Bradycardia, chest pain and Bisoprolol

[wendy6]

Last August I posted after having to go into A&E twice within a week due to Bradycardia, AF and chest pains. Was released after overnight stay in A&E told all ok as already on Bisoprolol and Apixipan and AF not fast. referral to Cardiology. I experienced 2 weeks of AF on and off 24/7 then it settled.

Now 8 months later still waiting for that Cardiology appt. Heart has had frequent odd Ectopics and sometimes slow heart rate. However 3 weeks ago I suddenly had episode of Atrial Flutter which lasted for 5 hours so reluctantly went into A&E. They captured it on ECG and after 7 hours it settled on its own - 13 hour wait in A&E again was told go home not to worry and another referral to Cardiology but this time they did direct request for Echocardiogram and Holter monitor. Actually had the Echo last week but still no Holter monitor. For the past few days Ive been having frequent bradycardia... slow heart rate and intermittent chest twinges, bit breathless. This is exactly what happened last August, feels horrible.

I had a successful Ablation in 2015 for AF and Atrial Flutter.... No problems until last August.

Im seeking reassurance really, they don't seem to worry about my symptoms so I assume nor should I!????

[baba]

How slow is your "slow heart rate"?

[wendy6 in reply to baba]

My normal rate 65-70 but it has been running at 45 - 55 for long periods of time

[baba in reply to wendy6]

Just my opinion, I'm NOT a medic.

I don't think you should be taking Bisoprolol with such a low heart rate, discuss with your GP.

[56-er in reply to baba]

You are right

[Palpman]

You mentioned Bradycardia a few times but did not state your heart rate.In my experience if I have Bradycardia at lower than 45 bpm then it precipitates to all types of arrhythmias.

[wendy6 in reply to Palpman]

I Know thats what is worrying me. I have long periods of 45 - 55 bpm. Makes me feel lightheaded and I have chest tightness and twinges. Im hoping its Ectopics as there are missed beats about every 6 -10. But worried it could be something else like Sick Sinus Syndrome. Its definitely not AF as get that as well at other times.

[Palpman in reply to wendy6]

Normally GPs don't treat bradycardia at those levels. At low hb one tends to feel the strange palps especially skipped beats more due to pauses being longer.

I often have a hb of 37 but only if I'm at home by myself. Never in hospital or when at my GP.

[56-er in reply to Palpman]

But taking Bisoprolol at such low HR. just aggravates the situation.....

[Hidden]

Morning,

I too suffer with bradycardia sometimes with a resting heart rate of 28 but it sits around 42 now when episodes happen. I was on 2.5mg of bisoprolol after being told I had left ventricular hypertrophy to help ease the workload on my heart, with palpations, ectopic beats etc. Last year my heart rate dropped to 30 while at work so I was blue lighted to A&E , i had all the test done and discharged after 8 hours when everything had settled down, then i had another episode again a few weeks later while at my doctors and spent another 9 hours in A&E with the same outcome. Over the next 12 months I was constantly feeling tired, fatigued and light headed with daily episodes with a low Heart Rate of 34. The cardiologist requested i stop taking bisoprolol immediately as he wanted a true idea of my resting heart rate drugs free and said if its still low and I'm symptomatic he will fit a pacemaker.....its still low, I'm symptomatic but still no change. I had a implant loop recorder fitted in September and 6 months on I'm still suffering with bradycardia and being symptomatic. The other week I had a few bad days with a low and fast irregular heart rate so i called the pacing team but i was told all was ok but my hr was 42? I checked it with a pulse oxymeter, my watch and finger on wrist method all accurate. I was told to perform a manual download from my base unit and they would get someone to check it over but I've not heard anything yet. Also i recently went into hospital for a unrelated operation and while I was having my obs done the nurse changed the monitor twice thinking it was faulty due to the readings and called the doctor over to check all was ok. I was awake during the op and it was funny to see all the doctors and nurses gathered around the monitors looking puzzled then asking was I feeling ok with all the alarms going off etc....i know its not funny but this is how its been for me over the past few years and I can see everyone else notices it too but I feel like nothing is being done. Basically I feel like something drastic has to happen before anything will be done but I don't want to keep pestering my doctor/cardiologist. Ive had many test over the years with findings of left ventricular hypertrophy, bradycardia, mitral valve regurgitation and congenital heart disease. Sorry about the long essay but this is my experience so far with bradycardia and bisoprolol etc.I hope you get things sorted out soon and keep us all updated on your progress.

Best wishes

Taz.

Bradycardia

[JOY2THEWORLD49 in reply to Hidden]

Hi

What is the 31

and what reading is the 96?

Where is H/R?

I have a nicroLife BP monitor which shows systollic then under the diastollic then below to one side H/R. I press m to record it.

E will stand for Err and then it shows nothing but ERR.

cheri jOY

[Hidden in reply to JOY2THEWORLD49]

Hi,The 31 is my heart rate and my Oxygen level is 96.

Cheers

Taz.

[JOY2THEWORLD49 in reply to Hidden]

Hi

Whow.

When my boyfriend's diastollic rate is 35 he's off to hospital.

They give him a spray and he's back!

Both with heart conditions I'm getting to know and care about him.

cheers JOY. 74. (NZ)

[Hidden in reply to JOY2THEWORLD49]

I'm surprised I'm still standing when I gets that low like you said 35 and it's time to go the hospital to get checked out. Hope all goes well with you both.

[wendy6 in reply to Hidden]

Thank you Taz70 for your reply. what you have said is really interesting. Puts my worry over low heart rate into perspective, its not that low. Today my heart rate is 62 but still lots of arrythmia, ectopics , SVTs so feeling breathless if I walk upstairs and chest is very tight. Ive reduced my dose to 1.25mg in morning only instead of morning and evening. See if that helps. first A&E doctor told me not to take extra Bispoprolol if heart is slow, 2nd time A&E doctor told me to increase dose if getting ectopics. No one has advice if heart is slow with ectopics!? I dont know what else to do, I was put on Bispoprolol a few years after ablation as I started to get odd SVTs and ectopics not on any other heart med apart from Apixiban.

[Hidden in reply to wendy6]

Hi Wendy, everyone's heart rate is different so I don't want you to think yours is nothing to worry about or not because its higher or lower it can depend if your symptomatic too, fatigued or breathless etc. We know our own bodies and we know when things aren't working properly so we just need the reassurance from doctors to investigate it. Unfortunately like you I have had appointments cancelled and rearranged for a later date due to staffing levels and then been told by one doctor to increase my bisoprolol dose while another said stop it immediately and I need a pacemaker to another saying more test are needed to be done beforehand. Believe me I've had many test done but now just waiting to see what there next move is but I'm symptomatic good and bad days with low or tachy heart rate, palpations and ectopic beats plus tightness in chest and shoulder/back pain but I have this implant recorder so do I need to worry? They are watching me from the hospital but if I feel terrible at times why aren't they acting on it? Like you say you we just want guidance and reassurance so hopefully it will all be sorted out soonP.s my hr is 47 this morning.

Best wishes

Taz.

[56-er in reply to Hidden]

You should not be on Bisoprolol......it just aggravates slow heart rate...

[Hidden in reply to 56-er]

Hi, I was originally on bisoprolol to ease the workload on my heart due to having left ventricular hypertrophy palpations, ectopic and irregular heart rate etc. But after 12 months of feeling exhausted with dizzy spells and a heart rate of between 30-40 at times they diagnosed bradycardia too so the bisoprolol was stopped last April. The cardiologist wanted to see what my true rhr was medication free and i was told if its still low then I might need a pacemaker...it sits around 40 when I'm having an episode of Bradycardia but it has been as low as 28 at times. I'm still waiting to see what happens next. I also have a leaking mitral valve and congenital heart defect.

[Ppiman]

The results of your echo scan will reassure you, I feel. I had an ablation in 2019 for AFl and it showed I had LBBB also (with the usual wide QRS). I now only occasionally get AF but get many days with slightly fast rate (85-120) and lots of ectopic beats with couplets and triplets. This often is associated with mild chest discomfort, which has never been explained to me and seems of no concern to my GP or the specialist I saw. Have you mentioned yours to your doctor and, if so, what did he or she say?

I take a small dose of bisoprolol when I feel uncomfortable, and it seems to help but does lower my pulse to under 50 for spells, especially later in the second day after the dose. Again, I was told this isn't a concern. When I took lager doses in the days of flutter, it seemed to bring on chest discomfort, also.

Steve

[wendy6 in reply to Ppiman]

Thank you for reply Steve, yes hopefully the Echo will reassure but it could be some time before I see a Cardiologist. Its interesting that you also have mild chest discomfort not many people mention this with ectopics and missed beats. My normal dose of Bispoprolol is 1.25mg morning and evening. So for past 2 days Ive only taken 1.25mg in morning. My heart rate is now 60 - 70 but Im still weird arrythmia ..... 4 slow beats, a missed beat, a few wiggly flutters, few normal and repeat. Are just different these ectopics? Is going on all night and from when I got up this morning. If I walk upstairs get a bit breathless. Chest uncomfortable feeling tightness not pain.

Unfortunately on contacting them to chase Holter Monitor appt I found out yesterday that after most recent visit to A&E with Tachycadia Atrial Flutter for 7 hours, instead of this bumping me up to more urgent it has had opposite effect (I really dont understand how) a new referral was made to Cardiology Diagnostics for Echo and Holter Monitor (ive been waiting for 8 months already since last A&E visits) anyway they told me Im a non urgent case so will now have to start again with a wait for another 8 months!!!! This as you can imagine has really upset me and is most likely contributing to anxiety and heart misbehaving.

[Ppiman in reply to wendy6]

You and I seem to share lots of similar symptoms, and, yes, you are right that chest discomfort figures little in comments on this forum (and yet it is mentioned regularly in descriptions of AF and AFl, interestingly).

For me, the discomfort seems to be similar to what I used to think was gastric symptoms (I have a small hiatus hernia and take esomeprazole for reflux acid issues). These all seem to merge in with what then I learned were not gastric but cardiac, symptoms - but now I am lost as to what the cause is. I once thought the discomfort must be some kind of "angina" but of a very mild form, and yet it certainly isn't exercise-induced, well, I don't think so, and it last a long time, often feeling muscular, for example.

It's become a worrying mystery for me and, with the palpitations being especially pronounce this past month, keeps making me thing I ought to see my doctor about it - but that's easier said than done these days and, well, I have discussed all of the same things before and have been told not to worry and just take bisoprolol as and when needed.

Steve

[JOY2THEWORLD49]

Hi

How low H/R? At rest?

What is your medication dose of Bisoprolol?

Metropolol made ne breathless Bisoprolol did not. Also no pauses with Biso..

Cheri JOY

[wendy6 in reply to JOY2THEWORLD49]

My normal HR at rest is between 65-75. I take 1.25mg Bisoprolol morning and evening. Today my heart rate is jumping between 55 - 85 as per monitor with arrythmia. Can be normal for a minute then arythmia or runs of ectopics for few minutes, normal and repeat has been like this since Tuesday.

[JOY2THEWORLD49 in reply to wendy6]

Hi

Oh Dear.

From what I understand heart specialists are concerned when H/R is over 100 at rest.

I'm not sure about jumping around.

Because of a bad rib cage I don't feel my heart's AF.

Could be flutters. You might need a pacemaker, ablation.

Take care JOY

[56-er]

Hello Wendy

Your story scarily resembles my own.

I had Bradycardia. Two ablations later still prescribed Bisoprolol.

I told my Cardiologist, that every time I took Bisoprolol, within fifteen minutes I got arrhytmia and flutter. He just smiled and told me that "you are the only one".

Bradycardia is not as common as Tachardia and drs. rutinely treat it as they treat everyone else. ( Tachardia patiens) . I was in hospital bed after an emergency due to very slow heart rete (low 40-s), when a nurse rushed in saying that " you should not be taking that medications, your heart rate is down to 40.

So after a couple years I decided to Wean-off Bisoprolol. I took me a month of minutely reducing my dosage to nothing. Today I go for weeks before I experience a flutter, and it would not last longer than a couple seconds.

I am not suggesting that you do this. But talk to your dr. and ask the question of why you need to slower your heart rate with Bisoprolol, when your problem is slow heart rate.

Maybe a Pacemaker is your solution.

Wish you good health..