Background is I had 2 ablations in 2019 but Afib started coming back in 2021 so I was put onto flecainide and bisoprolol. The flec ended up causing more issues but since stopping flecainide and staying on bisoprolol I've been doing pretty well. I was on a very low does of 1.25mg daily, I had an occasional bout of Afib, (usually post exercise) which a second dose seemed to settle very quickly.
However I just couldn't cope with cold fingers and toes, tried all sorts including heated socks/gloves, wearing 5 layers and everything in between!
So I am trying carvedilol, been on 3.125 twice daily but still getting A Fib episodes almost daily, had one today after walking the dog! I'm going to try 6.25mg carvedilol in the morning.
I'm aware that carvedilol isn't an anti arrhythmia drug.
Just wondered what alternate anti arrhythmia drugs other UK users are on?
I guess the other alternative is a 3rd ablation, but I have a ski touring 6 day trip booked in Norway in April as a bucket list item so no chance of any operation before that so need to find a drug that works in the next 6 weeks!
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kitenski
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Hi Kitenski. I didn't react very well to either of those drugs, so was taken off them and prescribed Sotalol which combines the effects of the two. I've been on 40mg twice a day for several years now. At first I was taking it 3 times a day, but was soon able to reduce it to twice. I get cold feet very occasionally but not cold hands. Daft as it sounds, my feet are colder in socks than without! I wear sandals for 3/4 of the year and they are fine.🤗
I didn't as I felt so awful at the time. I've looked since, and most medication side effects look scary, so just judged it by how I feel. I've been ok though it doesn't stop my afib sessions, but it makes me feel ok inbetween them. It's a balancing task I'm afraid.
I do. Nothing I have taken has ever stopped them. I am not suitable for an ablation, so I just have to put up with them. Life is good inbetween. Always look on the bright side of life! I recently watched Life of Brian again .😅
hope things settle for you soon. My cardiologist also uses Sotalol for some of his patients who do not tolerate Flecainide, it’s a type of anti arrhythmia drug and beta blocker in one. I’ve had no issues with Flec or metoprolol so not tried it.
I have found daily brisk 1 mile works am & pm helps. I then read hands & toes get cold because the middle body/heart is not warm enough so the amazing machine that the body is redirects blood to the vital organs leaving you with cold extremities. So I wear inside 4 layers and outside another one. Seems to have worked well in my case.
on bisoprolol I was walking the dog every morning, about 2-3 miles, with 4 layers on, hat, gloves, woolen socks etc etc! Still got cold, much better on the carvedilol (touch wood)
Diltiazem does a similar job and like bisoprolol has a mild anti arrhythmic effect depending on what sets your AF off. But does cause cold feet unfortunately. The alternative to Flecainide is Propafenone but it can also cause issues.
Hi kitenski, I am afraid like many myself included you may find every medication can have a drawback and we have to accept that for the 'greater good' of our health condition.
I take the betablocker Nebivolol and have cold legs and feet but accept that knowing the BB is helping my heart . I also took Flecainide a couple of years ago and found it made my AF episodes longer and more frequent and when not in AF made my heart rate too low and fainting meant I had to stop it . Now Flecainide is my friend supporting my recent ablation and keeping my in NSR with no discernible issues .
So if it was me and as you say ''staying on bisoprolol I've been doing pretty well'' I would accept the cold feet and hands which I find is not so bad in the summer anyway .
I have been told not to expect a perfect treatment for AF , to see as a bonus anything that reduces the incidents of AF for a length of time or improves the symptoms and quality of life...
thanks doodle68 I enjoy skiing and walking in the Lakes/Yorkshire dales with cold temps, which really become impossible with bisoprolol!! Even with heated gloves and socks, and I've not even been out recently in "proper cold" conditions!
The trouble with ablations they should not be done lightly. Cause they freeze or scar to stop AF or try to. You can't get back what your heart is made up of.
No I'm not a Dr but I use my experience in my life to guide my interest.
Ex nurse.. who keeps up the learning, research etc to help others.
2019 brought a Embolic Stroke with AF and within 4 days the Carotid scan showed a shadow on my Thyroid. 3 operations since Stroke for various reasons - Thyroidectomy plus 12 lymph - 2 infected Papillary cancer, sling TVT Johnson & J removed & Right Shoulder inner cuff done Oct 2023.
Now I'm being recalled for CT Scan as legion in Level 3 in the recent Neck Scan.
I do think some on this Forum will talk to you about Pacemakers as they get your whole medical picture.
I would have liked to see an avge Day and Night Heart Rate.
At 47 avge Night H/Rate I awake with COLD SHOULDERS.
There is a range with exercise/activity which wouldn't go UP as HIGH as your H/Rate for your age. If you go online and put in your age and what your heart rate should go up to might first make you concerned with your high heart rate with activity. At 185avge Day on Metoprolol meant side effects of pauses at night, excessive sweating, couldn't exercise or exert as headed for a lie down with no energy. With no followup and Dr wouldn't change me off it (I didn't want it over history "Breathless". Just reduce it.
I demanded a Heart Specialist and a Hospital carried out 2 x24-hr H/Monitoring in 2021. Changed me to Bisoprolol. H/Rate dropped to 156 avge Day.
That Specialist ignored my "still no quality of life".
A Locum came aboard who has suffered AF.
Would I go private and see Dr W... I considered and turned up there. He had results of 2021 ECHO, ECGs, Monitoring. History to him was important. He found my H/Rate at rest 120 plus.
He gave me CCB Diltiazem 180mg which was too much and the report said I could have up to 360!!!!
Within 2 hours my 120 plus came down to 51.
It is very regulating because my 47avge Night never changed. Stayed there and even though I have the 120mg early morning and Bisoprolol 2.5 PM.
My guess that the ablations may have brought down your H/Rate to 30. Cold extremities point to LOW level.
30 is too low even at night and if you still have AF that is another risk.
I feel you need someone interested in you. All history! Before and after ablations, when you get AFs, Persistent, rapid etc. From the stroke and diagnosed with rapid and persistent (which means long term but could be controlled on meds).
Ask Dr and others who is the best.
What did your ECHO show? Mine early 2021 enlarged heart, severe dilation Left Atrium, RVentricle regurgitating -apparently they go together. Over time Bisoprolol may sort it.
My Locum says, but back to Hosp H/Specialist laughed.
Hope is a wonderful anti-anxious positivity. Guess who I enjoy better but she left December when the pressure was put on her. 15mins each consult and 45 patients a day. She is in her 80s dear sole.
My last 24-hr H/Monitor showed a positive change in H/Rate to control. No pauses with Bisoprolol/Diltiazem.
I have been discharged to monitor my own meds. Too many on the waiting list! This Specialist back to public reported the under prescribing of controlling my AF Heart Rate.
Damage has been done.
But ECHO 2023 before my R/Shoulder Operation shows that my heart has become normal size!
I understand that a pacemaker would stop your heart from going under say 40 when you are asleep. I think it could stop your heart from over say 150 during activity.
Maybe moderate your activity. Inflammation can be produced in your muscles and cause AF. After a day of competitive outdoor bowling, at the Urologist appointment they found blood in my urine, that Specialist said it can happen after exercise.
But it may have been the TVT Sling which was removed later than 2017.
It is important to know that any level over 100 for H/Rate at rest would not allow you to have any operation.
Just in time for March 2022 my H/Rate was controlled.
I hope this helps. It would be interesting to know if your Low 30 at Night was a result of an ablation.
I’ve never had a low 30 HR reading? JOY2THEWORLD49
Apple. Watch says 38 which I take with a pinch of salt! I’ve given avg day and night rates. The whole max hr minus age has widely been debunked as been incorrect.
I’ve had two catheter ablation with heat as far as I know.
My high HR is atrial flutter .
I’m sorry but your reply is very confusing, I’ve not seen resting HR over 100
It’s.true the nhs in the uk won’t invest in a specific person but I’m sure i can get this under control by seeming data and asking questions
If you have to get up in the night do you get dizzy? shaky?
They say it's how you feel.
How is your AF H/Rate assessed? 2 types, persistent or comes and goes.
A friend too had 1 ablation your type. He had it for years. They found he had 2 different areas firing so both were dealt with. He is AF free with 2 years behind him and he was on 5 different meds.
Did you have a Stress test, or Sleep test- sleep apnea?
Just only through the various pointers.
As a fit athlete, folks go low in BP (yours is v good) and low in heart rate.
Combinations make it more difficult to control.
I guess the specialist will solve levels for you.
But you can see that low h/rate does cause blood not getting there so you're go cold. What happens when you exercise your feet and elevate your feet whenever possible.
When all avenues are covered until research comes you will live with it.
Bisoprolol you could get Dr to reduce further as your BP is good.
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Has anyone ever been told that ablation will not work for them?
