I am delighted to say that things are fine so far. I still get some breakthroughs of about once or twice per month for a few hours. Most importantly in all this time I haven’t woke up once at night to find my heart racing, which is BLISS. I feel the med is doing its job and actually controlling the rate. I always believed that the Bisoprolol reduced my blood pressure, especially at night and so causing more episodes.
There’re no adverse reactions so far. Monthly blood tests for the first six months were ok. I always take the med with food as I read it can cause diarrhoea.
I’ve such confidence in the med that I try now and just get on with my life: I’ve put my handheld ECG unit in a cupboard. Due to my anxiety, I used to “go looking for episodes” which sometimes caused more episodes. I only use it now to confirm when I revert to NSR.
As I am only mildly asymptomatic. I generally just listen to my body as to when I’m having an episode. i.e. Small palpitations, dizzy spells and increased urine frequency. Etc. Luckily, I can usually self-revert to NSR within a couple of hours by light exercise/ entrainment.
Note that I’m sure there’s some episodes that I don’t identify, but is that a problem?
I take anti-coagulants following a TIA a year ago.
I recognise that meds don’t last forever as they are effectively “holding back the tide”. I’m just enjoying things as they are.
Written by
Vince1001
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Glad the Dronedarone is working out. When you say you have "occasional breakthroughs", I assume you mean that you are in normal sinus rhythm most of the time and occasionally have short afib episodes?
Bisoprolol is a very weak anti-arrhythmic and better for simply rate control. Definitely has a place, but my non professional opinion is that it's over prescribed and often does nothing more than give you unwanted side effects. Dronedarone, on the other hand is a true anti-arrhythmic, like Flecainide and it also has some beta blocker qualities built in.
I always know when I'm in afib, so can't personally answer whether or not unidentified episodes are an issue. There can also sometimes be a fine line between over and under monitoring. If you're concerned and don't want to keep pulling out your Kardia, an alternative would be a wearable watch (Apple or others) that only monitors heart rate. Assuming you go into fast afib, then you could confirm with your Kardia only if your heart rate jumps. If that is still too much monitoring, then I would say not to worry about those episodes as long as your doctor is not concerned.
By "occasional breakthroughs" I do mean I am in NSR most of the time, with the occasional AFib episode and the odd ectopic. These are double beats or missed beats which I do notice.
You raised a good point about the Apple watch, I can see some benefits provided I don't become obsessive monitoring it. nb. My pulse only increases by about 20 points when I'm in AFib, i.e. from 50 to 70 bpm
My HR in afib is around 150 versus in the 70's in NSR. So with me, heart rate is a good indicator of whether I'm in afib or not and when it jumps like that I do an ecg on my Apple Watch or Kardia. And with that big a jump, I usually know something is awry without even checking my heart rate. In your case, a lot more subtle with the heart rate.
I love the Apple Watch, however, their background afib detection function (separate from their ecg function) is really not reliable, so I'd save my money if that's all you want it for.
I agree with you that gadgets can make you focus too much on your heart rate. The less you think about what your heart is doing the better your heart rate is. Took me years to realise that.
If you are not symptomatic or only mildly so, and keep a low rate, you should be fine, health wise. I have an elderly friend with full time AF bit, like you, with a low rate, and he's done very well indeed over the years with only warfarin as prophylactic treatment. In an ideal world, I imagine it might be good to have a heart scan every couple of years to check on things, but your doctor is the answer to whether that is needed.
I like the Kardia and Apple Watch and find them friends not foes. the effects of anxiety are rather individual, so I would never generalise and suggest these devices are best avoided by people, but it seems that in some cases they certainly should be.
Good to hear that Donedarone is working for you. I am on it now for the past three months and apart from ectopics things are going fine. I have had no episodes for two months now.
I think you have it pretty well sussed by my experience. I have same or similar experience. In the end we just have to get on with life the best we can although its not nice going through these adverse experiences from time to time.All the best Vince.
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First post, AF affected by autonomic system?
Atrial flutter
returning to NSR after taking Flecainide 
Return of AF
Bisoprolol making things worse?
