Bisoprolol and arrhy

[Wednesdaystar22]

hi I am on 2.5mg daily of Bisoprolol. My question is does Bisoprolol reduce episodes of arrhythmia or does it just reduce heart rate? I have paroxysmal AF and GP has recommended increasing the dose to 5mg daily but I am reluctant as I am a runner and my resting heart rate is 45-55 BPM, sometimes lower. But arrhythmic episodes seem to be increasing in frequency. Any views would be much appreciated.

[BobD Volunteer]

In general it is a rate control drug not a rhythm control one so yes it slows your heart rate. For rhythm contol you need a drug like flecianide or propafanone.

[Wednesdaystar22 in reply to BobD]

thanks Bob that’s really helpful.

[DevonHubby1]

Wife was on Bisoprolol for PAF for a few years. Dosage varied over the years, and at one point when her resting HR was regularly dropping into the low 40s they did drop the dosage.

It may have been psychological or may be the reduced peaks made it less noticeable but for a few years she felt that the Bisoprolol did reduce the number of occasions of AF.

[Wednesdaystar22 in reply to DevonHubby1]

thanks for your reply, much appreciated

[Tellingfibs]

My Bisoprolol has been increased over the last 5 years from 2.5 mgs daily to 10 mgs daily. I have paroxysmal Afib and I think the Bisoprolol was prescribed because I had little bouts of minor tachycardia that made me feel rough. The drug has worked well for me, but it’s true that my heart rate can go quite low. My GP and cardiologist have both said that the low heart rate would only be of concern if there were accompanying symptoms like dizziness or fainting. I suppose the rate lowering effect of the Bisoprolol is only relative to your natural heart. If your normal heart rate was 80 and it reduced to 60, that would seem low. If you can still run, it means your heart’s capabilities are not compromised by the drug, but if you feel dizzy or faint or have chest pain, then get yourself assessed.

Annie.

[Wednesdaystar22 in reply to Tellingfibs]

thanks, much appreciated, it’s always helpful to talk to others with knowledge and experience of AF

[Wednesdaystar22]

thank you, much appreciated

[Ppiman]

I gather many people's AF is triggered by increased HR, so rate control can stop this and reduce AF episodes more safely than using a strong anti-arrhythmic like sotalol or flecainide. I guess that is the case with me as my episodes increased a few weeks ago and starting just 1.25mg bisoprolol daily, instead of as needed, has stopped any further episodes, although owing to the very infrequent nature of my AF, that could be chance.

My problem is that my rate drops quite low naturally and can drop into the low 40s at some point in the evening, although symptomless.

Steve

[Wednesdaystar22 in reply to Ppiman]

thanks Steve, your reply is much appreciated

[kingsnorth]

l take 2.5 for high blood pressure and to help with ectopic beats l find even with that dose l do get tired plus my nose constantly runs which is a flipping nuisance. I. Was told by cardiologist they slow down heart rate

[Tplongy in reply to kingsnorth]

Me too with the runny nose Kingsnorth, I could fill a A4 page with side effects from Bisoprolol 🙁

[Tomred]

Bisoprolol hasnt reduced the number of afib bouts for me ,but has reduced the rate of a bout.

[Wednesdaystar22 in reply to Tomred]

thanks for your reply, much appreciated

[kingsnorth]

it’s so uncomfortable keep having to wipe your nose especially bad when the weather is cold

[Wednesdaystar22 in reply to kingsnorth]

thanks for your reply, much appreciated

[Halfheart]

It's very difficult to keep running if you are on a beta blocker, you just can't get your heart rate up where it needs to be. I found switching to flecainide allowed me to exercise normally, and also did a better job of keeping the afib at bay.

[Wednesdaystar22 in reply to Halfheart]

thanks for your reply, much appreciated

[Decaf_Andy]

I’m a cyclist and untreated I get AF more than once a week, lasting around 24hr. It’s annoying and of course hits my cycling performance. I decide to try fleccanide 2 weeks ago and it was recommended that I took 1.25mg (the min dose) of bisoprolol merely to address the risk of fleccanide causing a 300bpm flutter. For a few days I took just the bisoprolol to see what it did on its own.

My normal unmedicated resting heartbeat is in the (often low) 40s. I get occasional Apple Watch warnings of rate persistently below 40.

Since starting bisoprolol my RHR is fairly consistently about 40 or just below. I get several such low warnings a week. Aside from that I had no symptoms and I have no problem with HR in the high 30s.

Started Fleccanide a week ago and feel no side effects and have had no AF so far.

However, it does seem that when exercising I cannot get my HR up. A hill climb that would have resulted in pushing my HR up to 160, now only reaches 140 and I feel slightly less powerful as a result. However, I would describe the power drop as maybe 3-4%. In AF the drop is 30%.

[Wednesdaystar22 in reply to Decaf_Andy]

hi decaf Andy, thank you for your helpful response, it was useful to know information about your HR particularly when cycling. As a runner it sounds as though Fleccanide might be useful for me (and several of you have mentioned Fleccanide in your responses). This is a tricky condition balancing AF episodes with tachycardia and I might consider going back to my GP for a review, given that my AF (not my tachycardia) has increased recently. Once again, many thanks everyone.

[kitenski in reply to Wednesdaystar22]

If you go on regular flecainide they tend to recommend you also take bisoprolol in parallel as a rate control, due to some unwanted side affects of flecainide!! I'm a cyclist and runner and still manage to do ok, my running times and cycling power are down but good be a lot worse!

[Vonnegut]

Bisoprolol reduces heart rate. It does not prevent or stop AF. I was prescribed Flecainide ( by a doc I found through the AFA ) which I first used successfully as a PIP and now take regularly am and pm which mostly prevents episodes, with an extra one as a PIP on the very rare occasions that the idd episode occurs so they never last more than a couple of hours. Good luck finding what works for you!

[Wednesdaystar22 in reply to Vonnegut]

thanks Vonnegut that’s really helpful. The Fleccanide sounds like it could be helpful and I’m going to talk to my GP.

[Vonnegut in reply to Wednesdaystar22]

Good luck with that. When I took it as a PIP, I was told to take one of the 1.25mg Biso if my heart rate was over 140 twenty minutes after taking the 100mg of Flecainide which it rarely was. Do hope you find what helps you as we are all so different (and, of course, like all the other stuff, it comes with side effects)! And the original Accord make worked, unlike the other make I was given instead recently. I had to find a pharmacist that stocked the original brand and get my surgery to send them an electronic prescription!

[Wednesdaystar22 in reply to Vonnegut]

thanks, very much appreciated, all the best

[Vonnegut in reply to Wednesdaystar22]

And to you in finding what works for you. And remember all the drugs come with side effects! My fatigue has increased and my digestion is messed up! But I’m still alive at 79 if not “going strong”!