Good morning. I’m going to contact my cardiologist about this but I’m currently taking 10mg of bisoprolol daily following some complications (including high HR) after an ablation. I feel fine, if a bit tired, but my heart rate is floating around 50bpm which seems a bit low to me.
Has anyone else had a low heart rate due to bisoprolol and what happened?
That is what bisoprolol is supposed to do . So long as you are not passing out or getting dizzy 50 is not dangerous short term but I would discuss with your EP maybe reducing the dose as that is quite high.
I’m currently on 2.5mg a day with an option of increasing to 5mg a day if I feel I need it. I do probably about 3 days a week which works for me. I’ve been told 10mg a day is the maximum that should be taken. And I should watch my HR as it must not go below 40 no matter what dosage I take in 24 hours.
Wife has had her Bisoprolol adjusted a few times by GP to balance between reducing PAF episodes and low resting HR. Currently at 2.5 mg and resting HR about 50.
Hello. I am on 10mgs Bisoprolol daily ( this time last year, only 2.5 mgs ! ), and it is keeping my resting heart rate at about 60, but it does sometimes go as low as 50. My GP and Cardiologist both say that the important indicators are symptoms. If you are dizzy, unstable, unable to do ‘normal’ things, then make the doctor aware, but if you feel ok, there is no need to be anxious. I have learnt to check in with my GP if I am worried ( sometimes a phone call is enough ), rather than brood and worry - which can trigger the Afib you are trying to manage in the first place !
Hi, My Pulse went down to mid 40s for a few days not much symptoms apart from low energy. I mailed cardio nurse who told me nothing to worry about if no symptoms eg chest pain, fainting etc. A week or so later pulse went back to mid 50s which is what it is normally with the bisoprolol of 2.5. I take. At the time I was taking antibiotics for tooth infection and also had a slight cold so perhaps that had something to do with the low pulse. Hope that helps 👍
Hi, I have been on 2.5mg of Bisoprolol following unsuccessful Cardioversion and successful Ablation about 2 years ago. My resting HR is always around 42 but sometimes drops to 38 through the night. I do have the odd alert from my apple watch through the day saying its dropped below 40. I go to the gym most days so don't lack energy. My cardiologist did raise my dose to 5mg after ablation but that made me very dizzy so it was dropped back down. My cardiologist isn't concerned about my low heart rate as long as I don't feel dizzy. Like others have posted, in my experience, low heart rate is OK as long as you are not feeling dizzy or have low energy.
My heart rate was controlled at 50 with bisoprolol for many years but had to stop recently as it is now under 50 with no medication.
Hi there. 10mg of Bisoprolol is a high dose, but you don't say how high your HR went, and what your resting HR was before you had problems.
To answer your question, I take only 1.25mg of Bisoprolol, and have noticed my resting HR drop since I started it 6 years ago.
When I was not in AF, my resting heartrate used to be 48 and I felt fine. The Bisoprolol brought it down to 43 and I didn't feel so good . However, the AF sent it up to 120 or more. With Bisoprolol the AF was only around 80, so I stuck with it.
But unfortunately Bisoprolol makes me exercise intolerant on hills and stairs. Able to do it but sometimes it feels as if I have weights on my legs. As I still take Flecainide my EP is adamant I need Bisoprolol with it to stop certain other arrhythmias, so I carry on.
However last year an ECG showed a heart rate of 36 and it was recommended I have a back-up pacemaker for when the HR dips. I agreed because I have always been bradycardiac and suspected I might need one at some time. In fact EPs say that bradycardia is a sign you might one day get AF because your natural pacemaker is not great. Anyway my PM is set to keep me above 50bpm, so I think your EP will be happy with yours at that level.
As I hardly get AF any more I'm wondering about stopping the drugs, but that's another story...it didn't go well when I tried it before....
You said, "As I still take Flecainide my EP is adamant I need Bisoprolol with it to stop certain other arrhythmias, so I carry on. "
In most cases, yes, you need some AV node protection such as Bisoprolol. That said, you can get the same protection from other drugs, either different beta blockers or a calcium channel blocker like Diltiazem. That's what I'm taking with Flecainide. So if the Bisoprolol is not agreeing wth you, talk to your doctor about trying out other drugs for av node protection. Maybe one will agree with you better. Also, and this really depends on your history, you could ask to try a PIP approach. Here, you would not necessarily have to be on Bisoprolol or any drug for nodal protection, since you would not be on daily flecainide. Then, if you go into afib you would take the prescribed amount of the nodal blocker a certain amount of time before you took the flecainide. But again, you wouldn't have to be on it all the time like now.
Jim
You are right. Thank you for that. I was starting to think along the same lines. I halved Flecainide on the EPs advice 4 years ago but after 3 weeks was getting AF after lunch everyday. I took extra Flecainide for it and after a while the EP recommended a regular dose was better under those circumstances. Worth another try do you think?
Yes, it's not just about what drugs will help your heart, it's also about what drugs you can tolerate. Like they say, afib won't kill you, so it's really about QOL. Again, like yourself, I'm on flecainide and a nodal blocker, in my case diltiazem. But under my doctor's supervision, I'm experimenting with different dose combinations of flecainide and different nodal blockers, to find the right combination that will not only keep me out of afib, but will make me feel well. I'd rather feel well and go into afib every month or two, than stay out of afib permanently but feel awful all the time.
In your case, your beta blocker seems to be bothering you. So ask your doctor to try different beta blockers or a calcium channel blocker like I'm taking. And if you lower the dose of Flecainide you might need less nodal blocker.
As to going into afib after meals, you might want to look at changing what you eat and how much you eat. I found the FODMAP diet beneficial. Also smaller meals. And weight loss can also help.
Jim
Thank you for your thoughts. . I think you are right about diet. I think my AF is vagal. For three years now I've followed a diet geared to reversing pre-diabetes and have lowered my blood sugar and blood pressure to normal levels and my bmi is a steady 23. That has helped the AF too which is why it could be possible to cut the drugs down. I like your suggestion about different nodal blockers. (Although I had a bad time with calcium channel blockers a few years ago with bad headaches and flushing- felt as if I was on fire!) I agree that feeling good is important and finding the right right combination is the key.
Hi there yes I too was put on bisoprolol but only 2.5mg and found my heart rate would go down as far as 40bpm at rest in the evenings and it would spark the afib episodes off every other day...im going to see my electro cardiologist this Friday about further treatment Inc abalation option .. but back to the bisoprolol I found it lowered my heartrate to much and since I stopped it two weeks ago I have had a lot less episodes.. weather that's just a coincidence I don't know but it definatley put my heart rate very low...
Bisoprolol and low heart rate 
PAF with Low Heart Rate ??
Heart Rate
Sudden High Heart Rate
atrial fibrillation then high heart rate 
