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Blood pressure medication during an episode?

Buffafly profile image
19 Replies

Before I start, yes I am going to seek professional advice!

On Friday evening I felt a familiar bump and went into AF - fortunately slowish because I have a lot to do moving house. Last time that happens I stopped taking my BP meds until I reverted, on the principle that my BP was being lowered enough by the AF. This time I didn’t think of that and today my heart has speeded up and I feel very lightheaded, bent down to put something in a bin and nearly fell over when I straightened up. So just wondering what other people do/think? I take Diltiazem and Candesartan which both lower BP so maybe both is too much? I’ve just dug out my BP monitor and my BP is perfect sitting quietly so maybe my theory is rubbish……

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Buffafly profile image
Buffafly
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19 Replies
pottypete1 profile image
pottypete1

Very interesting Buffafly .

I take Candesartan but no longer take any betablockers due to my conductivity disease with heart block.

Being in AF will always create chaotic situations particularly if you are on these medications. These situations will also create stress as we know - not a good situation to be in.

What happened to you needs to be discussed with your EP urgently to get best advice.

With the best will in the world us “armchair experts” should not be relied upon for best advice.

I hope you can sort this all out satisfactorily.

Best wishes for a speedy NSR.

Pete

Buffafly profile image
Buffafly in reply topottypete1

😀 I wish. I’ve seen an EP once and that was the day after he did my ablation. After that it’s been cardiologists all the way and then only when things go pear shaped and I don’t even have a regular cardiologist. There has been vague talk of a pacemaker to allow me to take meds to slow my heart rate safely but I think I’ll have to make a lot more fuss to get that offered. So it’s either 111 or my GP.

pottypete1 profile image
pottypete1 in reply toBuffafly

Sorry to hear that. It is such a postcode lottery. One thing this forum has taught me is the widely differing care that is available around the country.

I have been told that a pacemaker would help with other meds being available.

Pete

Luludean profile image
Luludean

hope it settles soon !!!!

If monitor says bp is good that is reassuring.

Pace yourself !!

wilsond profile image
wilsond

I hope you have rung 111 Buff,as this is unexpected new symptoms. I hope you feel better soon

JaneFinn profile image
JaneFinn

Oh I’m sorry about the AF, Buffafly, especially with the house move… very much not what you need.

I know it’s true that BP can drop when in AF, but funnily enough I’d forgotten that, as mine always seems to go sky high, along with my heart rate (140 - 200 bpm resting rate). Though it’s impossible for me to get a reading on my home monitor when in AF - does yours usually work? Good to see your BP is normal at least.

Because mine goes high I take my BP tablets as usual… but I don’t know if that’s right. Sorry not to be any help.

Hope you go back into NSR really soon xx

Buffafly profile image
Buffafly in reply toJaneFinn

That is helpful though. I feel much better this morning, it was just yesterday afternoon for an hour or so that was a bit scary. I have ‘mild’ sick sinus syndrome and a tendency for my heart to pause when I revert - or my heart’s trying to revert I think, hence the pacemaker suggestion. Next time I’m going to take the time to take more Kardia recordings so I’ve got something to show a cardiologist.

Strawberryfields1 profile image
Strawberryfields1 in reply toJaneFinn

Hi there, how long do you stay with the heart rate at 200? do you take anything else or just try the at home methods? Thank you!

JaneFinn profile image
JaneFinn in reply toStrawberryfields1

Hi strawberryfields, in an AF event, I wouldn’t stay long at 200bpm without getting checked out, but generally mine peaks at that for definitely less than an hour, and (so long as I stay totally resting) it then hovers around 140-170. I was told to take extra Bisoprolol (up to 5mg extra, in 1.25 increments) to try to bring it down. I can’t take any anti arrhythmics (eg flecainide) due to an episode of VT, so I don’t have that option to help conversion back to NSR

Originally I was told to go to a&e at any rate consistently above 130bpm that doesn’t come down an hour or two after extra Bisoprolol. (When I left it 11 hours before going in, they told me off in A&E!)

However, I then got the opportunity to ask my EP when I can sit it out at home and when (if ever) I need to go to a&e. He said that for me he would advise: if the rate stays over 160bpm at rest for over an hour (with extra Bisoprolol), I should go to a&e within the next 2 hours. Otherwise it’s ok to sit it out at home, as I prefer that. If it remains between 130-160bpm (again using the maximum Bisoprolol) he said best not leave it more than a day or two. (And obviously, as for anyone, if chest pains, fainting, any serious symptoms, always get help straight away, whatever the rate. )

I should stress that this is what he said for me, but I think how long to leave it at a high rate depends on factors that will be different for different people. The best thing I got was this personalised advice. It gives me confidence and takes away that anxiety of ‘what do I do?’.

I should also say I haven’t followed my guidelines exactly 😂 I always leave it way longer than he said, because my experiences at a&e since 2020 have been awful. I’d rather stay home and relax and try the breathing and manoeuvres people on here so helpfully recommend, and hope and pray I go back into NSR! But if I were at 200bpm I don’t think I’d be in doubt. I think I’d be feeling too awful to want to leave it for longer than he advised.

Hope that makes sense :) Jx

LizLancashire profile image
LizLancashire

I wrote a reply earlier this morning but for some reason it hasn't posted. It was an A & E dr who withheld by BP medication as he'd given me extra bisoprolol. I always check my BP when in afib now. I started with an episode mid morning yesterday so only took Edoxaban and bisoprolol earlier until I got out of bed and checked BP. It's 101/70 so haven't taken amlodopine today.

Ppiman profile image
Ppiman

I think the drugs take a while to exert their effect and also to reach a "steady state" in the bloodstream, so stopping them briefly is likely not a good idea. They have rather wide-ranging effects, too, so, again, stopping is likely not a good idea.

Steve

LizLancashire profile image
LizLancashire in reply toPpiman

I wouldn't have made the decision myself but as A & E doctor did it and explained why I feel confident to do it now.

Ppiman profile image
Ppiman in reply toLizLancashire

I always trust doctors. I realise many here don't and I do always ask questions, but I feel that their training and experience to be worth its weight in gold.

I was prescribed a blood pressure medicine called losartan, even though I don't have high BP as the cardiologist said it was excellent at protecting the heart.

Steve

LizLancashire profile image
LizLancashire in reply toPpiman

My BP was borderline. GP left the decision up to me but because of AF I decided to take small dose of amlodopine. Good news is I'm back in normal sinus rhythm after 24 hours.

Ppiman profile image
Ppiman in reply toLizLancashire

There's quite a lot of evidence that some of these drugs extend life by protecting the heart. I do hope it’s true! 😊

LizLancashire profile image
LizLancashire in reply toPpiman

Yes, hope so too.

bassets profile image
bassets in reply toPpiman

I take this too but wasn't told it protected the heart.

Ppiman profile image
Ppiman in reply tobassets

It seems it helps the left ventricle in some way and the heart output. I have something called left branch bundle block (LBBB), so that might be why I was given it?

Steve

bassets profile image
bassets in reply toPpiman

Glad its helping :)

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