Hello, I eventually got diagnosed with PAF after 8 years after people on here suggested I get a Kardia machine - so thank you for that!
I went to see Cardiologist yesterday and I explained how beta blockers have brought my resting HR from 60 to 46 over the years and I was worried that it would keep getting lower - I often feel bad when it hits low 40’s. So he has suggested going from 25mg Atenolol to 2.5mg of Bisoprolol a day. Has anyone else done this and have you had any negative experiences from it?
I’m 53 and my Cardiologist is pushing to give me an ablation whereas I don’t think I need one as I only get a racing heart occasionally and because of how slow my heart is - it often only goes up to about 140 anyway. I’m trying to lose weight - but it is happening very slowly but I’m hoping as it comes down and I’m more active - the PAF might get better? Nothing else has been suggested to me - what have other people tried? Sorry for long post.
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My heart rate was always low even when in AF I had persistent and now permanent AF was prescribed bisoprolol at the outset but made all symptoms worse especially. Breathlessness and fatigue tried different dosages and different medications and combinations of medication but all of
them within the first month of taking them brought my HR down to the mid 40’s and I could not cope. I was back on a low dose of bisoprolol after about 9 months of trying all the different meds and one Saturday morning could not even manage to get down stairs. My wife phoned the hospital and my old cardiologist
was there and he said just come off them which I did and that made me feel a whole lot better after a week or so. When I went to see anew cardio in a new area she insisted on putting me on medication again - I was only on apixaban when I first saw her as I am now. So we tried digoxin 125 - why she started at the high dose I don’t know. Same thing happened. Anyway found out there was a lower dose and asked to be changed but only on those for about 3 weeks before I had my first successful cardioversion and even though I have gone back inti AF since (had 3 successful cardioversions longest time out of AF was 15 months.). Never put back on beta blockers, calcium blockers or any rate control medication. It’s worked for me but as I say I never had fast HR even when in AF.
Thank you for your reply. Think some of us are just not right for beta blockers. I have felt bad on them right from start - but Gp answer was always to just up the dose! I’m glad they seem to have sorted you out better now!
How often are you still getting attacks despite the atenolol?
What is your BP like?
What other investigations have they done regards your diagnosis, such as scans to look at the structure of your heart?
I am not medically trained and I really don’t want to worry you anymore than you are, ( believe me I know how anxious this can make us) but if your goal is for your HR to not reduce too much like your atenolol has done for you, Bisoprolol, even at 2.5 mg is likely to be very similar to atenolol in that respect and it is highly likely that your HR will be reduced to a very similar rate, based on what your resting HR used to be. They are similar beta blockers.
I really don’t want to disagree with the expert cardiologist of course as they’ve suggested this for a reason. I just know, based on my experience that Bisoprolol has bought down my HR a lot and I know it’s done similar for many people on this forum. I started on 2.5 mg and my ‘normal’ resting ( in front of TV) used to be 65 ish, went down to 51/52. I’m now taking 1.25mg and ocassionally it drops to 53/54 in front of TV, but my resting HR used to be a bit higher than yours was. Saying that though, I haven’t had any Afib since last November and bisop has certainly helped that, which is the aim at the end of the day.
You won’t of course know until you do the switch as we are all very different. It takes a couple of weeks to settle so don’t jump to any conclusions straight off. Have you got a plan B if it’s the same? Do you have a follow up appointment? There are other drugs they could try on you, such as calcium channel blockers.
Hello - thank you for replying. I usually get episodes 2-3 times a month. I did have high BP and they put me on amlodipine which has bought it down to a normal level most of the time. I had an echo done 6th July but he did not have the results back when I saw him. He says he going to see me in 10 months time but if everything is as it is now then he said he will discharge me. I am still worried that the new beta blocker is just going to do the same but as you say I can only try and see.
Nobody has ever suggested anything other than beta blockers or an ablation.
Forgive my ignorance, but how can the Cardio 'discharge you' when you have a chronic condition that can change at any time.? Granted I live in South Africa, but my GP insists I see a Cardio every year and the Cardio tells me if I have any concerns in between visits then I must see him. He does the echo etc at the visit, tells me his findings while I am there and sends a report to my GP together with the ultrasound images, - I don't understand this waiting as the ultrasound is just 'there' immediately.
It sounds like you get better treatment in South Africa. I think this is a typical uk hospital in a rural area. Apparently his secretary was on holiday and that is why he could not provide details of Echo. But I do agree I don’t think I should be discharged as I have ongoing symptms and we all know things can change rapidly.
Ah, ok. I now see you are already on a calcium Channel blocker - amlodepine for your BP.
I think I can see why the cardiologist is trying you on a different beta blocker, though, I do wonder if the outcome for you, will still be the same. Bisoprolol also brings down BP and HR. Looks like they are trying all combinations.
You can but try this combination.
I’d really push for the results of that echo as you shouldn’t have to wait 10 months to have that. I suggest keep ringing the cardiologist secretary for them, because they should write to you with the results and CC your GP into them. Honestly, keep calling until you get a proper answer, it is the only way. Be their worst nightmare. In my experience you have to, otherwise you get forgotten, I’m sad to say. I also wouldn’t accept being discharged ever with this condition and please try and stay on their books. When you speak to the cardiologist secretary ask if there is an ‘arrhythmia ’ nurse you can call if you need advice. Most cardiac units should have them and these are specialist nurses who can give advice.
If your HR is still very low when you start Bisoprolol, please can I suggest asking the cardiologist secretary to bring forward your 10 month appointment and if not, ask how you can do this and tell them why you need it, or badger your GP to get in touch with the cardiologist. They shouldn’t make this so hard for you as your investigations are still ongoing.
I just take Diltiazem (calcium channel blocker) because my resting HR is lowish and I have had pauses in the past. That is why I had an ablation. I agree with Teresa.
Thanks for your reply- what do you mean by pauses? Do you mean from your medication? Or do you mean in your heartbeat? I have had a few instances where I felt like my heartbeat stopped and just for couple of seconds didn’t know when next heartbeat would be. It felt like I was going to die! I’m probably being over dramatic though as I do suffer bad anxiety.
Pauses in my heartbeat of several seconds, made me feel I was going to pass out. Luckily I was able to catch some on my Kardia and my cardiologist and then EP said I had a choice of ablation or pacemaker so I had an ablation which was fairly successful. But I can only take a low dose of diltiazem and not allowed Flecainide .
Hi I can only speak from personal experience Diagnosed with PAF 2017 , naturally low HR of between 55/60 and when taking 1 25 mg Bisprolol it dropped to low 40's so stopped taking it My PAF is mild generally with just fatigue and initially the anxiety that comes from the fear of heart failure or worse .
Having come to terms with living with AF it's far less a burden in my life and although my 2019 cryo ablation wasn't successful I'm now looking forward to my follow up RF ablation in 2 weeks time .
I take anticoagulants which for me are a sensible precaution and a statin to ensure cholesterol doesn't clog my arteries
It seems Bisprolol is the go to medication for most GP's and cardiologists but isn't suitable in all cases and in mine had a negative effect and made no difference to my episodes of PAF .
It's an individual decision really and my EP is comfortable with the choice I've made .
We do disagree on BP medication but I think 130/80 is fine and taking Amlodipine reduced my BP to 106/66 which I don't think is necessary and made me feel odd.
I think we are all Guinea pigs and we have to try several different combinations of medications before we get the one that works for us.I wish my cardiologist had explained about pills in pockets and stuff as he has only ever told me about ablation Or full time beta blockers.
I might try and get second opinions from another Cardiologist- they might have more ideas.
Cant you just take the beta blocker when you have an episode? Why would the doctor make you take it daily when the principle job of a beta blocker is to slow the heart rate?
That would seem like a good idea to me but no drs or cardiologist has ever given me that option. It wasn’t until I came on here that I knew that could be an option. Time for a new cardiologist maybe?
I’ve just been put on Bisp 2.5mg 2 weeks ago and my heart rate dropped almost immediately from around 57bpm to 47 bpm and lower (under 40 bpm whilst sleeping). I feel absolutely lousy. I contacted my GP who in turn tried to contact the cardiologist (who is on holiday) for advice. 2 weeks on and nothing has changed - extreme fatigue, tight chested, slow Hr. So today (rightly or wrongly) I cut the Bisp in half to see if my quality of life would improve. It’s watch this space for me I’m afraid.
I know exactly what you mean. I wish I had objected more when I first f got put on beta blockers. I was so tired and chest pains. They did not make me feel better - I felt worse. But drs answer was to up the dosage. I’m hoping this new one will be better but I don’t think so. I hope you find the right dose for you and that it makes you feel better!
I have just been told I will be prescribed Flecainide + a beta blocker as PIPs, to use if my heart rate rises too high during an AF event. Not sure I need the beta blocker, but will see what happens when I try each PIP. I do read a lot of negative experiences of all these heart-bending drugs (as I call them).The drugs prescribed must depend partly on the results of your cardiogram, and unfortunately you are still waiting for this news about your heart.
Thank you for your reply. Yes i think they need to see my results before saying they will discharge me etc as if there is anything wrong structurally then surely it will be a different conclusion. I do like the idea of a PIP but not one dr has ever suggested this but I guess it is all trial and error.
I have PAF and I'm on a daily dose of 1.25mg Bisoprolol with 2 x 50mg Flecainide. I was originally prescribed a daily dose of 2.5mg Bisoprolol but I found that my heart rate and blood pressure were dropping too low at times, so I had the dose reduced and now I am OK with this. I have never taken Atenolol though, so I have no experience of this drug.
Jamesvdv, am on same meds and dosage as you plus apixiban to thin blood. No problem with any episodes of AF since first 2 followed by cardioversion in each case. These were 2 years ago. After second episode I was prescribed the Flecainide and Bisoprolol which I take religiously. I’m 66 and reasonably fit. No weight problems.My only problem is lethargy. This was never a problem for me before AF as I was very active. Also some negative effect on my facial skin.
However I have fear of returning to regular fitness sessions in case AF attack. Yet I know regular exercise is generally recommended to help maintain overall health.
Hi gtkelly. I don't have any particular issue with exercising (other than I should do more) since being on the regular medication for PAF. I do cycle regularly and also do some hill walking (when on vacation). The only difference I find now is that the medication seems to prevent my heart rate from going too high during a workout. This, I find to be an advantage because, prior to this, I used to think that my heart rate was running away and my CV system was using most of the oxygen leaving an inadequate amount for muscle movement. This is now not the case and I think that things run more in balance, when exercising.
Thank you for your reply. I am wondering if they have put me on 2.5 as I have been on beta blocker for 8 years and 1.25 might be too much of a drop. If I have same problems on this I will ask if they can drop to 1.25.
I think you're rather young to he signed off if you have a chronic heart condition! That's like sensing you away till it gets worse - not acceptable! Talk to patient liaison at your hospital and tell them you're concerned about this attitude. Think also about what your goals are - you say you only have the AF once a month and the rates aren't high. If it doesn't bother you much then it's about getting a medication regime that works for you. I'm kind of surprised you're not going for ablation - are you against it - or hoping you'll get better?
Thank you for your reply and your good advice. My hubby seems to think it might be good if I got discharged so then I could go to a new cardiologist at different hospital. I guess I’m scared of an ablation. I care for my hubby who is early onset Alzheimer’s and I worry who would look after him if something went wrong. I suffer terrible anxiety. I don’t think it will get better - but I’m hoping by losing weight and eating healthier and exercising more that it might help? My dad had permanent AFib for over 20 years - he had a daily beta blocker - and he had no symptoms at all. He never had any ablations or anything. I guess we are all different.
Exercise and healthy eating definitely can help and there are a few here who've got their AF pretty much in remission that way. Worth doing for your general well being anyway. Everyone is entitled to a 2nd opinion you know, and we all have the right to refuse meds.
Hello, my only comment would be watch Bisoprolol, I find I can tolerate 1.25mg but 2.5mg makes me dozy and aches . All these things seem to be a trade-off.
Hello I got the Kardia mobile 1 lead. Cardiologist have to take notice of these. This shows up AFib, Brachacardia andTachacrdia. The 6 lead one will pick up more.
I’ve just spent most of the night in A&E - and have been prescribed exactly the same - 2.5mg Bisoprolol. Though I can take less if it makes me too woozy. My resting heart rate was in the 40s on dronedarone, so I suspect this might be a replay.
I also got a magnesium drip, though the bloods were fine.
I’m waiting to go on Flecainide and Bisoprolol as a ‘pill in the pocket’ - but have been waiting for an echo. Wish the A Fib had waited until after that.
Usually I’m fairly asymptomatic, but this time it felt a lot worse. I’m one the waiting list for a cryoablation - I reckoned that if I felt it wasn’t right for me then I could back out.
The more I learn about the progressive nature of A Fib, the more it convinces me to get the ablation, especially when meds aren’t always perfect.
Apparently there is a greater chance of them working, the earlier down this path that we have gone. So I’m thinking ‘strike while the iron’s hot’ or while the freezing balloon is freezing.
Having said that, there are new treatments all the time, and waiting could mean you get an improved method.
I’m sorry you have had to spend time in a and E. It’s never nice. My dad had permanent AF -he had no symptoms but they found it when he had to have an operation when he was 60. I’m guessing mine will progress and become permanent but while it’s not too bad - I don don’t want to take risk of ablation. I care for my hubby who has early onset Alzheimer’s and my daughter is type 1 diabetes so that is a worry too.
It’s all dependent on our own situation isn’t it? You’ve got such a responsibility as a carer, and I do understand that entirely. I’m already late 60s, and I suspect that I’m further down the road with this, even though it was only properly diagnosed in February. Those Kardia devices are very handy for me today, and I’m so please to go back into NSR!
I suddenly felt woozy when typing that reply, had to stop and close my eyes for a second. And I’m back in sinus rhythm! Can hardly believe it as my other episodes have lasted around a week.So either the Bisoprolol or the Magnesium sulphate drip.
Maybe it is working for you then! Kardia is such a good little thing. At moment my AFib episodes don’t last very long and I try deep breathing when they come to slow it down and that does seem to help mostly. I have only landed in Aand E twice where HR has been really high and I couldn’t do anything to get it down.Hoping it all goes well for you now 😊
Thank you! It was certainly good to get a shorter episode! I don’t seem to have much luck with the techniques to stop it early. It’s great if you can stop them early. For May and June, it felt like a was in it 25% of the time.
i had to come off bisoprolol as it gave me a low pluse of 40 still on 5mg of enalopril down from 20 butnow been added to verprampril 40mg x 4 aday and it is working
I dealt with medication side effects for over 5 years with my PAF. Hated it every day. Although recommended by doctors early on, I too was concerned with the relative risk of an ablation. I finally had an ablation 14 months ago.
- It eliminated my PAF.
- No more medications (except bp control).
- And the best result—anxiety release! Possibly the most significant health effect from the procedure.
I’m so glad that you are free from all the horrible medications! It sounds like an ablation has really helped you then. I really am going to have to face my fears!
Don’t get me wrong, an ablation is not a picnic in the countryside. But for most, the procedure recovery is less than a week and heart healing is about 3 months. For me, there was only a couple days of discomfort. After that, it was very little bother. The best to you in whatever you decide.
Have you had an echo cardiogram? An echo will tell you the ejection fraction, how much blood you are pumping. With afib you pump less blood, long term this cant be good for the brain and body. That feeling terrible is the body talking to you. Once i found i had afib i got the ablation. There are also long term side effects from the drugs.
Thanks for your reply. I had an Echo 5 year ago and they said everything ok. I had another on 6th July but when I saw cardiologist- he could not give me my results as his secretary had been on holiday - so hopefully he will send to my GP soon. Did your ablation wrk well?
I had an RF two months ago and had two cardio versions since as well to reset. Been in rhythm for 2 weeks now and hopeful (in the blanking period). I suggest you look into a PF ablation, its quicker, easier, safer and more reliable. You are 53 as i recall, too young to have these issues as IMO can lead to other issues due to lower blood flow, enlarged heart etc...
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