Anyone else tapering off bisoprolol or any ... - AF Association

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Anyone else tapering off bisoprolol or any other anti-arrhythmic/beta blocker?

Elli86 profile image

Hi guys.

14/15 weeks post ablation and I’ve been told to taper off my 2.5mg bisop. Started on Tuesday.

Had an adverse reaction Tuesday evening, seemed like withdrawal, felt very agitated and couldn’t sleep etc but seems to have improved now. Had a rather unpleasant bloating episode last night which I was convinced was going to put me into AF but didn’t 😁👍 chuffed about that.

Going to go down to a quarter tablet next Wednesday and see how I get on 🤞I’ve tried to taper my tablets down before ablation and never managed to get this low without going into AF. So maybe a positive post for once 🙏🙏🙏🙏🙏🙏

Anyway just wanted to hear from people who are going through the same thing currently, have done in the past or just anyone with advice or suggestions would be great.

Thanks guys 👍

60 Replies

Hi Elli.

I can only speak from my experience with Bis. My cardio told me stop there and then (2.5mg at the time). TBH I thought it was a little strange as my understanding is you need to reduce the amount over a few weeks.

However I was 100% ok and no problems. I think the worry can be the worst thing.

Hey - I hope it works out for you. I'm sure it will.

Paul

Elli86 profile image
Elli86 in reply to Paulbounce

Thanks Paul.

Yeah my EP told me to come straight off as well but I said I was going to taper and they agreed. So far so good I hope. Quarter tab next week and then nothing the following week 😬😬😬😬 both looking forward to it and crapping myself at the same time 💩

Hopefully all goes well 🙏🙏

Glad to hear you came off with no issues and thanks for input 👍

Paulbounce profile image
Paulbounce in reply to Elli86

My pleasure Elli. I feel you will be just fine. Sometimes the fear is greater than the reality. I think you'll be ok and have no need to worry. Let us know how you get on - I feel a postive result coming ;-)

Enjoy your weekend.

Paul

Elli86 profile image
Elli86 in reply to Paulbounce

Cheers Paul much appreciated 👍

Enjoy the weekend 😁👍

Elli86 profile image
Elli86 in reply to Paulbounce

Have you had an ablation yourself Paul? Forgot to ask. Do you take any meds at the minute?

Paulbounce profile image
Paulbounce in reply to Elli86

Hi Elli.

I take an anticoagulant and a beta blocker everyday. No ablation yet.

This is why I feel safe - I know my stroke risk is reduced and HR controlled. Easy to say Elli but now you know you have afib it can dealt with - please try and get in to that mind set. Check out breathing tec's on Google - they can work wonders too ;-)

Enjoy your Sunday.

Paul

Elli86 profile image
Elli86 in reply to Paulbounce

Oh right ok. Well hears to hoping both our NSR continues 😁👍🤞

Thanks for advice and good luck 👍

Paulbounce profile image
Paulbounce in reply to Elli86

Good luck to you as well Elli. Just for the record I'm not in sinus - far from it but my body has adjusted a little.I hope it all goes well for you - I'm sure it will.

Cheers Paul

Elli86 profile image
Elli86 in reply to Paulbounce

Oh right sorry Paul. I’m assuming your permanent af then? Atleast your controlled though so that’s a good thing 👍

Better to come off it. I was on 2.5mg gor 2 yrs and got kidney stones and 20kg weight gain. Changed to Ivabradine and all well so far.

Elli86 profile image
Elli86 in reply to Tricia7048

Thanks for response Tricia.

I don’t seem to have had any issues with weight or kidney stones since I’ve been on it, just over a year now I think. I’m tapering off drugs completely now though to see if ablation has worked 😁👍 hoping that’s a good thing 🤞🤞

Tricia7048 profile image
Tricia7048 in reply to Elli86

Oh thats good then. Wishing you all the best! Im really unlucky with all meds!

Elli86 profile image
Elli86 in reply to Tricia7048

Thanks. Yeah meds don’t seem to agree with me either which is the main reason I went for ablation.

hi ellie unlike you i have not had an ablation but tried to lower dose of bisoprolol to see if i could manage on less, but started getting afib more often, please go slow and be careful best wishes

Elli86 profile image
Elli86 in reply to Tomred

Thanks Tomred.

I tried exactly what your doing pre ablation many times and never managed to get down to half my tablet. Best I could manage was 3/4 of 2.5mg tab. If I went down to half I would be in af within a week so I’m hoping that’s a good sign 🤞

I must say though even the 1/4 tab reduction made me feel better. I felt great on 1/2 tab pre ablation but like I say my heart just wouldn’t hold on it.

This time round I notice a huge change on 1/2 tablet. Mental clarity has come back in spades and feel a lot more energetic. Don’t feel quite as good as I did pre ablation but I’m assuming that’s because my heart is still recovering.

Can’t wait to see what being off all tabs completely feels like after being on meds solidly for a year and a half. Just hoping my heart holds 🤞

Thanks again 👍

I tapered off of bisoprolol over a long period starting at 3.75 mg.about a year later I haven't taken any for some time,I haven't had any problems at all,my heart rate is still low around 50 ,but it's never been higher anyway.very occasionally I get a fast irregular beat but this is due to consuming excess sugar,so therefore I can control it,I do have a box of bisoprolol in case I need them ,but now I just take the blood thinners and nothing else.

Elli86 profile image
Elli86 in reply to Ronnieboy

Hi Ronnie. Thanks for input.

So how long roughly were you tapering off for? Was this after an ablation? So your now just taking bisop as pip?

Good news that you no longer have to take meds outside of anti coags 👍 I bet you feel 100 times better for it?

Ronnieboy profile image
Ronnieboy in reply to Elli86

About a year ,yes will still use as a pip,no not had any medical treatment for AFib ,I've lost a lot of weight which also has helped I believe,,

Elli86 profile image
Elli86 in reply to Ronnieboy

Good news on the weight 👍 did you have a few issues coming off then? As it took a year to complete?

Hi I had an ablation in May and after review by the cardiologist in October was advised I could stop the same beta blocker as you either by weaning myself off it or cold turkey. I had dropped earlier in the year from 10mgs to 2.5 cold turkey with a few minor problems during the first week, so did it cold turkey this time too. No major issues or really minor I could blame on the beta blocker. Have taken pip flecanide x 2 for pulse rate 180 which worked for me

Elli86 profile image
Elli86 in reply to Lucymoo

Hi Lucy. Thanks for response.

So since your ablation in may have you had any af? Or just the high heart rate which you took flec for? How are you doing in general since your ablation?

Lucymoo profile image
Lucymoo in reply to Elli86

Hi, using a Kardia has noted some suspected AF events and I have felt I was in AF a few times but the events didn’t last very long…..usually under 30 mins. I’m not just on apixiban and a 5 days holter tracing showed no AF events but some sinus arrhythmia which is not a problem. I’m a positive person but did struggle after the ablation with a variety of problems til they settled around October. I feel a lot better since stopping my flecanide after one month and now my beta blocker. I’m 68 female and feel occasional AF is not life threatening tolerable with PIP. Personally I would not have a second ablation if it comes back with a vengeance. But that’s my take on it I know there’s lots of people have had more than one but not for me

Elli86 profile image
Elli86 in reply to Lucymoo

I’m coming to end of month 4 myself now so hoping after I taper off it’s onwards and upwards 🤞

I’m undecided myself if I’ll have a 2nd ablation but trying to stay positive and hope I won’t need one at the minute 🙏

Hi, Yes I tapered off flecanaide cut the dose in half over two week then stopped no problem. Then cut my beta blocker in half from 2.5 , I have been doing this for nearly two week and I have 3 days left, then stopping. I have had a few unsteady beats since cutting in half and I am a little nervous that af might return, but so far not detected on my cardio mobile. I will plough on and keep my fingers crossed for both of us.

Elli86 profile image
Elli86 in reply to stoneyrosed

Hi stoney. Thanks for response.

Glad to hear you came off flec ok. I did not get on with the stuff at all. Sounds like we’re both cutting down at exactly the same time. I’m on half tab now and going to make it a 1/4 on Wednesday and then if all goes well zero the following Wednesday. Like you say fingers crossed for the both of us. I’ve had the unsteady beats you mention as well. Heart seems like it’s trying to adjust. Hopefully goes well for the both of us 🤞🤞

Have you had an ablation same as me? Is that why your cutting down?

stoneyrosed profile image
stoneyrosed in reply to Elli86

Yes had my ablation in March but never got the follow up call so eventually rang them myself. Cardio told me to just stop taking the meds except blood thinner. I said I would prefer to wean. Now down to 1.5 beta blocker but getting a few fast heart beats not sure what’s happening but I will stop the blockers in a couple of days and just hope. 😁

Elli86 profile image
Elli86 in reply to stoneyrosed

How are you doing in general then since ablation? Do you feel recovered or close?

stoneyrosed profile image
stoneyrosed in reply to Elli86

Recovered from procedure yes, and I have had one bout of AF a week after the ablation, since then I haven’t detected AF. I do still get a general feeling that the heart is still sometimes beating irregularly which is a slight worry but overall no AF which is fantastic. I do hope that once I’m off the meds the heart will find its own rythmyn and will feel more settled and confident. Good luck Elli 👍

Elli86 profile image
Elli86 in reply to stoneyrosed

Yeah my heart definitely feels unsteady. Especially since tapering off. Like you say I’m just hoping it’s finding its rhythm and will settle 🤞

Thanks again for input and hopefully goes well for the both of us 🤞 good luck

I am one of those who had great problems coming off Bisoprolol - bursts of adrenaline that caused my heart to race, constant high heart beat, 80bpm plus and in general a very jittery feeling. I thought I was making a mistake coming off and that my heart really needed the medication, but I googled and found many many accounts of others who had the same problems stopping. I was on 1.25mg and had just stopped, it didn't occur to me to cut down gradually and at that time I had never seen it written about here on the forum. It took 3-4 months for me to feel 'normal' again.

All that said, I have had to go back on Bisoprolol after many months as I am being treated for something non-AF and had developed tachycardia, and Metroprolol did nothing. But I will know better next time.

Elli86 profile image
Elli86 in reply to irene75359

Hi Irene. Thanks for input.

My resting heart rate seems to have gone up slightly since I’ve stopped. Only by 5/10bpm though. Feel like it’s gonna take a while for my heart to settle.

Have you had an ablation irene?

irene75359 profile image
irene75359 in reply to Elli86

No, I haven't. I was diagnosed six years ago during my second episode and eventually had regular medication but then with the help of my GP I stopped everything except anticoagulant and started using 200mg flecainide and 1.25mg bisoprolol as a PiP. I only had perhaps three episodes a year. Taking bisoprolol very occasionally didn't affect me in the same way as taking it regularly.

Elli86 profile image
Elli86 in reply to irene75359

How long have you been doing pip now then? I was using flec as pip for about 5/6 months and a good percentage of that was NSR. It stopped working for some reason though and I had to take it weekly so they put me on it full time and it was downhill from there. That’s why I went for ablation in the end.

irene75359 profile image
irene75359 in reply to Elli86

Maybe 4 years? I am guessing! But round about that. It has always worked in a couple of hours, so my AF burden is very light. Consequently I never felt the need to pursue an ablation.

Elli86 profile image
Elli86 in reply to irene75359

And you only got around 3/4 episodes a year?

irene75359 profile image
irene75359 in reply to Elli86

Yes - I thought (and my GP agreed) that taking 4 x 200mg a year instead of 365 x 100mg was a no brainer!

Elli86 profile image
Elli86 in reply to irene75359

As long as your happy and your quality of life is good then I suppose that’s all that matters 👍

Was taking 2,5 mg for 6 months after being diagnosed with PAF. Was not really necessary as my BP never goes above 80 bpm. Was feeling worse and worse (no stamina, balance problems, almost fainting from time to time) so tapered to 1,75 during a week and then stopped completely. Feel fine again.

Elli86 profile image
Elli86 in reply to RaraAvis

That’s good news Rara.

Hopefully it continues. Do you not get any af since stopping then?

RaraAvis profile image
RaraAvis in reply to Elli86

My AF remained same as before. Paroxysmal, no symptoms.

Elli86 profile image
Elli86 in reply to RaraAvis

Oh right ok. Well makes sense for you too come off then. Hope it continues 👍

Good for you in tapering off as you're doing. My former electrophysiologist suddenly changed my potent prescription off Bisoprolol and Flecainide, without any tapering whatsoever, which sent me into a 2-1/2 day a-fib episode that the hospital couldn't control with drugs until I had a cardioversion. I've since fired that doctor. Just take it slow and easy and you'll be fine.

Elli86 profile image
Elli86 in reply to Snowgirl65

Thanks for input.

Yeah I’ve heard some horror stories on here about coming off cold turkey. They wanted me too but I said I wanted to taper and they had to agree 🤣 either way I’ve got a drawer full of bisop so I’d have been tapering anyway.

How you doing now?

Snowgirl65 profile image
Snowgirl65 in reply to Elli86

I'm doing fine now -- knock on wood, and thanks for asking. The events mentioned were in 2014. I've since had a cryoablation by said doctor who didn't ablate all he said he would, so a-fib was much in my life for a few years after. I got a new EP last February who eliminated some medications, and had a radiofrequency ablation in April. So far so good!

Elli86 profile image
Elli86 in reply to Snowgirl65

That’s good news 👍 glad it’s going well for you. I’m hoping I won’t need another one but the way I’m recovering and how long it seems to be taking I’m preparing myself for maybe needing one.

I suffer from inflammation under normal circumstances though, so maybe my heart is inflamed still and just taking its time to recover. I’m not too sure too be honest. I’m hopeful that coming off meds may perk me up 🤞

How long were you on the table for both your ablations? Was it a quicker or longer process the second time round? Did they map your heart second time round or just re-ablate the pulmonary veins again?

Snowgirl65 profile image
Snowgirl65 in reply to Elli86

Maybe because of your inflammation it just takes a little longer for you. I think it's too soon to tell if you'll need another one; everyone heals differently. Regarding my ablations, I was on the table for 5-1/2 hours for the first cryo in 2014. That was because the EP at that time nicked my phrenic nerve causing my diaphragm to freeze up. I think he had a panic attack at that point, but I started breathing again very quickly. Also, he said my esophagus was blocking his route to a back vein, and only "tried" to ablate that one. My new EP took care of that one in April. That second ablation was only 2-1/2 hours. And yes, my heart was mapped -- an amazing 3-D imaging from front to back. I hope coming off your meds will perk you up, as you say!

Elli86 profile image
Elli86 in reply to Snowgirl65

That’s what I’m counting on 🙏 like I say I suffer from inflammation in general muscles so I don’t see why the heart muscle would be any different. Probably going to take 6-9 months I think before I start to feel like I’m improving properly.

The annoying thing is I had started to feel like I was turning a corner 3-4 weeks ago when I then went into af. Since then I feel like I’ve gone back to week 4-5 of recovery again. Doesn’t make sense to me but who knows what’s happening. Just hopeful it’s back on the mend again 🤞

My ablation took 4.5 hours which I felt was quite a long time as well. Hoping that if I do need another they will map it all properly like they did with you, target the specific areas and get it all wrapped up on the second attempt, if it isn’t already.

I hope you continue recovering as well as you seem to be this time round and can be AF free from now on 🤞 sounds like you’ve been through the ringer a bit so could do with some luck 👍

Snowgirl65 profile image
Snowgirl65 in reply to Elli86

Thank you, and very much the same to you!

My experience currently is back to having afib and tachycardia episodes after tapering off flecainde (2nd ablation 2 months ago). Hopefully episodes subside, but did not after first abalation. Fingers crossed I suppose... Hoping for heart stability for you. Keep safe

Elli86 profile image
Elli86 in reply to listerines

Hi listerines.

Thanks for input and well wishes and I hope your heart settles down soon too 🤞

How long after your ablation did you start to taper off then? 2 months sounds very soon and I’m assuming you tapered off for a few weeks atleast so makes it shorter still?

Hello Elli86 So for both my 1st ablation in Oct 2020 and my 2nd ablation Sep 2021 I was advised/ told by my afib clinic (under instruction from EP) to come off all flecainide at exactly 2 months (there was no talk of tapering - though I took an extra 7-10 days to taper the dose down just for my mental health more than anything else). From others posts on this forum and others 2 months does seem to be quite quick to try coming off the rhythm meds. Heart seems to stay relatively stable on the medication but the ablations to this point have not helped me come off the flecainide for any significant period of time. All the best to you - keep safe

Elli86 profile image
Elli86 in reply to listerines

Thanks for input listerines.

Sorry to hear that neither have worked thus far. Does sound very quick to try to come off but I’m sure they had their reasons to tell you this? What’s your next move from here then?

Good question Elli86, have been deliberating as to what my next move should be... Should I push for 3rd ablation if afib episodes continue over next few months (as primary reason for last 2 ablations within 11 months was to hopefully come of some if not all heart meds), or try increased dose of current meds to see if keeps me out of afib or increases time between episodes (and then consider another ablation if episodes get worse in future) . From everything i have read though the meds are juat a stop gap measure and will eventually fail (though many have good success for many years sometimes decades). Have an appt with afib nurse next week so guess i will start there.How are you doing? Hope tapering is going ok for you.

Elli86 profile image
Elli86 in reply to listerines

That’s a tough decision listerines. Personally I think I’d probably attempt another ablation but that’s just me. I’m sure you’ll make the right decision in the end and good luck with that 👍

Tapering is going ok so far. Not great not bad. Steady is probably the appropriate word. Come off completely next week so hoping not too many fireworks 🙏🤞🤞

Yes I tend to agree with you have come this far with two already and am only 49 so would like to try and still find some longer periods of no arrhythmia and no medication use. Will see what my EP suggests.Really hope it is smooth sailing for you next week - if it is any comfort my father-in-law who also has afib tapered off his bisoprolol and antiarrhythmic medication after his first and only ablation 6 years ago with barely an ectopic beat. All the best

Elli86 profile image
Elli86 in reply to listerines

Good to hear about your father in law. I hope my weaning & ablation are as successful as his 🙏🙏🙏 I’m not usually that lucky though but wait & see I suppose 🤞🤞

When was your first & second ablations? Did you get any relief at all? Were you very symptomatic before? Any other co-morbidities?

Hello again Elli86 - hopefully things have stayed relatively stable for you in the last little while. Are you close to being completely off the bisoprolol at this point and how are you feeling? You asked about my previous ablations - 1st was in Oct 2020 and 2nd was in Sept 2021 - I was quite symptomatic going into my first ablation with episodes lasting up to 2-3 days at times and on average happening every week or so. The flecainide and bisoprolol did help a bit with the episodes before my 1st ablation, but did not bring a ton of overall heart stability. After the 1st ablation stayed on flec for 2 months and this kept me in NSR for approx 2 months (one period of afib early on brought on by sleeping on right side and lots of ectopics) - after weaning off flecainide though at the 2 month mark started having pretty regular afib episodes again. Not as severe as before ablation but not great either so after discussing with afib nurses and EP went back on flec in Feb 2021 and had only one episode till 2nd ablation in Sept 2021. Should also note that I have no other comorbidities (heart or otherwise), but do experience near daily bouts of ectopic beats (PACs) from just a few to 1000s per day - this seems to be the new normal for me as the ectopics have been with me for about the last 18 months. (also these increase dramatically when I wean off flecainde and I believe, that along with runs of tachycardia, this helps to push me into afib episodes)

After 2nd ablation Sept 7 2021 stayed on flecainide until 2 month mark with no afib episodes, but again coming off the flec at 2 month mark started in with regular afib episodes again. These episodes seem no better or worse than the ones I was having after 1st ablation (lots of palpitations, HR 80-130 and lasting 6-8 hours in total), Have again discussed with Afib nurses and have gone back on flecainide - hopefully will increase time between episodes again. Am to do this for a few months and then we are going to try and wean off flec before next appt with EP to see how heart is doing at that point. If need be will be discussing 3rd ablation with EP at next appt.

Overall, I would not say that the ablations have been anywhere near a complete success as based on my overall health/ heart health going in I believe I was a very good candidate to see full control of afib for a number of years and with it the possibility of coming off all meds and having greatly improved quality of life (I am aware that ablations are no cure/ silver bullet). That said, life is always in shades of grey and I do think that the ablations have been successful in combination with the flecainide in improving my quality of life and in providing much greater periods of NSR - for which I am grateful. Prior to my 1st ablation I was in rough shape and most afib episodes were extremely challenging, with quite a few ending up with me heading to hospital (due to high heart rates).

Sorry to bore you with all the details - but you did ask

😀😀😀

Elli86 profile image
Elli86 in reply to listerines

Wow! Sounds like you’ve been on quite the journey! It’s good that it sounds like you’ve made some improvement atleast. I hope it gets better for you and maybe that 3rd times a charm saying will come in handy 💪 sincerely hope it does as I’m aware how frustrating the aftermath of an ablation can be. I’m hopeful that mine has been a success 🤞🤞

I stopped anti coag 3/4 weeks ago and started to taper off my bisop 3 weeks ago and took my last 1/4 tab on Tuesday evening, with the possibility of taking 1/4 tab every other day for a further week depending on how things were going. Unfortunately I’ve caved in today and taken another 1/4 tab as I’ve been unexplainably tired and was getting some low grade tachy, 97 bpm while resting about an hour after a small walk. So popped another pill with intention of taking every other day and slowly making this gap bigger depending on how I feel.

I’m well aware coming off tabs can be a tricky process so I’m treading extremely carefully and trying not too push it too much. Felt pretty damn good yesterday so not too disheartened today. Just my heart getting used to the new norm I hope 🤞🤞

I think that the approach you are taking is a sensible one and if it feels right for you mentally and physically then I would hope the health professionals you are working with would support the approach as well - with the ultimate goal being long term heart stability for you (which I hope is attainable for you in the weeks and months ahead). I can certainly empathize with taking a slow and steady approach, as matters of the heart can certainly be anxiety inducing (especially the tachycardia runs).I also think it is very positive that you are down to only a very small dose of bisoprolol every couple of days (frankly beta-blockers have a very safe history and dosing profile so if you are going to be on a med a little longer, then this is the perfect dose and type of meds).

Let me know how things go in the coming weeks - wishing you the best here - keep safe.

Thanks listerines. Appreciate the well wishes. Hope it all works out for you also 🤞

I have a feeling that the higher than what I would expect as normal heart rate is also partly down to a bug that I just cannot seem to shift. I’ve had it since 1st of December so it’s just rotten luck that it’s coincided with me coming to the end of my taper off meds 🤦‍♂️ Obviously the heart struggles to find a new normal when coming off betas anyway, so throw a bug in on top of that and it’s only going to make it worse I would assume?

Never ending cough at night and especially in the mornings and really bad congestion all round. Just cannot budge it and I haven’t had a bug for bloody ages so it’s Sod’s law that I get one now. All I know is it’s definitely not covid as I’ve done 5 tests since it started.

Pain up the ass to say the least 🤦‍♂️🤦‍♂️🤦‍♂️

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