In my previous posts I mentioned that we booked a private appointment with cardiologist. After mum had a heart monitor for a week, the consultant confirmed that mum’s average heart rate was around 86, and the peak was around 160. The consultant has doubled the dose of bisoprolol so now mum is to take 2 tablets per day (3.75mg). This change was from this Monday- 5/2. Mum was fine up until yesterday evening, then she started feeling anxious again. She hasn’t had much sleep and this afternoon, she ended of taking Promethazine as she said she could not relax at all. I’m so stressed out. I thought we worked out the root of the problem- the fast heart rate and I assumed that mum would feel more relaxed. Now I’m confused and not sure what to do. I have a telephone appointment with GP next Tuesday, but in the meantime, if mum gets like this again, the only thing that seems to help with anxiety is the promethazine, even though we’ve been told this is to be used only if mum cannot relax, it can’t be taken regularly. My stress levels are so high, I just cannot relax. I feel helpless
Confused, Don’t know what’s going on! - Atrial Fibrillati...
Confused, Don’t know what’s going on!
When I was taking a beta blocker like bisoprolol I also became anxious.
I don't know if the timing of her anxiety corresponds to her taking bisoprolol, but if it does, there are other medications that that serve a similar function without the anxiety.
In my case, it was the calcium channel blocker called Diltiazem which I tolerated better.
Jim
Mum has been on bisoprolol for over a year and a half, the anxiety seems to happen at random times, particularly in the evening. Does the calcium channel block help with heart rate? Mum also has HF and I’m thinking is that why the consultant prescribe bisoprolol?
Yes, Diltiazem helps with heart rate just like bisoprolol. In fact, in many cases, the drugs are interchangeable.
Your mom was probably prescribed bisoprolol, because that is the most common treatment in the UK, but that doesn't mean it's necessarily the best for everyone.
I'm not saying that your mom anxiety is caused by bisoprolol, but I think you have a little to lose at this point by having het trying an alternate drug like diltiazem, and see if she tolerates it better.
Jim
Thank you Jim. Will mention this to GP next week when I have an appointment.
I haven't any answers, but I do know how it feels to be awfully anxious. I'm sure people will have talked about relaxation and mindfulness. It is helpful to try and deal with what is happening now not get embroiled in what might happen tomorrow. Maybe look on you tube for Andrew Johnson if you like a calming Scottish accent .Or Mark Williams mindfulness. He does various length videos all very relaxing.I can see it becomes a vicious circle .Your Mum is stressed so you are too. Sometimes all you can do is be there. Not all medical symptoms have cut and dried answers. If she thinks trying to relax with videos is barmy. You could try them for you.
Has the bisoprolol helped with heart rate? All this is very new and understandably scary for you both.
This is probably a silly suggestion, but maybe your Mum needs to do something rather than try to relax. I understand she is too poorly to exercise but if she could concentrate on some handwork or a puzzle or a game online it might take her mind off the anxiety. Have you checked her oxygen levels? I noticed she also has pulmonary hypertension which could make her feel breathless and that leads to anxiety. I can’t remember whether she has been diagnosed with heart failure but I’m assuming she has a degree of that so make sure any swelling of ankles/tummy is under control. Anything that affects breathing causes anxiety. I have found I sleep much better since I’ve had an adjustable bed - I used to get insomnia and eventually realised it was because I wasn’t getting enough air lying flat.
I hope you get to the bottom off the problem soon but in the meantime don’t worry about the promethazine if it’s helping both of you!
Thank you so much for your reply. Now that you’ve mentioned the breathlessness, mum has used inhaler more than usual, I put that down to the cold and on top of that, the heating hasn’t been working for a few days! Luckily that’s sorted out now. Mum does have an adjustable bed and has it slightly raised. Thanks again.
Does your Mum suffer from asthma as bisoprolol can aggravate it?
Mum doesn’t have asthma but recently, she’s been using a blue inhaler as she has felt breathless quite often. Didn’t realise that bisoprolol could be causing that.
Bisoprolol caused me to have breathlessness and to cough a lot which was one of the reasons I stopped taking it. It turned out that all other beta blockers, calcium channel blockers and rate/rhythm control drugs caused the same to me - tried about half a dozen and mixes of a couple or more during first year with AF so I am just on apixaban.
Oh no, so u guess that’s a common side effect?
Bisoprolol was the worst and there are quite a few people who have this with bisoprolol so it should be worth asking for either a change in dosage or a change in medication.
I have been asthmatic for 49 years (I am now 78), as well as having Permament AF, permanent but asymptomatic. Beta blockers can exacerbate asthma, so I've never been prescribed them. I happned to check on the side effect of Promethazine. Arrythmia and palpitation are one of the many potential side effects of that drug. Fortunately I've never suffered from anxiety. My father had 2 nervous breakdowns in his life, and know that anxiety gets you nowhere. My permanent AF is not life-threatening, although I make sure I take my anticoagulant daily.
Hi
Sounds like as before that your Cardiologist should try a CCB like Diltiazem.
Rapid heart rate in itself made me sweat excessively. Any exertion made me fatigued and I had to stop.
BBs Metoprolol 1st and Bisoprolol did not control my heart rate.
Read below mjames1 found control in CCB Diltiazem.
cheri JOY. 75. (NZ)
Thank you. Will discuss with GP about the CCB.
Hi
I don't know why GPS just put up BBs. Little happened in my case.
It needed a whole investigative stance.
But a GP probably won't change anything - it is back to Cardiologist. Dr referring back.
I'm sending prayers for a solution.
cheers JOY
Aww, thank you Joy.
Having read posts here for many years, I have learned there are many different treatment possibilities dependant on the patient's individual reaction and cardiologist favoured ones. I would get back to the cardio asap with as much info on your Mum as possible.
I agree with secondtry and Jim. Bisoprolol, anecdotally at least, is known to cause or worsen anxiety in some cases and alternative meds can do a similar job for these people. I'd be contacting the consultant via their secretary and explaining what you've told us.
Nicky,
I am sorry you are going through that with your mom. My mom is 82 and we she is also having various episodes of anxiety.
She is now on Metropol for SVT and Zoloft for the Anxiety. Now she is experiencing pretty severe pain from Spinal Stenosis, she is waiting on medicare approval for a MILD treatment.
There is not a whole lot I/you can do for her she has good days and bad days. You and your mom will unfortunately have to come to the realization that it takes time to find the right drug combination and that it may not be found, and/or it might not be 100%. Maybe others will disagree, but this is hard.
My mom's anxiety is easily spiked. But at least now she has been told no more alcohol, after a lifetime of drinking, so that is one positive.
I hope you can find a level spot, good luck.
Thank you. Let’s hope our mums get the right treatment and manage to overcome these horrible anxiety episodes.
7HiI have psvt which used to be clearly bad I was always having to go to hospital for adenosine.
Since being on medication. It is a lot better. I originally took 1.25mg once a day. The felt a few ectopic after a while so the cardiologist said I could take 2 x tablets a day. I notice they made me really tired to begin with so I increased by half a tablet and it controlled the ectopic so that what I stayed on. 1 full 1.25mg tablet in a morning and one half of a tablet 12 hrs later at night. I was still having odd episodes where I needed to go for adenosine. The cardiologist then told ne I could go on waiting list for ablation or try medication first as it works for some ppl.
I opted for the medication route. Now, touch wood I take 1 and half bisoprol tabs a day and 50mg flecainide twice daily and have had no bad episodes needing hospital since and that's 2- 3 yrs now 😀
It also seems to have eased anxiety to what it was
Hi there iam sorry to learn that your mum is having heart issues at the moment which is a big trigger for Anxiety and stress I have been there myself suffering on a daily basis. I didn't know what Anxiety was about until the day I found out. It has a big impact on the body and many times you are that wind up about things the you faint and that what happens to me. I know these are very stress full times for you because you are looking after your mum, once you have got your mum settled try and relax your self because if you are stress yourself that has a big impact on yourself palpitations will start to happen plus fast heart rate, feeling lightheaded, tingling all over the body sudden feeling you are falling. I have experience this many occasions.Try and think positively the best you can and Never give up..I thought about given up many times but family always make to think that I need to keep going. Take care.
Thank you so much for your encouragement. Honestly, the lightheaded feeling is affecting me, since mum has been feeling this anxiety, I’ve been getting the lightheadedness every day. I find it really difficult to relax until I feel mum is feeling calmer.
Hi Nicky. What do you usely do after you have got your mum settled and relax. Try not to doing things which are going to be stressful like I found out last Saturday I was playing the piano, once I finished my second song, I started to experience uncomfortable central chest pressure and it lasted for 2hours, I stared to panic and made things alot worse, I was going to phone an ambulance but I just couldn't do it nor did I go to A&E (ED). I WAS STUPID NOT TO GO.I looked up on the Internet if anyone else has experience this. I just blamed geting Anxious but it was the first time it happened to me. I have played the piano 100's of times. Iam now scared to play again.TAKE CARE.
Oh no, that doesn’t sound good.
I just try and watch something on TV to relax, and try to focus on that just to keep me distracted.
there are other anxiety medication’s and it should be looked into period I have anxiety and panic attacks and had a medication told to take it as needed so I did not take it very often. My EP told me that what I’ve been feeling with my heart now he believes is the anxiety and I need to address it full-time. He is not the one that has me on that medication. FYI not everything is caused by a fib. On the 13th I will have my first anniversary of my pacemaker. My doctor is thrilled with the results. One thing people need to realize is that a fib is not cured it can be controlled and kept from damaging our heart, but you still will feel it or for me. It’s
a typical flutter. I can go long time without it or I might have a week of it. It depends what’s going on. For the past month I had some kind of a bug they tested me for Covid but I did not have it. I was put on an antibiotic, and it appears, that’s what took care of it all, including the flutter when you are under the weather, there’s a good possibility you are going to feel more episodes
Just remember everything is a Band-Aid when it comes to a fib people here seem to think that whatever procedure they have is just going to make them all better. You might get relief you might not and you never know when it will stop working again. I had a cardioversion that lasted 3 1/2 weeks but it was 3 1/2 weeks of heaven, after having tachycardia for so long.
The past year has not all been roses. One thing that I have found is we need to get out of our head about our condition. That doesn’t mean don’t pay attention to certain things, but don’t let it rule your life because it will. My doctor did not want me using devices even an oximeter unless I was really feeling badly. Your heart rate will change minute to minute, depending on what you’re doing or even what you’re thinking about and if you dwell on it, you will make yourself worse. These are the things I have had to battle the past year and it worked, and for the most part I feel so normal. I never thought I could feel this way again. I do not have the stamina I used to have but a year ago I could not walk Because of my heart. Glass half full or half empty I prefer to think it’s full and I think it’s more than half full.
I had a very unusual condition. There was no pacemaker for me, and nothing else was working. I had gone into heart failure. Then I was blessed with an amazing doctor coming into my life. He has saved my life and made it so much better.
You are going to have to take a deep breath about your mom. Part of her anxiety might be you with your anxiety. I live with my cousin and every 15 minutes he would ask me if I was feeling better. It just doesn’t work that way. Your mom has to get used to her new condition and body. There are gonna be constant changes including medications, etc. some will work some won’t some will make you feel worse. You need to pay attention give it a chance, but if you’re really feel that bad, let your doctor know don’t ask us here we aren’t doctors we can only share what we know.
So she can’t take the medication full-time as I said ask about others. I was on lorazepam now I am on clonazepam which is much better. The other one made me feel a bit hung over. I take it twice a day to keep it constant in my body. I don’t feel anything from it, but that’s a good thing. It means I’m not feeling my anxiety. Only someone with anxiety and panic can understand what I mean. Some people get antsy for me. I go into a dark place and there’s nothing you can say to help me, sometimes I will hyperventilate out of the clear blue sky and have tears pour down. My doctor said we just can’t keep up with all the things in our brain that are constantly working and something may flit by that may upset us even though we don’t realize it. If we knew why this all happened, we would probably all be rich and we wouldn’t have a problem.
Please address her anxiety because it’s going to create problems with her a fib. My EP feels my heart at this point is excellent. In fact, my ejection rate went from the 50s to the 70s and my heart rate now is usually around 71 even after taking the dog out. it was 180+ since my first a fib attack I had several ablation could not have more because of scar tissue, and I dislike hearing about doctors who continue to do ablation after ablation there are other things out there don’t let them write you off because of age or anything. I have a doctor that think outside the box he is young In Humble and he told me I’m not going anywhere he’s got this for me
A fib is not a killer I will be on an anticoagulant probably for the rest of my life and that’s fine with me because it beats having a stroke. Yes they are coming out with new things. I had my AV node blade it the watchman and others are not for everyone. FYI.
Best of luck. You are great with your mom. I had a child that cared like that.❤️
Thank you so much for your response. I will definitely be asking GP for something suitable that mum can take to control the anxiety as and when she gets them feelings. It’s just so frustrating when everything you do doesn’t seem to help. I think now mum gets scared that the anxiety will be coming on so she gets nervous. To be honest , I think I’m doing what your cousin was doing by keep asking mum if she’s feeling okay, but I am trying to do this less and I try and just have a chat with mum about normal things to try and distract her from the anxiety. I really hope we get to some point of normality real soon. Thank you again
you are very welcome Nikki. Yes you mean well but it’s stressful because it just makes her keep thinking about it and we do that anyway especially in the beginning find out about her being on something all the time. Mine originally was as needed but my EP is the one that felt I needed it all the time to keep it consistently in me not just when you already are having a panic attack. It’s a little bit late at that point. and then chances are your a fib is going to act up a little bit. It’s just a normal reaction to the stress. It’s that fight or flight that everyone has at one time or another but with a fib we feel it by getting thumps or whatever. I take one in the morning and one at bedtime now, I don’t feel anything from it and I also am not having any anxiety. You may notice she is going to be a little bit blah and not react to things like she might have before. Many of these things do what is called emotional flattening. I don’t like it but I like panic even less. It just means you’re not gonna be freaking out over things and she may seem like she doesn’t care about things. You can pretty much tell me anything and I have the same reaction these days. It’s OK because it’s just a normal medication reaction. and if it helps keep her a fib at bay that’s what you want. Taking one when I was already having a panic or anxiety. Attack is not good enough. A fib is not who your mother is. Your mother is still your mother don’t let her become her illness. easier said than done believe it or not because I was thinking about it constantly that’s why my doctor did not want me to get any type of device because you look at it constantly and bottom line is your heart rate changes constantly and if you don’t know what you’re looking at, it’s gonna scare you leave it to your doctor to watch that stuff unless she really was feeling lousy or passes out, etc. yes that can happen. Odds are pretty good. She may not have it now, but that was how I started I woke up on the floor one night. It was my first attack so to speak. Also keep an eye on her balance, etc. medication can make you lightheaded. She’s probably gonna have a lot of odd feelings at first but it’s OK. It has taken me a year, since my pacemaker was put in, now I am comfortable with it. I will tell you having a doctor you believe in is the best thing you can do for yourself or for your mom. I am sharing my journey with you. Hopefully it will help her if she’s anything like me if she doesn’t say anything it means she is feeling OK if she gets a thump she may tell you it’s just a thump. Eventually they will get it all under control. I hope just remember there is no cure These are ways to control not fix. as I said, even my special pacemaker, I still get thumps and flutter the differences my pacemaker is in charge of my heart, so there is no damage being done anymore if the time comes about a pacemaker reach out if you want because I will tell you I feel I am a success, and I am very happy. I have mine.
Thank you so much for your support, it’s reading posts like these that give you some kind of hope. You are so accurate when you’ve mentioned that mum probably isn’t her usual self, I guess from your experience you can completely relate. Thank you for sharing your experiences.
you are very welcome reach out anytime. I am not in here a lot, but I do check messages and I will always respond to someone because people did that for me
When we first get this I think it is like any medical problem, it’s going to change our life and we don’t like it and it’s hard to get used to. It’s not so much having to do anything different because honestly things that we did that would trigger it we pretty much can’t do now. My doctor didn’t have to tell me not to go jogging because I couldn’t walk down the hall to the bathroom but it’s accepting all of this. That’s hard. I hit bouts of depression and I do now, but not as much. When we have failures which we will, whether it’s an ablation or cardioversion etc. we are going to get upset. No one likes failure. I had a serious problem with my cardioversion last year. When I woke up they told me and I cried. Had been hinging on it being successful, including a new medication. I mentioned to you and it was all off the table.I became very focused on dying something I have never done before. I worked law enforcement I never thought about death. I was too busy doing my job and living life. But that’s how bad a fib can affect you mentally and emotionally. That’s why I mentioned getting out of your head. Keep an eye on your mom and remember we can’t just snap out of it that’s not how our brain works. We don’t purposely get this way and I want to scream at people when they act like it’s something we’re doing that we can stop. I had depression and anxiety to getting a fib. Also, I have a typical flutter and had a typical a fib. It was more reason and more difficult to get it controlled.
I do believe attitude goes along way. I have always been a happy positive person. I like to think of myself as a cheerleader but sadly I couldn’t cheer for myself.
You are gonna be great for your mom I can tell that you and you’re learning about it. You don’t need all the technical knowledge. I learned so much from my doctor because he is also a teacher for EPs and I was a sponge soaking up everything because of the specialty pacemaker, I have, etc. The basics are good enough to learn, such as what might trigger when it acts up I mentioned ice cream Oh my goodness here comes the flutter lol but it’s not gonna stop me eating ice cream. I just take my time and deal with it. It’s not bad it’s just there.I finally got my glass of sangria again. It was good but I will say it’s not something to make a habit and it was only one glass filled with ice. Your mom will figure out whether it’s a spice or over eating which I find definitely will give me flutter yes flutter is a pain in the neck. It obviously does don’t want us to have fun lol.
I keep adding stuff like that in my post just to show you my attitude. They say don’t sweat the small stuff and it’s all small stuff. This is not a heart attack I am a very visual person. My EP refers to himself as the electrician and my Cardiologist is the plumber, so that is how I think of what’s going on inside. I compare my electrical with a string of Christmas lights. A bulb goes out everything goes out you fix it, and then two days Later, a different one goes off. Our ablations are not failing. It is usually another spot or they didn’t quite get all of it. My doctor would not do another ablation because of my scarring because he said you can be off just a millimeter, and the ablation will not work. He did not think it was worth doing that knowing the risk of not getting the spot was very high. It’s not the skill of your doctor. If you look my doctor up a Saini of the heart Institute of East Texas. You will get an idea of how amazing he is. I think he came out of the womb to fix hearts. He is so passionate about it. It’s why I love him. He was even on the TV show Jeopardy in college and won other fans of him have told me different things like this. He thinks outside the box like he did with me and sometimes he takes other people off because he won’t just do what everyone is doing if it’s not gonna work.
Beware that there are some doctors that do ablations and cardioversions like they are nothing and they are not nothing. Also watch the meds for your mom because they are not one size fits all. I was on multaq for quite a while. It’s not unusual for our bodies to get used to something so it no longer works the same way so now I am on Metropol sucrate and it was just increased a month or two ago. I don’t know how long I will be on it, I do know I will be on an antique coagulant most likely the rest of my life, although they are coming up with new things every day, so who knows. I have absolutely no trouble taking one of those. I don’t want to have a stroke, and the odds of having one with a fib are extremely high.
You are going to find a lot of good information here ask Bob I think he has answers just about everything
Good luck, hon. Tell your mom it’s not that bad I’m here this time last year I didn’t think I was gonna be and even my primary doctor recently said that he thought I was going to die. he can say that now because I didn’t and I’m doing so great. Obviously he didn’t tell me that at the time. It wasn’t a fib. It was the fact that my heart failure was so bad for so long. I had not known that since I was diagnosed, I have had tachycardia. I don’t know if that would’ve made a difference now I understand why my doctor in Florida would get me into the hospital so fast.
You and your mom can learn about all of this just don’t overdo it and make yourself crazy
Big hugs
Thank you so much for sharing your journey, and thank you for your support. I really appreciate you taking time out to respond.
What’s an acceptable rate? 
ecg on Apple Watch different to the red heart section 
If your heart rate is being controlled successfully with drugs does your heart still beat erratically?
A LITTLE CONFUSED
I need some advice about what to do
