resting HR was 55 on that, Now on 2.5mg and HR can be 55-60. But when asleep can go down to 38 BPM.

I was given Flecainide in 2016 as PIP. I have had 3 attacks in a month, 2 last week. 2 lasting 10 hours and the last only 2 hours. Took Flecainide x2 straight away but maybe not working as well now.

I think my AF is a symptom as I have posted about before, as if I do any manual work or lift heavy items this seems to bring on the AF after 4 to 12 hours. Then my chest/neck .back aches and hurts when moving or twisting. Its bad today. I also have a lot of fatigue and Post exercise malaise which I blamed on the beta blocker but did stop for a few weeks and it made no difference.

Mt lifestyle has changed drastically over the last 5 years, as I dread doing anything manual or DIY as I feel so rough and sweat buckets.

SteelHeart profile image
SteelHeart in reply to ian16527

I, myself, am also under a very strong influence of physical activities. That's why I believe that, apart of psychical stress, second important influence on cardiac arrhythmia is what we do. Heavy physical load has always made me problems and, yes, with some time delay...

You make an interesting point. As I read your post, I wondered how certain you can be that people are suffering because of taking beta-blockers? I'm guessing that doctors themselves must, in general, view the effects of the newer selective beta-blockers as benign. In terms of side effects, one comment from a large study was that "overall fewer patients were withdrawn from beta-blocker therapy than from placebo" (pubmed.ncbi.nlm.nih.gov/152...); and from another: "Almost all commonly listed side-effects attributed to life-saving beta-blocker therapy in heart failure are no commoner in patients on beta-blockers than their counterparts receiving placebo" (ncbi.nlm.nih.gov/pmc/articl...).

Also, my understanding is that lone AFib is rare and perhaps even non-existent, but that its cause is often not apparent. I wonder, therefore, whether cardiologists don't view beta-blockers as being in some way overall usefully protective of the heart's long-term health?

Against that, I have read that beta-receptors are widespread throughout the body organs and that even selective beta-blockers must, as a result, affect otherwise perfectly healthy multiple organs in some potentially negative way.

Steve

SteelHeart profile image
SteelHeart in reply to Ppiman

Hi, Steve! I'm so glad that the subject has intrigued you! I like your thought that lone AF does not exist! It really is so! The problem is, MDs do not understand what causes AF, so are really in trouble to explain it.

Ppiman profile image
Ppiman in reply to SteelHeart

I read somewhere that an arrhythmia always has a cause. I get the feeling cardiologists like to try to “protect” the heart from future problems and that drugs like bisoprolol are seen in that light.

Steve

SteelHeart profile image
SteelHeart in reply to Ppiman

Nothing in this world happens without the reason, so the "lone AF" also has one. And, to be realistic, this reason is likely to be the same for lone AF and for permanent AF. Wrongly, comorbidities, like high BP, are considered to be the possible cause of AF, but it is far from the truth. AF and high BP have the same cause and come in parallel, when this cause is present. They count to Dysautonomia. When the Autonomous Nervous System is out of order, than all the regulation in the body is in trouble. For instance, high body temperature is something that medical science has trouble to explain for a long time. Some of the explanations are very naive, like the one that increased body temperature kills the germs. No, the increase of couple degrees C can not have the positive result. Why the body temp raises when a person is ill?! Simply, because the automatics gets out of order and maintains wrong value. It even kills the patient in some cases, so definitely not a positive body reaction...

Ppiman profile image
Ppiman in reply to SteelHeart

I would think the body has major and complex interconnected “autocorrect” mechanisms learned from evolution or we would long ago have died out.

Arrhythmia is fascinating to read about. It’s amazing how much detail is known in terms of genetics and the biochemistry of such as sodium ions - and yet still the actual cause isn’t understood.

Steve

SteelHeart profile image
SteelHeart in reply to Ppiman

I am deeply impressed by the complex regulation we have in the body. It is a combined regulation, electro-chemical in its nature, but it gets disturbed from time to time, sometimes permanently. If you look at the list of the "chronic disease" (some 30 of them, you can find the list in HealingWell forum, USA), they all have unknown cause and are poorly understood and treated, if at all. All these health problems count to Dysautonomia and are the consequence of malfunctioning of ANS. Hard to repair...

It's possible to have AFib sometimes without symptoms and also AFib during sleep. So how would you know you are not having it? If it were me and been diagnosed with definite AFib, I'd be taking the meds. Having seen the results of AFib related strokes in my mother and grandmother. I am currently waiting for results of another holter test., after being told I possibly have AF or flutter.

I think it's a very relevant question! In the UK I believe AF broadly speaking is woefully mismanaged. I know I've spoken about this before but worth repeating - many of us get our first bout of AF diagnosed when we report to A and E and hey presto - a packet of pills and you're done! No lifestyle advice, no information, just those pills. I went into shock when our practice nurse casually mentioned at a blood test - you do know it'll get worse don't you? Many times even in my first few months of the experience I thought "I'm sure I don't really have it anymore". Looking back I think I should have had PIP, been monitored and taught how to manage. This could so easily be done in small clinics, as they do with speech therapy. But CDreamer is on the money - it's the risk factor that leads to this blanket treatment - AF is main risk factor for strokes esp in females. And TBF in my case my BP had shot up unbeknownst to me (historically I'd had low BP) and with the flooding in the UK of 2019-20 I could easily have become one of those stroke victims. We do need to change our attitude to illness in general IMO - all of us - not just the medics. It's no good waiting for the shoe to drop and popping a pill. Overhauling the way we deal with AF would be a good start.

CDreamer profile image
CDreamer in reply to Singwell

Wise words.

Singwell profile image
Singwell in reply to CDreamer

Thank you. Having a condition like AF causes us to pause and reflect doesn't it? I'm so grateful for this forum too - learned far more about AF and medication here than from any medic...

Billblue profile image
Billblue in reply to Singwell

Another good answer

SteelHeart profile image
SteelHeart in reply to Singwell

Thank you for your comment, you said it so nicely! As for the MDs, I still must admit one thing - they have no idea what really causes AF and other arrhythmia, so they are doing what they are doing in the dark, not really understanding things as it should be. For that reason, the patients should maybe be more reserved not only about treatment, but about everything else. Kind regards!

belindalore profile image
belindalore in reply to Singwell

Seems from what I've read in this forum from different posters, every medical system in every country needs overhauling. 😒Be safe and well.

I feel you make a very sensible argument. I didn’t have any major problems taking it and was on the highest dose of 10 mgs. Having near daily AF it felt sensible to keep taking it and when flecinade was added it was reduced to 2.5. Following an ablation my incidents 8 weeks afterwards are reducing and as soon as I’m reviewed I’m stopping it if incidents are infrequent or hopefully gone

I've been on 8.75mg bisoprolol since my cardioversion in January last year, and my heart rate is between 44 and mid 50s - never goes up to 60. I feel sluggish and slow much of the time, and get short of breath easily on exercise especially when I take the biso in the morning. But I'm not aware of having had any AF attacks in that time. My BP varies between 120/60 ish to 140/60 ish usually, and don't know if I need the drug (or another one) to keep my systolic BP down. My GP has referred me back to the cardiologist - so reading this discussion is helpful before I have the chance to ask about options. Thanks SteelHeart.

SteelHeart profile image
SteelHeart in reply to Belle11

Hi! My HR is about 48, but sometimes goes as low as 44 during the day. If I would take any beta-blocker, I believe that I would have serious problems. In general, people with naturally low HR should be very careful with BB.

Belle11 profile image
Belle11 in reply to SteelHeart

You certainly don't want it any slower. My heart rate before AF was 60 -70, then was around 90 while I was in persistent AF for 8 months. It's only since the cardioversion that it's become slow, and I don't know if it is now "naturally" slow or caused by the Bisoprolol!

I don't take beta blockers because of their side effects. Taken off them by medics. I have permanent AF. My only medication is an AntiCoagulant.

I did not put up with bisoprol , given it after my first afib atack I stopped it after 7 days. The cure was worse than the disease!. I went onto atenolol. Better but still bad. Stopped after 14 days. Went on to verapamil. No problems no side effects QAL fine. Stayed on that for 20 months, but afib kept breaking through, always high rate, and the afib progressed so eventually I had an 8 day attack where the medics stuggled to cardiovert me. Eventually Flecainide infusion in the CCU. That was no QAL either! Thats when I decided to get an ablation. I had 10 months of flecainide / Diltiazem whilst waiting for the ablation, then the 3 months review. Flecainide fine, Diltiazem pretty bad, QAL reduced.

But 3.5 years now post ablation and no drugs, QAL fine.

If the drugs had no side effects and they had kept AFib at bay I would never had an ablation.

My view is keep trying different drugs until you find one that has no side effects AND works. ie. no AFib breakthroughs. ( Afib begets Afib it will progress ) .

At minimum find the least bad drug. If this cannot be found have an ablation.

If I had could go back in time, I would have had one sooner. I should have realised after the 4th AFib attack that AFib was not going away.

The other take I had on drugs was given by a dispensing cardiologist , as I was trying to reduce my Diltiazem dose to improve my QAL: I think she said " all drugs can be poisons, its finding the right dose that makes it beneficial " ( or not) .

SteelHeart profile image
SteelHeart in reply to KMRobbo

Thank you so much for your reply! That is how the patients should behave in general - not only passively accepting the drug, but being critical and proactive, to find the best solution. I understand that people are willing to obey what MDs prescribe, but only the patient knows what use or harm he has from the medication.

KMRobbo profile image
KMRobbo in reply to SteelHeart

The first cardiologist I had who was the lead supposedly, has never seen me personally since my first appointment as I absolutely disagreed on carrying on taking the bisoprolol or anything else that made my life worse. It seemed I was supposed to take the pills and live with it as that was convenient . I also was reluctant to leave the office on the end of the 15 minutes appointment until i got some answers to what AFib actually was and what it was doing to me. Fortunately I had already changed drugs twice via my GP so it was done!

To be fair I did get a 24 hour monitor out of the appointment which was informative.

Luckily for me the person who was on my second hospital appointment was a visiting cardiologist who was much more helpful and took time to explain things and suggested things to try to reduce the drugs / side effects

and alternatives. He was however adamant that AFib would return again sooner or later, as there were a few things not normal on the 24 hour tape even though no full blown afib (unfortunately it was sooner) . It turned out he was an EP, which I only found out 20 months later. So as he was so helpful on my appointment that is who I went to for my ablation, even though I had to travel further .

Firstly there are numerous beta blockers I hated Bisoprolol and moved on to Nabivolol with no side effects I totally agree with others anti coagulation is important. quite frankly with those numbers hypertensive kidneys heart attack stroke are all on the menu

I had my first bouts of Afib after having Open Heart Surgery twice in April 2019 to repair an Ascending Thoracic Aortic Aneurysm. The afib wasn't pleasantly. At that point I was put on Amiodarone, which I stayed on for 4 months. had it again a few weeks later with Pneumonia and Sepsis. My Cardiologist put me on a small dose of bisoprolol (1.25mg) at that point to they could gradually take me off tha Amiodarone. Im also on losartan, aspirin and a stating. Later that year I had another infection but this time I had Tachycardia. I then had nothing since. I did ask my Cardiologist as recently as March about coming off bisoprolol, they did look at it but felt as I had had both afib and Tachycardia I should stay on it. He felt the bisoprolol wasn't helping keep my heart in rythm. Strangely enough it has now jumped out of rythm over the last 3 weeks and my Cardiologist is getting me back in for ECG's and to be put on a monitor etc. I'm not sure if things would be a lost worse without the bisoprolol. Without the surgery though I doubt I would ever have had Afib but I knew that was risk and I had no option but to have the surgery.

SteelHeart profile image
SteelHeart in reply to cjbroon

Hi! Here an interesting data, which I read long time ago. When a sound heart is transplanted to the patient who never had arrhythmia, the patients develop AF in a very large percent, if I remember well, in about 40% cases. Strange, isn't it...?

Singwell profile image
Singwell in reply to SteelHeart

That's absolutely fascinating! It means that something else is triggering the imbalance - what I've thought all along. I have a wonderful life coach who has helped me through this AF journey. One day he said to me - well, if you don't get it all the time, why should you get it any one day or another? Why not live your life as though each day will be one without AF. It helped me be more positive in my attitude.

SteelHeart profile image
SteelHeart in reply to Singwell

It is a very precious information, I found in an article long, long ago, at the beginning of my AF research. It eliminates all the influences we were thinking about and were suspecting to be the cause. But, if the food, coffee, alcohol etc., etc. are eliminated, what remains...? I have an idea, you say how it sounds to you... Not all the patients get the heart that "fits" their chest cavity. Maybe 40% get a little larger heart, so it gets "squeezed" in the chest, like it is the case in overweight people. It, than, disturbs the el. signals and we are in trouble... How do you like it?

Singwell profile image
Singwell in reply to SteelHeart

I think the body is more logical and organised than that, though I guess sometimes things go wrong genetically don't they, or why would people be born with a hole in their heart...

SteelHeart profile image
SteelHeart in reply to Singwell

This hole is a necessity because of the switching of blood circulation from picking up the oxygen in the placenta, to picking up the oxygen in the lungs, when the child starts breathing. It usually gets closed soon, but in some cases it remains open and poses the problem. Absolutely agree about the genetic predisposition - all of us, afibers, have genetic predisposition for arrhythmia.

Singwell profile image
Singwell in reply to SteelHeart

Didn't know that either. 😉

It seems that any shock to the body can trigger a.f. l completely agree with you when it comes to taking pills. I thought l was going to get a pace and ablate. Well l have had a pacemaker implanted and now the consultant says that an ablation will not be considered until l have tried all the drugs and l have proven that they don't work. Beta blockers make me feel like death warmed up and l seem to get the worst side effects from any drug. Since taking the medication is supposed to improve your q.o.l. what is the point if it is going to make you feel ill every day.

Hi SteelHeart.

I have commented before on your attitude to meds so I will say no more on your views about AF. However what has prompted me to post is your car analogy. I hope you are not advising people that it's safe to use the handbrake to slow a car down? It most certainly is not even in an old one with separate brake shoes in a separate drum. Manufactures never designed handbrakes to slow down a car. There are a small number of modern cars fitted with special rear axels that are designed to be used on the track to drift cars around a corner in the hands of an expert driver. Not for use on the road though.

All the best.

Roy

Hello, Roy! I am a driver with 45 years of driving experience, with about 500.000 km and with no single accident in the record. Additionally, I am a mechanical engineer, specialized in the field of motor vehicles, transport and agricultural machines. The analogy was just to make the text more picturesque...

Not unnecessary. Many query as to why one person gets this drug or procedure as opposed to a different drug or procedure when the conditions seem identical. But as I have observed, almost no 2 are the same. Many have multiple health issues, and they must be taken into account.Personally, I had never heard of any of the drugs mentioned here, as I am relatively new to this, and only knew of the drugs prescribed for me. I did learn quickly,,the difference between beta blockers and channel blockers, and the difference between Warfarin and newer blood thinners. It was a steep learning curve for sure. I also learned, that when it comes to doctors, and trust, many people are not as fortunate as I.

I also had a nasty reaction to a beta blocker.. Metoprolol, and could not function properly. I promptly called my GP, who called the Cardio and EP folks, and concluded the well meaning staff at the ER had put me on the wrong drug and promptly corrected it...to a channel blocker, Diltiazem.

Except for the fact my Medsafe alert pings me every evening at 9:00 pm to "take yer meds" I don't even know I'm on them.

So, it has been a educational and positive journey...guided and informed by many of the good folks here, and 'Ive never had my "head bit off" for asking questions, so no, not an unnecessary comment. 🙂

SteelHeart profile image
SteelHeart in reply to beach_bum

Thank you so much! Appreciate your support! My post was with the best of intentions, though some people were not very pleased with it... As BobD would say, we are all different, lol!

The trouble with drugs taken as PIP they may not keep AF suppressed (the aim is zero episodes) and indeed may encourage more by giving the system a 'roller coaster' ride rather than a flat one.

SteelHeart profile image
SteelHeart in reply to secondtry

I fully understand and accept your view! Never expected that so many people will react to my post, but it really is useful to hear others' opinions!

I know a lot of people cant cope with bisosporol and l am one of them. It was given to me at the lowest dose for frequent pvcs after a day in the ER. As I have bradycardia, and normal to low bp l didnt last long on that med before my heart rate crashed too low to function. Next try was diltiazem. Heart rate stayed ok but BP crashed so low it wasn't safe. So l have been med free and just putting up with the psvt and pvcs. I know they are not dangerous just annoying and tiring. But if I am confirmed with AFib l have no idea what med l would end up on. Doc did mention flicocaine low dose, but that definitely does not sound appealing. Btw l did not know you could take BBs or CCBs as pip ???

SteelHeart profile image
SteelHeart in reply to chicolini

Hi! Thanks for the reply, it was interesting to read it. Yes, beta blockers are absolutely wrong drug for the people with PVCs, but the MDs still prescribe them. It only demonstrates how little they know about cardiac arrhythmia. If you already have low HR, taking BB will definitely kill you! You learned it from experience, unfortunatelly...

Remember everyone is different and have different causes/triggers for their arrhythmia (I say Arrhythmia as AF is one of many ways your heart tells you its not happy). If I can give an example of what I trying to say (the example is an easier way of explaining it as the workings of beta channels and how they effect the heart is complete indeed) - Many take magnesium and believe it does them good and whilst this can be the case if your cells are magnesium deficient, magnesium does nothing for those that have sufficient in their cells (not blood count).

Now take Bisoprolol, a beta blocker, it will work if your heart is too sensitive to adrenaline or you generate too much adrenaline by reducing the adrenalin going to your heart and this in turn has a beneficial effect for many. Then again if adrenalin is not the problem it has no effect. By reducing the adrenalin in your body too much it can have detrimental reactions such have fatigue tiredness and arrythmia etc. Other ways beta blockers work is to control some of the side effects of other drugs such as Flecinaide where it can literally be a life saver.

As I always say Doc knows best, they may not be right all the time but they are the only ones with the knowledge of your particular problem. Unfortunately the armoury they have is not good and trends to help the symptoms rather than the root cause. In addition not all Docs are the same, some have more experience and consequently provide better treatment than others. EPs will generally have better experience and the best chance to get the right treatment - though not always, if you read my earlier posts from Dec 2019 you will see how my particular condition was treated.

Bottom line is that your comment will be right for some and not for others

I meant to add that Bisoprolol is not a good PIP due to it effectiveness profile and half life - though better than nothing.

Hello, my friend! It's been a long time. We used to exchange PMs where I was under the name "baraba". Have unsubscribed for a time, than subscribed again, under a different name. Your comment makes a lot of sense, there is no doubt about it. Wishing you all the best! Petar

Hello Petar, good to hear from you, glad your back with us.

One issue I seldom see mentioned is dosing levels. Quick example, I use a beta blocker for rate control of my permanent AF. But I've found half the recommended dose effective, my cardiologist agrees, and avoid much of the down side at that dose. My wife had a similar experience with a statin. Lower dosage levels are sometimes overlooked, or dismissed as ineffective, without consideration or experimentation. I think that's a mistake.

Couldn't agree more! In my comments to other peoples' posts, I always suggested to feel free to adjust the dose to a minimum that does the work. It is essential - to have a result and to take the minimum on chemicals! Glad that you think the same!

I do the same!!!!Gone 3 years with no problems then went into afib, now the last 3 times I went into afib I’ve had to be cardioverted but having been prescribed flecanide & bisoprolol but not been taking them, I’ve got the tools to convert myself. This I did 3 weeks back & last Saturday too, so now I’m taking 50mg flecanide & 12.5 mg metoprolol for a while & see how I go but hopefully come off them slowly & see what happens, as I’m very active normally but not while on the drugs!

My Family Practitioner is a very open-minded man. When I told him I was going to take an alternative route with a product out of Japan to treat my mild AFIB, he was totally open to it. I explained to him that all 3 cardiologists I saw were absolutely adamant that I take a blood thinner and a beta blocker for life. Not one of them had ever heard of the treatment I was taking, even though it is used worldwide, and all of them became defensive and dismissive when I turned down their drugs. My Family doctor said "remember, doctors are like car salesman. They are trained to sell cars. Period.". I always bear that in mind when making health decisions. There are so many alternative treatments for heart issues, proven through centuries of use, that I have to respect them. I think it is wise of you to question your treatment, and to gather as much information as possible. Good Luck!!

SteelHeart profile image
SteelHeart in reply to Kingst

So pleased about your reply! Us, the patients, have to be a little rebellious and to use our own head - it is our health in question after all!

Wow! Makes perfect sense to me. I have Afib , an ablation three years ago. Afib ceased for two year then reappeared off an on for no apparent reason. This year in February I had an attack which drove my blood pressure (systolic) to 162. I was prescribed Amiodarone, an ugly mean drug that works well for Afib, but wreaks havoc on the rest of your body. Within days my systolic was down to acceptable numbers. For the two and a half months that vital is consistently 119/60 (not bad for a 78 Tom), pulse rate consistently at 55. With the Afib I also started having PVCs, painfully so. Two weeks ago I stopped with the Amiodarone on my own, as recommended by a number of medical associates. Currently all vitals perfect and no pain with the PVCs. So I two wonder why keep up with a mean drug if all is well.

Thanks for the reply, Idaho! Deep in my soul, I am against any medication, except alcohol (in wine, lol). Why!? Not long ago, big pharma has had to admit, that BP drugs, prescribed to patients during decades, all over the world, are causing cancer, what they apologize for, lol! I do not remember the name of the drug, but it is a true story... For as long as possible, it is better to go drug free!

How much alcohol do you drink and do you have any sex and are you in a wheelchair? I don't want to affend anyone with my comments but you sound ignorant to me even though you had a white collar job. Mf old man did everything you state about not taking medications for af and bp and died unnecessary- from a massive stroke- thats where you will be heading! Also, your attitude is hate for all Doctors!

SteelHeart profile image
SteelHeart in reply to greatness

No alcohol, no sex, no wheelchair! Satisfied?! BTW, this is AF-forum, try to find another, to better suit your needs...

greatness profile image
greatness in reply to SteelHeart

Yes- you are a ignorant soul exactly what I Imagined. If you took medications for af and bloodpressure I'm certain your attitude towards doctors and pharmacies would be different and your future life span would be enhanced. LIsten MATE- you go to school and uni to learn- to work to earn money- to food outlets to buy food,etc. etc. You go to a cardiologist for treatment of heart abnormalities. All you are doing is farting aimlessly. BTW You are the ignoramus that ignores all medical advice re af and bp given to you on this forum. I liken your attitude to a bad smell from ignorance running in your arteries and veins-BTW I have sex and drink alcohol and Take my medicine for ATRIAl FIBRILLATION. I believe my chances of a REAl forfilling life is Miles greater than yours will ever be- you boofhead!!!

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