As we know, Afib questionsjust go on and on, so thank goodness for this forum where we can share so many questions and answers 🤗
Following my last post about the possibility of progression of Afib, I have managed to see an EP. It all happened very quickly as I was given a next day cancellation at King's College Hospital. I thought I was being referred to Barts,but that's another long story!
Like many on here,he couldn't say as to whether my Afib will progress to bigger and worse things - hopefully it won't!
For now, he has ordered another echo I (had one about 2 years ago, which was normal)a and an echo stress test (have never had one of those). He suggested that I take 1.25 of Bisoprolol daily to try to ward off any episodes. Seems a very low dose but I will go with it and keep fingers, toes and eyes crossed!he did say that I can take more if I go into an episode.
My question is about my HR - my restingH HR is quite low, yesterday it sat at around 56 and I know that it can dip a lot lower when I'm asleep. I'm now worried that the Bisoprolol will make it even lower.quite a few years back I was on Bisoprolol for my 'other' arrhythmia and it dipped so low that I was taken to A&E
I have to admit that I didn't discuss all this with the EP as there was so much else to talk about.
Thanks for reading and any thoughts/experiences appreciated.
Sue
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Spangle14
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My resting HR is around 48 and I've just had my Bisoprolol increased to 2.5mg and I've not noticed any problems. The AF nurse didn't seem to concerned over my pulse but from other posts it seems some people have problems with Bisoprolol.
Thank you Javo123jI have taken Bisoprolol on and off over the years and the main issue with it was the low HR. I suspect it causes a bit of heartburn too, but other than that, it doesn't seem too bad. That said, I am and always have been on a low dose. The most I've taken at any one time is 2.5mg
Hi Sue, like you, I was put on a daily dose of 1.25mg Bisoprolol and it has helped to ward off further AF episodes. Still get the odd breakthrough one, so I take an extra Bisoprolol, as your EP suggested. Since found out sleep apnoea is a trigger for my episodes so am now trying to wean myself off Biso, but that’s another story😊
Unlike you, my resting rate before Bisoprolol was low to mid 70s . The Biso had lowered that to mid 60s. I think, if I were in your shoes I would give the hospital a call and see if you can get hold of either an arrhythmia nurse, or the consultant’s secretary and get some further advice on that. I’m not medically qualified in any way but speaking for myself, I’d be a bit cautious taking it with a resting heart rate that low.
Sorry, that’s not much help!
Hiya Spangle/Sue
You may care to read through a recent post of mine on Bisoprolol. Just click on my user name and it should take you to my posts.
In short, I am having some debilitating side effects from Bisoprolol after 12 and half years and have just formally told my GP that I am cutting the dose down from 7.5 mg to 5 mg and then review the situation.
The most significant side effect is a lowering of my heart rate into the range of 41 to 58 bpm .... and I'm a 6 ft, 15 stone guy who functions best at 65 to 72 bpm - preferably at around 72. I have been quite stroppy with my GP and warned her that I have been on Bisoprolol and two BP drugs for 12 & half years without a review ! The rest of the time I feel like a Zombie from the village of the living dead !
If I may be honest, with my personal experience behind me, I would be worried even about 1.25mg of the stuff.
As I said, I am in the process of weaning myself down to 5mg however, my overnight HR drops to around 50 to 53. For me this is far too low. By far. I use a wrist located tracker watch, so it is on me picking up all sorts of stuff 24/7.
I actually would prefer to come off it all together and try something else.
Not medically trained, but my understanding is that bisoprolol is a weak anti-arrhythmic and therefore you have to weigh the risks versus benefits. In your case, the risk may be a too low HR plus any other side effects you may have, against again marginal benefits.
I don't know what your afib progression is, but if episodes are few and far between, I would ask to stop the bisoprolol completely. If they are very frequent then ask about an anti-arrythmic like Flecainide.
Another option is to substitute the calcium channel blocker, diltiazem for bisoprolol. Like bisoprolol, it's a weak anti-arrhythmic but it may not drop your heart rate as much.
56 is not really that low. The key is to find if rate goes lower especially when you sleep.
Ask your doctor to wear a holter monitor or other professional medical device to give at least a 24 hr reading. Will also help to determine appropriate medication dosage.
Suggestion: Make a prompt private appointment with the same EP if you have confidence in him/her and discuss your history and concerns over Biso. He needs to consider it further and you need to have more faith in the treatment or alternatives. He will very likely be impressed you have taken the trouble and assuming you take a list with you to discuss, a positive outcome is more likely. Good luck!
I agree with above comments. It’s really good to hear that this forum helps you. Great to hear other stories but I would speak to the arrhythmia nurse or the consultant and discuss your concerns. Good luck.
I take 2.5 bisoprolol daily and my heart rate is often between 43-55. I mailed cardio nurse about the low rate and he said if you are not having any symptoms don’t worry it’s fine.
I don’t think 1.25mg is a low dose as such since it has a significant event on the heart rate, I take this dose as and when needed rather than regularly. It reduces my rate to the high forties on occasion.
I rarely get AF currently but take the bisoprolol if I get any tachycardia out too many ectopics beats.
I was told by an arrhythmia nurse that if the heart rate goes too low but the bisoprolol is needed, that’s the most common indication for a pacemaker.
Thank you Steve, I was taking Bisoprolol as and when needed bit the EP I saw recently suggested taking 1.25 daily as I was getting AF a bit more frequently. Early days to say whether that will reduce the frequency, fingers crossed it will. I guess I will just have to keep a close eye on the HR and hope that it doesn't dip too low. It sounds like you get AF so infrequently, that it has not been deemed that you need to take it daily. Lucky you!
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