Bisoprolol dose

[MartinoH]

I have been AF free for the past couple of years and unfortunately had an episode last night. I’ve got a loop recorder implant and was notified that my heart rate was 200bpm and that I would be notified of a change to my prescription- I currently take 2.5mg bisoprolol. Unfortunately my GP has not been in touch and I haven’t received an updated prescription. My inclination is to simply increase my current dose to 5mg, it seems the logical thing to do under the current circumstances because I still feel symptomatic. Grateful for any views !

[pottypete1]

Non of us here are medically trained and we are therefore not, quite rightly, able to offer medical advice.

If your AF has now stopped it might have been a blip which can and often does happen.

If you are still suffering with a heart rate of circa 200bpm you must seek medical advice calling 111 if you are in the UK.

If the AF has stopped and then comes back it is also important to seek medical advice.

Pete

[MartinoH in reply to pottypete1]

Thanks, Pete. Thankfully the rate has calmed down, but I’m still in AF. Will be seeking further advice from my EP when he retrieved from holiday.

[Hidden]

Hello Martin, I’m sure you will understand that hardly anyone on this forum is medically trained therefore we are not able to advise or suggest changes to prescribed medication. However, it might help if we maybe come at this from a different angle. Normally for someone in your situation, the first thing to consider is can you think of any reason why AF kicked in so strong after 2 years. Have you over exerted yourself, caught Covid, had a scare, got drunk (I’m sure that’s unlikely! Eaten something unusual….I’m sure you will understand what I’m getting at. The next thing is to see what can be done to get you back in rhythm as soon as possible and that generally means a cardioversion or Pill in the Pocket therapy so try getting in touch with the EP (or secretary) who performed the ablation and/or the Arrhythmia Nurse attached to the hospital where you had the procedure. Not always ideal, but some with a heart rate in excess of 200bpm might even consider going to A&E….anything that will get you back into rhythm as soon as possible. In my opinion, upping the Bisoprolol is a bit like using a sticking plaster, much better to try for something that will work quickly, the problem of course is it’s Friday!

I’m intrigued about the loop recorder implant - does this mean you could have access to other sources of help? Sorry I can’t be more specific, others here I’m sure will have more suggestions……hope NSR returns soon…..

[MartinoH in reply to Hidden]

Hi , thanks for the advice . Yes have been in touch with my EP, unfortunately he’s away so the nurse suggested a change to my medication as an interim measure. I’m still waiting for details, hence considering increasing my bisoprolol dose in the meantime. Thankfully not at 200bpm now although still in AF and I have no idea why it happened. A bit disconcerting!

[MartinoH in reply to Hidden]

Just to add, the nurse I spoke to is part of the team checking the loop recorder downloads. She didn’t seem to think a visit to A&E was necessary at the moment .

[Hidden in reply to MartinoH]

If AF continues and you speak to the nurse again, suggest you ask about a cardioversion……worth a try!

[Ppiman]

That's what I've been told to do. If you have any issues with beta blockers that make this a bad idea, you would already have been told this, I hope. The main one, as I understand it, is that they can cause bradycardia. I was told that a persistent rate of over 100 needs to be reduced as it can eventually put strain on the valves and left atrium.

Steve

[manabouttown]

Really sorry to hear that you've had an AF incident and that your GP has been useless. Best bet is to call 111 for a chat.

[MartinoH in reply to manabouttown]

Thanks. Will wait to hopefully speak to EP on Monday, but failing that will take your advice

[ATSF]

Just give you my recent experiences with Bisoprolol. I have been on Biso. Since Candesartan started giving me severe rashes about 12 months ago, 2.5mg. My wife also takes 2.5mg. And as had no known problems. 2 months ago the dose was increased to 5mg. Recent visit to the consultant I was told to go back on 2.5mg. As it was slowing my heart to much. I advice seeing your GP or other before changing dose. Or perhaps phone 111 for advise.

[MartinoH in reply to ATSF]

Thanks, yes absolutely, that’s my main concern. I feel like I should increase the dose, but won’t in case my heart goes too slow ! Just need some professional advice. Such a tricky condition to deal with ….

[Nugger]

I use 10mg bisoprolol & 300mg flecanide to cardiovert myself on instructions from my cardiologist, had to use it twice last year, beats waiting 5 months in afib!

[SeanJax]

Heart rate should be below or around 100 bpm when in Afib for a long period and you cannot stay on high heart rate for more than 48 hours. If so please go the hospital or increase rate control medication to control it while waiting for the ep. The nurse should already took care of it . Next thing is the anticoagulants if your Chas scores requires it. Third step is to investigate why Afib came back after two years. An echo, metabolic panel and thyroid test are the minimum exploration. The last step is to look at your co morbidities especially hypertension and alcohol consumption if any. If so stop it. Life style changes are critical to maintain normal sinus rhythm . In a nutshell Afib is a progressive disease with or without ablation and control of co-morbidities is critical to stop the progression of the disease

[BlueINR]

I would wait to see what your doctor has to say about the dose and the med.

[Snowgirl65]

Can you call your GP to ask if he actually got the information, and maybe nudge him for a response?

[MartinoH]

Thanks everyone for your helpful comments, it is really appreciated. I think my rate is probably just about ok at the moment judging by how I feel. Hopefully all will become clear next week once my EP has had a proper chance to look at the heart rate download from my loop recorder.