Slow heart rate

[Camelia23]

I take 2.5mg of bisoprolol twice a day as well as Apixaban 5mg for AF diagnosed September 2019. Also 5mg of Ramipril for high bp diagnosed about 2003. The last 3 weeks I have noticed my resting heart rate is about 52 or 53. I walk most days and increase it to about 130 or 140 on those days. Should I cut down on my beta b eg. the night time one. I'm aware I must speak to gp but that has been difficult recently.

[BobD Volunteer]

Mid fifties is a little low but the importnat thing is how you feel? people tend to get too hung up on numbers and machines.

[Camelia23 in reply to BobD]

Thank you, Bob. I felt ok if a little tense about driving. I've done that drive now,so more relaxed. I think you have a valid point about numbers and machines. In another reply I mentioned about reducing the 2.5mg to 1.25 in the evening. I must phone doctor or pharmacist though. This morning when i arrived at destination my heart rate was 83bpm which after driving is not too bad. I shall be 79 in June so I'm a bit concerned about too low heart rate. All more reason to speak to medics! But thanks for reassuring me. All replies have been reassuring!

[jeanjeannie50]

I think GP's are only really interested in low heart rate when it goes down into the 40's. How how are feeling with yours in the low 50's?

I take the same amount of Bisoprolol daily as you do and I'm going to ask my Consultant this Friday if I can reduce my nightly rate to 1.25mg. I'm in constant AF so my heart rate is going high and low all the time.

Jean

[Camelia23 in reply to jeanjeannie50]

Thank you, Jean. I feel ok but I had to drive us, husband non driver, 22 miles and back so wanted reassurance. As I wasn't feeling faint or dizzy I thought it would be ok. I must try to speak to doc or pharmacist? Got home about 20 minutes ago and everything fine. Sorry you're in constant AF.

[pd63 in reply to Camelia23]

Been on 5 mg bisoprolol for nearly 3 years HR can go to high 40s a few hrs after taking it then slowly rises to mid fifties. GP said as long as I feel OK it ain't a problem

[Camelia23 in reply to pd63]

Thank you pd63. Yours is another reassuring post.

[wilsond]

Mine is always around 55 on 1.25mg bisoprolol. I had flutter and AF which sent my hr to silly levels. I am looking forward to stopping biso and flecanide so hope that will increase it a bit.I feel ok.but bit lethargic.

Talk to.your Dr when you can ! Xx

[Camelia23 in reply to wilsond]

Thank you, wilsond. I might try 1.25 mg biso this evening but you're right: I must speak to doctor. I had diagnosis of paroxysmal af initially but I know AF can beget AF. Saw cardiologist February 2020 who said that if I got many episodes of palpitations he would consider ablation. I thought I could reduce episodes by avoiding triggers such as stress, caffeine and alcohol. That helped a lot. I'm nearly 79 and my body says alcohol isn't good for you so that was easy. I enjoy coffee but usually just have one. But...stress is a little more difficult to avoid!

[wilsond in reply to Camelia23]

Yes indeed, stress is a big trigger for me, and others.Good luck with your enquiries. Xx

[Camelia23 in reply to wilsond]

Thanks for your good wishes xx

[Desanthony]

Mid fifties is low but not too low - mine went down to 36 one night on Bisoprolol. I was only taking the lowest dose too. If you feel OK then that's fine. My resting heart rate also varies between 55 and 58 usually. I was told to come off the Bisoprolol as the low heart rate was making me feel far worse than the AF.

[Camelia23 in reply to Desanthony]

Thank you, Desanthony. That's reassuring!

[Teresa156]

I’m another on 1.25 mg a day, with a heart rate that dips to 54 or 55 at rest, in front of TV for example, especially in the evenings. My cardiologist and EP have said that’s fine, if you feel ok.

If you do try and take 1.25 instead of 2.5 this evening, please can I suggest you take about 2mg, rather than go straight to the 1.25 ( so half a half again, if you see what I mean) for a few nights and if you’re ok, reduce again. Sudden changes in Bisoprolol can cause an increase in heart rate while it adjusts and you want to try and trick your body so it doesn’t realise what you are doing. Believe me, I speak from bitter experience. I bought jewellery scales to taper from 2.5 to 1.25…you may not need to go to that extreme, but I didn’t want to take any chances due to previous experiences. The little pills are powerful.

[Camelia23 in reply to Teresa156]

Thank you Teresa, that's another reassuring comment on my Post. I hadn't thought of being careful when reducing the bisoprolol. It makes sense!

[javo123j]

I have to agree with Bob. I'm on 2.5mg Bisoprolol once a day and my resting heart rate is always in the 40s. I have no problems so doctor said don't worry and carry on with medication. Early on I did stop taking Bisoprolol but heart rate didn't change much but afib episodes increased.

[Camelia23 in reply to javo123j]

Thank you, javo123j

[Camelia23]

Thank you, AnneFromOz. More reassurance. Do you live in Oz? I got that impression when you said about driving long distances!

[Gincalpe]

I saw my GP as my heart rate was low due to the same medication. The advice was this is fine unless you start to feel light headed when getting out of bed or a chair. I would recommend a GP visit just for reassurance.

[Camelia23 in reply to Gincalpe]

Thanks Gincalpe. I hope to speak to doctor soon

[Ossie7]

Hi Camelia , my resting heart rate sits at 50 to 55 on 2.5 mgs bisoprolol and dronedarone for rhythm control . I am 58 so a bit younger ! I feel good at rest , it’s exercise that does me in as I just cannot climb hills without being out of breath and it’s not the usual exercise out of breath .

[Camelia23 in reply to Ossie7]

Thanks, Ossie!

[Ppiman]

That is similar to mine and I take 1.25mg a day at present. The lowest was 43 yesterday although I don’t measure overnight at all often. I've been told it's nothing to worry about so long as is doesn't cause any symptoms, which is the case.

Your GP will reassure you. If you are taking it to reduce the chance of an AF episode happening, then I guess your GP will either tell you to try 1.25mg or not to worry, but I wouldn't self-medicate - always rely on a medical expert who knows your personal heart and medical history.

Steve

[Camelia23 in reply to Ppiman]

Thanks for your wise words, Pipman

[Ppiman in reply to Camelia23]

And thank you for your kindness in replying and so nicely. ☺️

I’m unfortunately not one of those who have only AF (“lone AF”) as it seems many here are, In fact, I mostly don’t get AF that often but do have a left bundle branch block (LBBB) and lots of “missed” beats (ectopics) with, like you, some slow rate (bradycardia). That’s why I think a GP is the best source of general information as he or she knows from training and experience what is safe and so on, given the whole picture.

You take 5mg a day of a strong beta-blocker, so I’m not surprised you get a low heart rate. I only took that much when I had fast atrial flutter (and took 10mg at times). I have read, though, that the response to bisoprolol dosing is far from linear and somewhat individual so your 5mg doesn’t necessarily equal four times my 1.25mg. Also, if I double my dose, my heart rate doesn’t drop much more than with 1.25mg.

Why not ask your surgery if you could experiment a little with the dosage? It really depends on how bad you feel when you have AF (as I’m sure you wouldn’t experiment if it was very symptomatic).

I was told that if a high dose of a beta blocker is a medical necessity, and it drops the heart rate too far, then a pacemaker is usually fitted to boost the rate.

Steve

[Camelia23 in reply to Ppiman]

Thanks again, Ppiman. I think your suggestion of asking surgery about experimenting with the dosage is excellent. Many apologies for misspelling your name first time!!! In my former life I was a teacher of English and would never have made that mistake!

[Ppiman in reply to Camelia23]

My name is Steve but they wouldn’t allow that when I registered here so I made up the name from the fact I take a daily PPI tablet for my stomach acid troubles!

You seem to have made your way through the several typos in my post above. You can tell it has been a stressful day with a painful but minor op this morning! I’ve corrected them now.

I hope you will keep us all informed how you go on.

And, by the way, what a coincidence. I was an English teacher, too, and still do some tuition. There’s a thing. That’s why I corrected the typos!

I’ve been reading a few of Philip Larkin’s poems today. This one stands out as a particular favourite:

Days

.

What are days for?

Days are where we live.

They come, they wake us

Time and time over.

They are to be happy in:

Where can we live but days?

.

Ah, solving that question

Brings the priest and the doctor

In their long coats

Running over the fields.

.

Philip Larkin

Steve

[Camelia23 in reply to Ppiman]

Yes, I know that one very well. I first came across it in my 20s. It's a good reminder for us.

[Jajarunner]

My HR is always about 52. Used to be lower still before ablations, in the forties. I think it depends how you feel. Might be wise to mention it to go or nurse xx

[Camelia23 in reply to Jajarunner]

Hello Jajarunner I have felt fairly well the last few days so I haven't phoned anyone yet. However you have a point. Think I will on Friday.

[southkorea]

i thought a low heart rate was a good thing. My brother is ninety in a few months and takes no tablets yet his heart rate is 48!

[JOY2THEWORLD49 in reply to southkorea]

Hi

There is NO meds for low H/R.

Once your 90s bro gets moving it should rise.

As long he feels OK with no dizziness or fainting leave well alone.

The risk is falling. So rise slowly.

Cheri JOY. 74. (NZ)

[Ronnieboy]

My hr is in the 40s and I feel fine,I can walk for miles and it creeps up to mid 50s,to be honest it doesn't bother me.

[Camelia23 in reply to Ronnieboy]

Thank you Ronnie. Today my heart rate, resting is 62! I'm grateful for all the positive comments.

[JOY2THEWORLD49]

Hi

I would be only cautious if YOUR RESTING HEART RATE (20mins resting no talking/moving) is over 95.

That means your H/R including AF UNCONTROLLED.

If you feel OK on 50s H/R OK.

cheri JOY. 74. (NZ)

[Camelia23 in reply to JOY2THEWORLD49]

Thanks Joy. That's reassuring too.

[Tapanac]

mine is roughly about 45 snd although quite often it is mentioned “heart rate a bit low” no one seems to be particularly bothered about it as long as I don’t feel ill dizzy or pass out

[Camelia23 in reply to Tapanac]

Thank you Tapanac. Quite a few people on here report the same.

[MWIC]

Hi - I had the same and my normal resting HR is about 52-55. I was on 2.5mg Bisoprolol and I felt like a zombie - HR down in 40’s - battled to get a GP to call me as no follow up to check HR down and explained - cut the dose to 1.25mg - made no real sustained difference but carried on - had a heart attack some months later and whilst in hospital the hospital stopped the Bisoprolol immediately and said clearly that I should not be taking it as my Heart rate too low - Agree the numbers probably not the main thing but how you are feeling whilst your heart rate is low - get proper advice - GP first (you might have a good one) and if not satisfied ask for an appt with Cardiologist to talk through

[Camelia23 in reply to MWIC]

Shocking that you had a heart attack MWIC. I don't feel too bad but if my heart rate went down into 40s I would be concerned. Thank you for replying

[MWIC in reply to Camelia23]

This isn’t suggesting any link and I had issues with arteries resulting in the heart attack- message here is you can’t always rely on the treatment you get and tbh when you are put in Bisoprolol we should be followed up to check Heart Rate hasn’t been affected too much / this follow up didn’t happen for me and I’m sure is the case for many others so always keep a check of your heart rate and push for advice if it’s lower than it should be or was before

[Camelia23 in reply to MWIC]

Thanks. Sound advice

[Blimeyohriley]

I’ve been mid to high 40’s since I started 1.25 bisoprolol a few years ago. Occasionally it drops to 42. I feel fine (except when in afib when my blood pressure really drops!) so my cardiologist isn’t concerned.

[Camelia23 in reply to Blimeyohriley]

Thank you for your reply. Interesting.

[LaceyLady]

well, if I was on that dose I’d be out cold! I’m having issues on 1.25!

[MONALISA0424 in reply to LaceyLady]

When I first started taking Bisoprolol I did not feel well at all and called my cardio. He said give it a little time and I think you will see the benefits. I take amlo 2x's day = 5mg's total per day and 2.5 bisoprolol 1x/day. My dr. was right, after a few weeks I was doing well with the Bisoprolol and my PAC''s were gone!!! My resting heart rate just sitting in LR is around 58 - 64 approx. and at night when I wake up and look at my Fitbit watch it will be around 54 - 58 approx. I asked my cardio and he said 50's is fine. I don't have AF just PAC'S and only occasional tachy. My mom has AF and a pacemaker for 10 years and now got a new pacemaker not too long ago. I hope you will be able to adjust to your bisoprolol.

[LaceyLady in reply to MONALISA0424]

Thank you for your info, I’ve been on Bisoprolol since 2019 and it does not suit me.

[Camelia23 in reply to MONALISA0424]

Thank you. That sounds good. I hope it continues. I've been on a longish walk with friends in the sunshine. 13k steps since getting up this morning. I had to drive to start point. Just got home. Heart rate 65. Feel a bit tired but that's fresh air and exercise. No zombie feeling.

[Chasemenow]

My heart rate when resting or sleeping is usually 52 to 57. Lately I have been periodically having lightheadedness . Terrified to change anything as went through a lot to get the right meds

[Camelia23 in reply to Chasemenow]

Thanks for your comments. I understand your fear.

[Seventy9]

Hi Seventy 9 here ( John ) was 79 now 83 years so been here like 4 years or so

But all good now able to do most things ok Including Towing Large Twin Axle Caravan lots of bookings on sites this year . Also Driving to France in June for a couple of weeks. Just letting you know that these Ramipril Tablets Work well .. Had 2 Cardio Ablations at The Royal Brompton in Chealsea. + 2 Cardio Versions these never did much .But the Ablations were amazing. Normal Sinus Rhythm now since August 2021 .Med 10 mg Ramipril Night 5 mg Bisoprolol and this year 2.5 mg Felodipine slow release. No problem at all with Tablets also take Warfrin but all good . Sure your Medication is fine

Regards John

Seventy 9

[Camelia23 in reply to Seventy9]

Hi, that's very impressive. I take heart from your post. No pun intended.

[Seventy9 in reply to Camelia23]

yes keep going very good Pun . Most people Who complain about Tablets think they need to look for Side effects but if they didn’t worry most not all would have No Problem.

That said I did try switching to the Tablet your on but did revert to Warfrin .

John