I have been on Bisoprolol 2,5mg for 10 years and during this time have been in Afib fairly regularly every 6 or so weeks. It usually lasts 12 - 24hours and then converts to NSR. In May I had Covid, and had 3 separate bouts of Afib within a period of approx 10 days. I increased the dosage to 5mg daily during those 10 days and I recovered well. When I subsequently then saw the cardiologist, he said I should not stay on this increased dose as it was slowing my HR down too much. I was feeling lethargic, so decided to then reduce the dosage to 1.25mg. I started feeling more energetic and so stayed on 1,25mg. I have not had Afib since May (It's the longest Afib free period I have had in the last 10 years). I recently read that Afib that is brought on due to the vagal nerve / being bloated should not not be treated with Bisoprolol. I will be sure to ask when I have my next appointment next year and I am not sure that this is what brings on my Afib, but has anyone had similar experience and perhaps give advice?
Bisoprolol: I have been on Bisoprolol... - Atrial Fibrillati...
Bisoprolol
Hi,
With regard to your comment "I recently read that Afib that is brought on due to the vagal nerve / being bloated should not not be treated with Bisoprolol".
In some people the vagal cause can be true. Not in every case. It is in my case although I have it well controlled now.
The thing is my diagnosis of paroxysmal AF and with it a prescription for Bisoprolol came first (January 2010) .......... about 12 to 18 months later came the understanding of how food/diet would trigger an AF event (via a dysfunctional vagal nerve). I was already well into Bisoprolol by then and just stayed with it.
The modern advice of not taking Bisoprolol if AF is through the vagal medium was unheard of back in 2010 .......... so I'm wondering why it is all of a sudden, 12 years later in vogue ?
At my next consultation with my Surgery Pharmacist I will raise the issue. Meanwhile I just plod along with my Bisoprolol and now have a nice steady HR of 63 to 67 bpm. Whenever I raise the vagal topic with my GP she either rolls her eyes or they glaze over ........ and I'm sure she isn't alone there either. My highly controlled AF is due to the advice of a Nutritionist rather than a normal NHS sugery practice.
BUT I still continue with Bisoprolol.
John
Thanks for your comments John. I believe my situation is very similar to yours and I should focus more on my nutrition.
John I get blotting in my stomach then go into AF. Is there a link or article you would recommend for nutritional advice ?
best wishes
Back in the day my symptoms of forthcoming AF event were, bloating, loud intestinal gurgling and diahorrea. Not in any order, sequence - any or all totally at random. Unpredictable.
My GP had bloods done for IBS and Coeliac Disease - but these returned normal. I then consulted a Nutritionist. If you are in UK go onto BANT website and there will be a search box for a Nutritionist near you. The building blocks of her recommendation were gluten free, wheat free and oats free ........... but these exclusions became much wider as time went on.
John
Yes I'm in the UK and have suffered from IBS all my adult life. I think I will look at removing food groups to see what works for me. I unfortunately cant afford to pay for a nutritionalist and doubt I would get one on the NHS.
Best wishes
Thanks to all that have taken time to reply. Each person’s experience seems to differ and I suppose we are on a continual learning curve with Afib
I have often felt that my heart is affected by my hiatus hernia and possibly irritation of the vagus nerve but when I asked about this, I was told that the vagal nerve was only very unusually a cause of arrhythmias and, when it was involved, it caused a much wider range of issues, including swings between brady- and tachycardia. It seems, though, that, a distended stomach can push the diaphragm against the heart and physically irritate it quite naturally, causing the heart to develop ectopic beats. These can lead to AF in prone individuals.
I take 1.25mg bisoprolol as needed, although I get AF only very occasionally. I take it more often for a racing heart and palpitations.
I was told that if I needed to take bisoprolol regularly that it might cause bradycardia. This is one of the main reasons why pacemakers are used for treating AF, I gather.
Steve
Very helpful for me. My cardio machine has shown Bradycardia several times since I've been taking Bisoprolol, but me blood pressure monitor shows AF. Last time this happened my heart rate was 34, that is when I decided to reduce my Bisoprolol to 1.25 (GP agreed).
Thank you.
That is a low pulse. Mine tends to go to maybe 47 or so at its lowest. When I was on digoxin it did go down to 39bpm, if I recall. I have recently started to take 1.25mg bisoprolol daily as my AF began to worsen just before I was due a small op, and my GP has just told me to keep it up as it is calming my heart nicely, even reducing the ectopic beats somewhat. Before that I took it only as needed. I am not sure what would happen now if the AF flared up again and I needed a higher dose.
Most BP monitors seem not to detect AF itself, but pick up, instead, an irregular pulse, which could be AF but is more likely to be "missed" beats, i.e. safe ectopic beats. That's what mine does. I think there are a few expensive monitors that can pick up AF, though.
Steve
Thanks for your reply
Hi 19VIC,
I have what I think is considered a type of ‘vagal’ afib (after food/ late evening episodes) but I think even that is debateable and have been taking daily bisoprolol 1.25 (reduced from 2.5 earlier this year) & I haven’t had an episode since last November since being on it, so for me a beta blocker works well with my afib, for now anyway.
Afib isn’t always vagal though and can be bought on by many things of which still isn’t fully understood.
I wouldn’t therefore take too much notice of the things you’ve read about vagal afib and beta blockers, personally, but that is only my experience.
Hi
I was on Bisoprolol in combination with Flecainide for quite a while. It serves as a rate controller and also compliments Flecainide. When I was taking both medications I adjusted the dosage as required, sort of in conjunction with my cardiologist!
AF can certainly be vagally mediated.
I had a suspicion at one time that the bisoprolol reduced my rate too much and actually triggered vagal episodes,
The longer I have suffered from AF and the more interventions with cardiolgists I have had, the more I realise that there is a long, long way to go before AF is fully understood. You will know more about your AF than most of the GPs you will see. You also know what your body experiences pre, during and post AF episode. No clinician will.
The vagal route seems to be very poorly understood. There are no drugs that I am aware of that can reduce these episodes. My experience is that trying to find an ingested trigger for it is impossible. Only the yawning, stretching, tightening of the belt etc.
Good luck to you.
Thank you - that's very helpful.
hi
Im on bisoprolol 1.25 and increase dose to 2.5 and even 5 if my heart rate increases above 100 but as my normal rate is between 45 and 50 i have to be careful because as you found too much reduces your heart rate too much. Im fairly stable so try not to mess around with it too much.
Its stress that causes me problems so all i can say is i am no doctor but if 1.25 works stick with it until told otherwise.
Thank you
Hi I'm on 5mg tablets of bisoprolol and i have read of many people having cut down to 2.5 or 1.25 mg. Does the chemist have bisoprolol in these amounts or how do you cut the tablet. I understand it would be in half then a quarter but they are so small
thanks
hI they do tablets in 2.5 and 1.25 so you can get that dosage prescribed. I keep 2.5 to hand in case I need to increase my dose although doctors are obviously not happy when you self medicate. My normal dose is 1.25. You can't get lower than that. My heart rate is between 45 and 50 so I have to be careful.
hope that helps
I've had a Cardioversion which on the 4th attempt was successful. Now 52 to 55 bpm without bisoprolol. I dont have a consultants appointment until mid December so wonder why I need to continue with the bisoprol. I monitor my blood pressure and heat rate regularly over the day all good. Will speak to the pharmacist and see if he will give the medication in lower amounts. Unfortunately my gp doesnt exist I only get a locum so no use there. Thanks for the reply and wish you the best of health
your gp or pharmacist would require notification from your cardio specialist so it might be better to sent them a letter or email and ask them if a lower dose would be appropriate. You need it in writing and as mentioned by other members telephoning is not normally successful so good luck
thanks Malcom unfortunately no communication between cardiology and gp. I had a Cardioversion two weeks ago and havent seen a cardiologist yet. My gp doesnt have a clue either as I see one of five in the practice neither one the same and often the locum. Will speak to the pharamasict see what they say
best wishes
I was on 10mg bisoprolol and flecainide for many years until I had apacemaker fitted and an ablation.These meds were then stopped ,I experienced awful withdrawal symptons for quite a while.However 18months on all is well. Good Luck for the future
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