Fainting: I played 18 holes of golf and... - Atrial Fibrillati...

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Fainting

Pab1 profile image
Pab1
30 Replies

I played 18 holes of golf and came in with AF and pulse of 135bpm. This went on for several hours so I took 5mg of bisoprolol (I had originally been on 10mg per day but suffered lethargy and so my EP reduced it to 5mg per day). I take 5 mg first thing in the morning so this was an extra 5mg. In the evening out at a dinner my vision began to fade and I felt faint. I lay down on the floor with my feet raised until I felt better. But this then happened twice more and I was very close to passing out. My heart beat was irregular - my Apple watch kept saying 'poor reading' which it does when the heart beat is all over the place! Do you think that the bisoprolol may have lowered my blood pressure to the point of passing out? If taking extra bisoprolol is not recommended is there something else I could take?

Many thanks

Paul.

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Pab1
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30 Replies
Pab1 profile image
Pab1

PS. I already have a pacemaker which will not let my heart go below 50bpm

CDreamer profile image
CDreamer

TBH I think you did too much in one day plus if you took your extra 5mg whilst still playing golf and continued - you had two opposing forces. Our hearts and body tends to react like that when we do too much, especially as we age. Having said that, good idea to talk to your consultant. You did the correct thing by lying down with feet raised.

My husband cut his golf down to 9 holes in his early 80’s and that he could manage. If we do things during the day we tend to have a quiet evening. Trouble is our candle become much shorter as we age so burning at both ends shortens the candle even more quickly.

Pab1 profile image
Pab1 in reply to CDreamer

Thanks

mav7 profile image
mav7

Great advice by CDreamer about limiting your activities time.

Are you feeling normal now, heart rate and BP normal ? Inform your doctor of the event.

BenHall1 profile image
BenHall1

I'm not sure I properly understand your dosage you describe. Bisoprolol can be a tricky little number and from the way you describe it suggests you are taking it as a Pill in the Pocket. To the best of my knowledge Bisoprolol is a drug used for controlling HR but it does have some properties which can have an effect on BP.

From my observations on this forum it seems most people are prescribed it to be taken in the morning ( myself included ) I had some odd side effects and my GP then told me to take it at night. Sorted. After over 10 years on Bisoprolol my GP has now switched me to another beta blocker, Nebivolol.

I would be inclined to go back to your EP and ask for a review of this drug including best times of day to take it. You don't say, BUT, I wonder what other drugs you maybe on that might not like working with Bisoprolol. Fer instance, are you on other blood pressure drugs that work specifically on BP, i.e. Ramipril, Felodopine ?

When you take your HR is it only from the watch or do you use a BP monitor ? Looking at HR alone while not looking at BP seems to me to be creating a false picture. I never rely on watches/gizmos alone.

baba profile image
baba in reply to BenHall1

A blood pressure monitor is NOT a good way of checking heart rate or Blood pressure in AFib. And tells you nothing about heart rhythm.

bean_counter27 profile image
bean_counter27 in reply to baba

"A blood pressure monitor is NOT a good way of checking heart rate or Blood pressure in AFib."

Yes, getting reliable BP can be a problem using BPM and recommendation is to do manually.

However, using it to also check HR and rhythm has been fine on the ones I've used.

Our older BPM beeps with each heart beat i.e. confirming it's picking up my heart beat. It was the irregular sound when checking BP one time that first alerted me to having arrythmia. It was one of the main reasons I decided to go to ED, where I was hooked up to ECG and finally diagnosed with AF.

In addition, I now have a new BPM - an Omron HEM7361T, which is actually designed for people with AF and detects whether I'm in AF.

So it really depends on the BPM you have as clearly some are better than others when it comes to AF.

BenHall1 profile image
BenHall1 in reply to baba

Without wasting too much time ..... bean-counter27 just about says it all. My Omron Evolve tells me if my arm wobbles during a take ( giving details of a false or inaccurate reading so I can ignore the result ), also tells me when I'm in AF. I use readings as a guide if I get an AF reading then I'll switch to my Kardia. Bear in mind I am often asymptomatic. So I'd have no symptoms that I feel anyway.

Happily though I'm not troubled by AF now and haven't had an AF event for about 4 years - and no cardioversion nor an ablation either.

Pab1 profile image
Pab1 in reply to BenHall1

Yes I will go back to my EP

secondtry profile image
secondtry

I would be talking to my cardiologist.

One of the important lifestyle changes for me has been to moderate exercise and include in my daily routine x2 1 mile brisk walks. As an all round sportsman (good at none!) I would be lying to say there are no regrets but prefer an AF free life.

Pab1 profile image
Pab1 in reply to secondtry

Thanks

Ppiman profile image
Ppiman

5mg is quite a large dose, so adding in an extra 5mg (even though you had previously coped with this) might have reduced your pulse, and perhaps BP, a touch too far. I would make the family doctor my next port of call to be sure all is okay, but I would suspect the beta blocker.

I get the "poor reading" indication on my otherwise excellent Apple Watch for much the same reasons. I use a Wellue AI device now when that happens for a better analysis.

Steve

Pab1 profile image
Pab1 in reply to Ppiman

Thanks for that. Would be interested to know more about hotel useful you find the Wellue and do you then have to pay extra for analysis.

Ppiman profile image
Ppiman in reply to Pab1

That's the beauty of the Wellue compared with other brands. Once purchased, the truly extensive AI analysis report is free to use as often as required. I had a Kardia for a long time, and couldn't fault it as it's such a neat, practical and attractive device. I found it had several drawbacks, though:

- the monthly fee needed to stop the frustrating frequency of "inconclusive" readings. Wellue analysis is always free.

- the limited duration of testing of 30 sec to 5 minutes (but only a 30 second analysis). The Wellue works for from 5min up to 24 hours with continuous analysis.

- the "noise" of the finger readings. The Wellue has the option to use noise-free chest electrodes.

The Kardia is more convenient, though, although I have since bought the smaller Wellue, which, whilst not as pretty as the Kardia, is equally convenient.

The Kardia does have the option of an extra "lead", giving a more detailed ECG "view" of the heart, but it uses the single lead for its determinations (unless you send one off for further analysis).

Steve

Pab1 profile image
Pab1 in reply to Ppiman

Many thanks for that I will get one.

Ppiman profile image
Ppiman in reply to Pab1

If you do, I can recommend buying direct from their website as they always seem to have attractive discounts.

Steve

kitenski profile image
kitenski in reply to Pab1

Pab1 I love the Wellue, I'll try and put a screenshot or two into a reply

babs1234 profile image
babs1234

hi Paul I was told to have a pill in the pocket for times like this. I’m not a doctor but would have thought the faint feeling is more to do with the AF but could be wrong. I only take 1.25mg but thinking I should be on a higher dose now. Exercise usually triggers mine. Hope you get it sorted

Pab1 profile image
Pab1 in reply to babs1234

Thanks

Cavalierrubie profile image
Cavalierrubie

lt is possible to pass out with AF., but if you have never done that before, then l would think you pushed yourself too hard and overdid it. Bisoprolol does lower BP and HR and you did take a large dose, so could be a combination of the two. Whatever caused it, l would be inclined to inform your GP for his opinion. Better safe than sorry.

Pab1 profile image
Pab1 in reply to Cavalierrubie

Thanks I will go back to my EP

Ant74S profile image
Ant74S

hi I’m on motoprolol I feel the same way

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Ant74S

Hi

Metoprolol gave me pauses! D have a 24-Heart monitor to check it out.

cheers JOY 75. (NZ)

Pab1 profile image
Pab1 in reply to Ant74S

Thanks

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Sounds like your cardiologist should consider CCB e.g. Diltiazem lower dose or 120mg like me.

BP meds should be taken at night to cover the early morning peak times. I take Bisoprolol 2.5mg PM.

Diltiazem 120mg AM.

Now I read you have a Pacemaker.

cheri JOY. 75. (NZ)

Pab1 profile image
Pab1 in reply to JOY2THEWORLD49

Thanks I will go back to my Ep

Ersilia2 profile image
Ersilia2

Better check with your Doctor, we’re you allowed to take an extra tablet when needed? I’m taking 5mg every morning and feel lightheaded every day.Hope you’re feeling well today.

Pab1 profile image
Pab1 in reply to Ersilia2

Thanks

TopBiscuit profile image
TopBiscuit

Personally I can't tolerate Bisoprolol at all - it does exactly what you said and makes me very light headed to the extent I have to lie down and raise my feet. I think it lowers my blood pressure, as you say.

You should talk to your doctor but yes, there is an alternative. You could have Flecainide to hand as a PiP, but that would have to be prescribed by a cardiologist. A GP can't prescribe it.

Pab1 profile image
Pab1 in reply to TopBiscuit

Thanks to everyone who has written. I will take the advice given. I will also contact my EP and see what he says.

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