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AF tiredness or med tiredness

DouglasE profile image
81 Replies

started with AF in March so new to the condition. Since March my Isorbide medication has been increased after 25 years (90 my) and then been prescribed anticoagulants (edoxaban 60mg) beta blockers (bisoprolol 2.5 morning and evening) atorvastatin (statin 20mg) and finally lansoprazole 15mg to help with indigestion after these new meds.

I appreciate AF causes fatigue but I’m needing to sleep in the day even though I’m getting a good nights sleep. I feel weak trembly and very down I know AF is common and people cope but I’m not coping Is it AF or the meds and has anyone had the same issues 😥

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DouglasE
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81 Replies
BobD profile image
BobDVolunteer

Beta blockers are known to cause fatigue but then so is AF . People usually find that they get better with time so early days for you yet.

DouglasE profile image
DouglasE in reply to BobD

Not sure what you mean by early days yet What I’ve read I would have thought I would now be used to the drugs.

BobD profile image
BobDVolunteer in reply to DouglasE

Maybe in a year or so you may have come to terms with the condition and re-thought your life. We all go through it and are able (in most cases ) to look back with greater understanding and acceptance. AF is a very long journey!

DouglasE profile image
DouglasE in reply to BobD

thank you. I’m probably not accepting it yet as I’ve always had a busy life and now feel debilitated.

BobD profile image
BobDVolunteer in reply to DouglasE

I was in the middle of a busy motor race season when mine first struck twenty something years ago and it took some determination some days I know. Nowadays I'd love to be as able today as I was then but the years have not been kind though not due to AF.

DouglasE profile image
DouglasE in reply to BobD

sorry to hear as you were probably a very active guy. I’m low at the moment as I’ve not had much help from the GP and trying to find things out myself but at the end of the day there is only you who knows how you feel. My GP just referred me to the British Heart foundation website which whilst is good very basic information. Let’s keep smiling in the adversity if we can.

BobD profile image
BobDVolunteer in reply to DouglasE

Have you looked on our main website Atrial Fibrillation Association.? Loads of fact sheets. booklets and info. Orginally in early 2000s I was acting as a patient representative with BHF on AF related matters but when AFA was formed in 2007 I switched allegiance and been here ever since.

DouglasE profile image
DouglasE in reply to BobD

I have looked and watched several videos but not seen fact sheets. Will have another look. Thanks

Aegean56 profile image
Aegean56 in reply to BobD

Totally agree. After my diagnosis, I was so anxious and sad about all the things I loved that I thought I'd have to give up. I joined a support group to address my health anxiety...really helped Would also like to add, that with the diagnosis there is probably a low grade clinical depression which can also zap your energy.

DouglasE profile image
DouglasE in reply to Aegean56

I think support groups help but can be a little daunting at times. I agree about the depression and taking this up with my GP this week. Not sure if you can take antidepressants with these medications. I have read so many contra indicators with all the meds I m prescribed.

BobD profile image
BobDVolunteer in reply to DouglasE

Since before AFA was formed I have been banging on to doctors about the need for psychological support for newly diagnosed patients with AF. "Cripes I have something wrong with my heart!" They seldom listen.

DouglasE profile image
DouglasE in reply to BobD

I think the shock of the diagnosis and the meds required and their side effects which you have to get used are enough to hit anyone’s mental threshold

Aegean56 profile image
Aegean56 in reply to DouglasE

Not sure what you mean by daunting. The group I was in was not specific to Afib but for anyone with health related anxieties. Meetings were totally voluntary and open. People tended to drift in and out as they needed to and it was surprising to find the number of people with similar issues. I found it very helpful . It help me control my thoughts and regulate my emotions. After all, Buddha said "we are what we think". Of course a discussion with your PCP or Cardiologist is definitely warranted.

DouglasE profile image
DouglasE in reply to Aegean56

what I mean by daunting is whether I would take other people’s issues on board or they would help but as you say it shows other people have similar issues

Aegean56 profile image
Aegean56 in reply to DouglasE

Having trained counselors as moderators helped quell those issues.I'm 13 years into this and it took me about 2 years to get settle around having Afib and living a joyful life not in fear in spite of it.

It is such an individualize little beast...which is why it so important to know YOUR body and rhythm (pun intended! ).

Hope all goes well with docs.

fibnum profile image
fibnum

If you are having AF, it is likely you will feel less energy due to both physical discomfort and anxiety. If you are feeling tired when not in AF, it could be a med or meds. Consult with your doctor about it. Do some moderate exercise daily and get out of the house and stay active. You might need a general physical exam and blood count. (CBC)

DouglasE profile image
DouglasE in reply to fibnum

I’m definitely anxious and feeling very depressed and don’t have much enthusiasm for anything so going to see the doctor this week. Had some blood tests today for the anticoagulant check and some other things so will see if anything comes up.

wilsond profile image
wilsond

5mg of bisoprolol would have me on the floor ,suggest you ask if this is really necessary or if an alternative can be used.

DouglasE profile image
DouglasE in reply to wilsond

thank you I’ve not felt right since been in the meds

Vonnegut profile image
Vonnegut in reply to DouglasE

1.25 mg of biso taken daily brought my heart rate down dangerously low and the pharmacist who had shown concern when he gave it to me (unlike the doc who didn’t even arrange a follow up appointment) told me to stop taking it after three days!! 5mg would have finished me off! Hope you find something that works for you with less nasty side effects though, sadly, all drugs seem to come with added problems especially with digestion I find.

DouglasE profile image
DouglasE in reply to Vonnegut

I’m hoping I get a consultation with the GP who is sympathetic to my tiredness and I’m not fobbed off with that’s a symptom of AF

Vonnegut profile image
Vonnegut in reply to DouglasE

Good luck with that!

DouglasE profile image
DouglasE in reply to Vonnegut

👍👍

Loplop profile image
Loplop

Went for a pacemaker check up and the technician although saying I was not presenting any worrying symptoms suggested I take beta blockers. I have requested to a Cardiologist first. Cannot see the point.

TopBiscuit profile image
TopBiscuit

It's quite reasonable to consider that you're reacting to one - or a combination - of the meds you're taking. A lot of people seem to have issues with Bisoprolol, for example. Your doctor/s should work with you to find meds that don't leave you feeling bad. What works for one person doesn't work for another.

You don't say whether you're in persistent AF or paroxysmal?

DouglasE profile image
DouglasE in reply to TopBiscuit

unfortunately I don’t know what AF I have I asked the nurse this week who did my original ECG and she said to ask the doctor. I have an appointment with him on Friday so going to try and find out more.

TopBiscuit profile image
TopBiscuit in reply to DouglasE

Who prescribed you all those meds? And you should be able to tell if you're in AF now by feeling your own pulse, if you know how to do that? The erratic heart beat is quite noticeable.

DouglasE profile image
DouglasE in reply to TopBiscuit

A consultant on a stroke unit prescribed the bisoprolol. I have not had a stroke but was put on that ward. The other meds by the GP following telephone appointment. I’ve tried doing my pulse without success not having any erratic symptoms

BobD profile image
BobDVolunteer in reply to DouglasE

Simple enough. If it comes and goes providing you with "events "when you feel dreadful with racing heart. it is paroxysmal. If it is there all the time it is persistent.

JefferyW profile image
JefferyW

I reacted quite badly to Bisoporol with similar symptoms and like you was not sure whether it was AF or drugs. I got a referral from my GP to the Arrythmia team at our hospital in Oxford who assessed me and changed my medication several times until I got something that worked although I still had some fatigue from the Arrythmia . I eventually went down the Ablation route which has worked and I just take medication for my blood pressure now - but I am aware it can come back.

You may have a different set up locally but personally found that the referral helped me a lot as they were knowledgeable and sympathetic as well as able to spend time addressing the issues that concerned me. It would be worth speaking to your GP about this option if it’s available.

Good luck and best wishes

Jeff

DouglasE profile image
DouglasE in reply to JefferyW

I’ve not seen a cardiologist as I was admitted to hospital with suspected HA which hadn’t happened and then discharged with a letter to my GP based on clinical notes. This is on of the reasons I am stressed as I feel I’m working alone

Dicorn profile image
Dicorn

Morning. Has your cardiologist suggested an ablation to you. They can be very successful in treating AF and give you several years of normal heart rhythm. Over the years I have had three which always settled my heart. As a consequence and still taking 10mg Bisoprolol and Edoxaban, no fatigue at all and able to continue with my sports.

DouglasE profile image
DouglasE in reply to Dicorn

see my reply above. Not seen a cardiologist personally. I’m 71 so don’t think I’d be considered for ablation

BobD profile image
BobDVolunteer in reply to DouglasE

Nonsence. No age bock on ablation. I had one at 74 and know people in their 80s.

DouglasE profile image
DouglasE in reply to BobD

Interesting I thought it was an age related option.

Tantaanna profile image
Tantaanna in reply to DouglasE

I had an ablation at age 76

secondtry profile image
secondtry

You don't say how often AF episodes occur. However, I would wait a couple of months and then if no better book a private appointment with a trusted cardiologist. I would say it is the meds and there are several alternatives if you don't get on with one or more.

My cardiologist put me on just Flecainide as I had lowish BP & HR.

DouglasE profile image
DouglasE in reply to secondtry

thank you. Had I not been diagnosed with AF through an ECG following two falls I wouldn’t know I had it. No palpitations

secondtry profile image
secondtry in reply to DouglasE

Many of us had it for years before diagnosis without realising, sometimes a quite severe episode, just calling it a'funny turn'.

DouglasE profile image
DouglasE in reply to secondtry

no one could identify why I fell backwards twice so was sent to a neurologist and had an MRI which showed all clear.

Teresa156 profile image
Teresa156

Hi Douglas E,

I agree with WilsonD about the Bisoprolol amount. Did they put you on that straight away? Who prescribed that for you? Are you always in Afib, or is it paroxysmal ( i.e it comes and goes?) Bisoprolol is usually taken once a day as it lasts for 24 hours, but some people find they need to take a smaller amount twice a day, but not many and it’s usually after some trialling the initial dose to see how they get on. 5 mg is quite a lot for one day and this is what is probably contributing to your tiredness. Do you know what your heart rate is now since being on the Bisoprolol as the rate will be reduced by this drug and that can also be contributing to the tiredness.

DouglasE profile image
DouglasE in reply to Teresa156

I take 2.5 bisoprolol twice a day morning and evening I was started on this one n discharge from hospital as my heart was racing. I’ve not felt right on this but told to let it get into my system. Im at that point now where I think I’ve given it enough of a trial as my life is dictated by tiredness and I could fall asleep every time I sit down something I’ve never done before.

Teresa156 profile image
Teresa156 in reply to DouglasE

Hi DouglasE,

A&E do tend to dish out the Bisoprolol to all affected by Afib/heart racing. One size does not fit all and unfortunately, they tend to think it does. When I was diagnosed by A&E they too got my heart down and back to NSR by giving me 5 mg bisoprolol and a prescription for 2.5 mg ( once a day) which I then reduced to 1.25 last year, as that was too much for me. I am paroxysmal though and my episodes are infrequent. Are you in Afib all the time? What is your heart rate? Are you in sinus rhythm now? That will dictate how often and what dose you need ultimately.

None of us are medically trained but my advice would would be to discuss very soon, if you can, with your GP about reducing your Bisoprolol, as this will definitely be what is causing your tiredness. If you do reduce, you need to do it very slowly though and slower than what the GP tells you ( I speak from experience) and you will need a pill cutter.

DouglasE profile image
DouglasE in reply to Teresa156

I cannot tell when I’m in AF as o do not have pounding or any other symptoms. I am assuming the bisoprolol is keeping everything at bay. I was diagnosed from an ECG and medicated with anticoagulants and then bisoprolol was added about 2 weeks later. This all happened in March and left to it Just had a anticoagulant and cholesterol blood test this week so got a face to face appointment on Friday to discuss my mental health which has been affected and hoping I can discuss the medication also

Teresa156 profile image
Teresa156 in reply to DouglasE

Hi DouglasE,

I’m sorry to read about how it’s affecting you and I do know how you feel as I have felt that way as well and still do. It sounds like you are asymptomatic, in that you don’t know when you are in afib.

A lot of of us have smart watches that monitor when we are in afib and they also advise us of our heart rate. Or you can buy a ‘Kardia’ machine ( you can buy these from the BHF )they are a hand held device. They can take your ECG in the comfort of your own home. The machine is very well thought of and provides a similar ECG to the type you get in hospital. You can also show your GP or a cardiologist.

Unfortunately you can still get episodes of afib. despite taking bisoprolol. It won’t stop the Afib, it just slows the heart rate.

As you are so tired, it could be that your heart rate is very low due to the bisoprolol and this will make you feel very tired. 2.5 mg bisoprolol made me feel exhausted and i can only imagine how you must feel on 5mg,

When you see your GP, ask for a referral to Cardiology. As you are newly diagnosed, you should be on their ‘books’ and they will also do an echocardiogram ( a painless scan) of your heart to check how it’s working, as someone with Afib, you should have this done.

Good luck,

Teresa

DouglasE profile image
DouglasE in reply to Teresa156

that’s an interesting concept of being asymptomatic. I had numerous ECGs and a echocardiogram whilst I was in hospital and kept being asked if my heart rate was always fast. I was very anxious at the time so didn’t ask how fast it was. I am a worrier so not sure if I should monitor my rates as I am fearful of it becoming an obsession. Jury is out on this for the time being.

Teresa156 profile image
Teresa156 in reply to DouglasE

Yes, it certainly sounds like you are. I wonder if they’ve given you that amount to get the rate down, the trouble is, it may be too low, but you’ll find out at the GP surgery. Anxiety will certainly increase your rate. I only have to think I might be in afib, then panic and I can raise my heart from 65 to over 100 in less than 20 seconds. Deep breaths get it back down again 😊

I know how you feel about the watch, or Kardia, ( I don’t wear my watch in bed as I know I would look) but it’s also peace of mind. The fact that you don’t know your HR could be a blessing, but at the same time, it would be good to know how often you are in afib, especially as you are newly diagnosed. If you are in afib often, for example, most people would want to keep a check, especially on the rate and would initially be trying to get back into rythm.

DouglasE profile image
DouglasE in reply to Teresa156

the letter from hospital to GP said they wanted it down to 80 and advised them to increase bisoprolol if required. I was very anxious when my GP tested me and it was 89 but I’d not been on the meds very long. Hopefully it has come down more after a month. I read a lot of people have these katsina etc but I even get anxious when I see the advert for AF. Im doing meditation/mindfulness each day to help with the anxiety so maybe I will be able to take the plunge and get a watch in time

Teresa156 profile image
Teresa156 in reply to DouglasE

Hi again,

I did reply earlier, but it looks like it’s disappeared. It sounds like you may have been in afib at a heart rate of 89 when on that amount of bisoprolol but I’m no expert, that is a guess. Bisoprolol works quickly, You need more answers and a plan for a way forward from the Gp that you are seeing. I do think you should get either a Kardia or a smart watch so you can tell what is going on as it will make you better equipped to ask the right questions, otherwise you will continue to be in the dark over your condition,

The aim is to get you back into sinus rythm initially but you don’t know if you’re in afib or not. I do hope you get answers from the GP.

DouglasE profile image
DouglasE in reply to Teresa156

thank you for your reply input and will see what the Gp says

Speed profile image
Speed

Bisoprolol (Beta blocker) at 2.5mg / day had a significant effect on my ability to do any exercise. It was prescribed alongside the Flecainidr (anti-arrhythmia). In agreement with my EP, we dropped the Bisoprolol. It may be this that’s having the biggest effect.

DouglasE profile image
DouglasE in reply to Speed

thank you for the feedback.

Gra55 profile image
Gra55

It took a year to get me out of AF, all that time I was on Edoxoban, after getting back into normal rhythm I was still getting breathless. Two tears later a change from Edoxoban to Apixiban and my breathlessness and tiredness disappeared, much to the surprise of my cardiologist who had claimed the medication wasn't the cause! We only found out when due to an operation unrelated to heart or AF I had to stop Edoxoban for 2 weeks and after a week I realised I wasn't tired or breathless

DouglasE profile image
DouglasE in reply to Gra55

that’s interesting.

Cabinessence profile image
Cabinessence

I felt exactly the same plus out of breath and a bit zombie-ish. I came off 2.5mg x 2 of Bisoprolol and went on to Sotalol and after a few days felt sooo much better. Which eliminated AFib as being the culprit as far as I was concerned. Unfortunately the Sotalol was not as good at controlling my heart rate, so now back on Bisoprolol but half the dose as before. Still feel tired and out of breath but not as bad as before. You could cut the dose in half and see what it does for your heart rate, as that's the most important thing.

DouglasE profile image
DouglasE in reply to Cabinessence

I will see what the locum GP suggests so far as cutting my meds

Ppiman profile image
Ppiman

I never get a good night's sleep, having had insomnia for years on end. However, I'd think that tiredness resulting from AF is very common if the AF reduces the efficiency of the heart at all. I have read that people cope differently with this., with some not noticing and others being debilitated.

As for your AF drugs, then a beta-blocker, acting on the heart even when it's not in AF, will slow the output and have a similar effect, I guess.

I also take a PPI, but esomeprazole now, rather than lansoprazole. I can't cope without mine but if you can and do not get lots of persistent acid reflux or regurgitation, then I would use it only as needed as the long-term side effects from these drugs, safe as they generally seem to be, even in the long term, are not fully known.

Steve

DouglasE profile image
DouglasE in reply to Ppiman

thank you. I’ve had the lanzoprazole every day as the wind pain was chronic but might try leaving one off now and again to see what happens

Ppiman profile image
Ppiman in reply to DouglasE

Wind pain, at least if it is lower end, can be very severe and is a kind of IBS, I have decided. I've been surprised just how bad it can be myself. I'm not sure a PPI drug would help that much but maybe? They work by reducing stomach acid so the digestion then relies on the enzymes instead, I gather.

Steve

DouglasE profile image
DouglasE in reply to Ppiman

the lanzoporale has helped me but know they have some side effects that put people off. But don’t all meds!

Gumbie_Cat profile image
Gumbie_Cat

That’s a lot of new medications all at once. It is so difficult to tell whether it’s meds or condition isn’t it!

I felt very low when I was told that further ablations would not help, so that I’m stuck in persistent AFib. Though only on Bisoprolol (2 x 2.5mg) and Apixaban. I had similar fatigue, and difficulty walking uphill (no strength in my legs), and did tend to blame it on the Bisoprolol. Had started with 1.25mg per day before my ablation at the end of last year. On dronedarone for a while following the ablation - similar feelings and it didn’t keep me in rhythm. Bisoprolol increased to 1.25 x 2 before my consultation.

When doubling that was suggested I really worried about more fatigue, but the consultant felt that it was the high heart rate while walking that was the problem, and not the beta-blocker. It took a couple of months, but I am feeling better on it now. Still getting those tired legs, but pushing on through it. I am maybe one of the lucky ones for whom Bisoprolol works though, and we are all very different.

Hoping that you get sorted with the AFib medications.

DouglasE profile image
DouglasE in reply to Gumbie_Cat

thank you. I understand everyone is different but helps hearing of people’s experiences

2learn profile image
2learn

hi, I have constant overwhelming tiredness since I was swaped from warfarin to apixaban. I also had a stroke that complicates matters. No medic seems to want to deal with the tiredness or investigate. The heart consultant said it could be the bisoprolol so stop that which I have done but no difference. There's lots of possible issues, do you have sleep apnea, do you have pain at night, is it a side effect of statins which can cause muscle pain, perhaps take the biso in one dose at night, so lots to investigate hope your medics will listen.

DouglasE profile image
DouglasE in reply to 2learn

I have no he statin at night as advised but not getting muscle cramps more weakness and sometimes a bit wobbly when I’m tired. Would prefer to speak with a cardiologist but in view of long waiting lists only have the benefit of my GP who is having to use locums which is not helping as there’s no continuity

Kimhari profile image
Kimhari

I've had AF few years now in and out of hospital with it at first. Over time I find there are good days when I can do mostly what I want. Then bad days not energy depressed becos I can't do anything on these days. But overtime I've got used to the good days and except the bad days and take things easy on these days. Keeping positive helps me on my bad days, because I know after resting up I might have a good day after.

DouglasE profile image
DouglasE in reply to Kimhari

a very positive approach but think I’m a long way off at the moment

Jetcat profile image
Jetcat

bisoprolol can make you lethargic to say the least.!! I remember when I first started taking it and noticing how tired I was all the time.!!

I’m still on it now after years and still feel tired but I’d rather feel tired but have a steadier heart rate, so that’s the predicament I’m in.🤪👍

DouglasE profile image
DouglasE in reply to Jetcat

I agree with your sentiment but need to get more clarification from the medics Think I’m on a journey

Jetcat profile image
Jetcat in reply to DouglasE

don’t get too disappointed about the tiredness though Douglas because as time went on things did improve and after about 6 months I wasn’t half as tired or lethargic. I still feel it sometimes but having said that Iv still got more energy than most of the folk with and there not on them.!!👍

Jetcat profile image
Jetcat in reply to Jetcat

the folk I work with I meant to say. Predictive text.😡

DouglasE profile image
DouglasE in reply to Jetcat

that’s encouraging. I have a friend who is 10 years older than me and has had AF since 2015 and still plays golf That’s what I want to achieve but as I feel now it seems impossible. Fingers crossed that I get back to it.

Jetcat profile image
Jetcat in reply to DouglasE

you will.👍 I’m taking 10mg daily, the max dose I do believe.? If not then some kind person on here will let me know 👍 I could still do full a round of golf no problem. If I could play.! I work full time. Entertain my grandkids regularly, and still manage to have a ride out on my cycle, you’ll be fine Doug, there are other meds you can try if you really can’t tolerate them but I’m sure you’ll get used to them.👍

DouglasE profile image
DouglasE in reply to Jetcat

well done playing the golf. I’ve just retired and really want to get back to the golf even if I need a buggy as it’s a hilly course.

Dippy22 profile image
Dippy22

Are you taking regular blood pressure readings? Bisoprolol severely reduced my BP and I felt sleepy and washed out when I took it. It doesn’t suit everyone.

DouglasE profile image
DouglasE in reply to Dippy22

I don’t have a BP machine as I don’t believe my BP readings have ever been an issue. I could ask my pharmacy to check when I next visit.

Dippy22 profile image
Dippy22 in reply to DouglasE

They’re relatively inexpensive on Amazon. Handy to have one at home.

DouglasE profile image
DouglasE in reply to Dippy22

👍

Dippy22 profile image
Dippy22 in reply to DouglasE

I bought this one for £21.99

Home BP machine
DouglasE profile image
DouglasE in reply to Dippy22

my friend has one as her husbands BP had to be monitored and I got the impression they were using it more than required that’s what worries me that it would take me over. 😩

Dippy22 profile image
Dippy22 in reply to DouglasE

That’s them, this is you. It’s entirely up to you how often you feel the need to use it

Mine sits in the shelf unless I have concerns like when you’re started on new meds, having bad AFib, etc.

DouglasE profile image
DouglasE in reply to Dippy22

good point

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