Some of my AF friends on here may recall I had an echocardiogram way back on 14th August, as i was getting a bit SOB on stairs and slopes.
I finally got the report on this Friday, 24th NOVEMBER....I almost can't believe I have had to wait THAT long.
Anyway there has indeed been a change since the last one, a year ago, "a modest reduction in overall pumping function of your left ventricle" .
So it has been suggested to see my GP to be prescribed Ramipril, if suitable, and then a face-to face appt in Cardiology and a repeat echo scan in 3-4 months.
Anyone on here had an experience of Ramipril....?
Wondering if it will be instead of Bisoprolol or as well as??
Your opinions always appreciated : )
Written by
Wightbaby
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It's not good to have to wait that long but I'm not at all surprised. I hope that you will soon be sorted out.
My local hospital referred me back to my EP in November 2022 after a 3 day stay on cardiac ward and cardioversion . Still no contact in spite of further admission and another cardioversion in June this year. Its only because I'm an 'old hand ' with all this palaver that I'm just going with the flow and leaving it to my GP & hospital to sort out.
I was prescribed 10mg Ramipril around 2007/8 .. I'm still on it. It was prescribed as a blood pressure control med. No side effects. I was later put on Bisoprolol 5mg, and from that point on I was on Simvastatin, Ramipril, Bisoprolol, Felodopine, all together ( just different meds at different times of day )... no problems until this year when I began to feel like the Zombie from the Land of the Living Dead with Bisoprolol and changed to Nebivolol.
These days, in my working hours down time, and where I feel I have been the victim of a NHS injustice usually because my surgery is beyond incompetent I do not hesitate to complain.
For what it is worth my view is Ramipril is a BP specific drug whereas Bisoprolol is a heart rate control drug with properties that make it useful for BP control.
Thank you for your reply, Interesting as my BP was 118/66 at the end of September. Which I think is fine.??? I have a face to face with GP on 11th December so will see what she says
Since I have been in persistent/permanent AFib my left ventricular function has gone from ‘good’ to ‘only slightly impaired’. I notice this as heavy legs on hills and stairs. They haven’t suggested anything for that apart from continuing on the bisoprolol and Apixaban.
I checked out Ramipril on the NHS website - and it seems to work for high BP and also for heart failure - by widening the blood vessels and making it easier for the heart to pump blood around.
I imagine that you would still need to stay on Bisoprolol as this is to keep the ventricular rate down, and works in a different way. (Even though it can also be used as a blood presssure medication.)
I must admit that this is my main worry about being in permanent AFib, wondering about how my heart function is going, and whether I will get more echocardiograms to keep an eye on it. Maybe it’s a case of making a fuss if the symptoms get worse.
I was told that there's plenty of high quality evidence that antihypertensive drugs such as losartan and ramipril improve the prognosis for the heart and act as cardio-protectives over the long term. They operate differently from beta blockers, so I doubt your prescription for that will change.
I was put on Ramipril by an assistant ElectroPhysiologist who hadn’t seen me and hadn’t bothered to check my low blood pressure history. She said it was a drug to protect the heart. Immediate effect was awful, two pills , one day and I stopped it myself. Just suggesting that you check everything!
Hi - I was diagnosed with AF and H/F nearly 14 years ago and was put on Biso, Digoxin and Ramipril. I was told that the Ramipril was to help the heart pump more efficiently and protect the heart. I am now in permanent AF and have been for some years, never had an ablation or cardiversion (never been offered). My meds have changed a little no Digoxin (had side effects) changed to Diltiazem and fives years ago changed biso to Nebivolol. I take 5mg Nebivolol and 5mg of Ramipril been on same dosage for years. Only side effect with Ramipril is a slight dry cough at times (well known side effect) but does no bother me. As far as Echocardiaograms go, I have not been regularly given these only when things have gone a bit wrong so a bit hit and miss. I did have one last year, I had an op for bladder cancer and they decided that before they went ahead they wanted an echo done (this had nothing to do with Cardiac department, urology requested it). This year I was in hospital wth a virus in August, heart seemed fine but someone (not cardiac department they were not involved) decided I needed another echo so I am on waiting list for one (approx 6 months waiting list here) who the results will go to I have no idea. I have had no involvment with Cardio department for the last 3 years used to have regular yearly checkups, so I guess they have discharged me.
Ramipril is for high blood pressure and Bisoprolol is a beta blocker. I am on both as well as blood thinner and statins.
I have found that I have had to have the bisoprolol increased every year to keep my heart stable. During a period of extreme stress recently, nothing worked however.
I'm not surprised it took so long to get the results of your echocardiogram as I waited three months for mine also.
I find that my heart reacts very quickly to even mild stress......like a disagreement with my husband! Or it might just be that I get stressed more easily...hard to tell which!!
Hi WB. I seem to recall an earlier post from you about the delay as I commented on it. It would be interesting to know the extent of the reduction in pumping efficiency eg mine is now gauged at 30% - so I’m treated for heart failure and on the waiting list for a pacemaker. I was initially prescribed ramiprill last year but quickly taken off it as I was already on lorartan -both are ACE inhibitors and work, in my case, alongside bisoprolol and other meds. I saw Dr Connaughton in September; he’s retired but working part time. He was satisfied that I was appropriately medicated and that no further action was required for the time being as I’m now under the HF/device team at QA and my GP.
I hope ramipril works for you -worth asking if you have no other defects which might hinder an improvement. I can understand your frustration at the long wait - I’m awaiting an MRI scan to be done at Southampton General and can’t progress further until that’s done as the device team need the info to determine what type I will have.
Yes, I was aware Mark has semi retired...a great loss...he has "looked after me" for the last 10 years. I am pleased he did the latest report for me.
Thank you for sharing that information, very useful to know. My pumping function has dropped from 62% to ...well he has quoted 2 figures....Visually assessed between 45-54% and Quantitative between 51-55%. Don't really understand that tbh. How do you feel at 30%? PM me if you like.
The other defect I have is mild to moderate leaky mitral valve..so will have to ask if that will hinder progress! Thanks for the tip. I have a face to face (steps back in amazement!) appt with my GP on 11th December...so watch this space.
Hope the wait for your MRI is not too long. Keep me posted.
I have mild Afib.I am using (2.5) bisoprolol - to reduce heart rate.
I was on ramipril for some then switched to telmisartan.
Here is what I found:
".. Both trials found that, compared with ramipril, telmisartan provided significantly lower mean 24 h blood pressure, greater mean reductions from baseline in 24 h blood pressure (P < 0.0001), and significantly greater reductions in systolic and diastolic blood pressure during the last 6 h of the dosing interval".
It appears telmisartan is better.
Bisoprolol is tricky as it makes you lethargic. I was on 5.0 but decided to reduce without advising my cartiologist.
Checked heart rate regularly and then told cartiologist. He was ok.
I won't suggest anything as your situation will be diff to mine.
I have learned that you cannot go by others experience of drugs, for myself an Ramapril a few years ago, i felt so ill thught i was on the way out literally. I take Bisoprolol but only as pill in the pocket, as i have a natural slow heart rate of 50, and on Bisoprolol, as beta blockers bring h.rate down, it was around 43 which is far too low, so Dr. now has me only taking them if i get AF attack.
With drugs it is a question of not one size fits all. trial and error is the only way.
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