Hi I suffer from Paroxysmal AF. I have been taking Rivaroxaban for 2 months.
I saw the cardiologist and he has started me on 2.5mg Bisoprolol daily. I took my first dose at 10am and by 2.30pm my Heart Rate had dropped to 50 bpm.
My question is to others who take Bisoprolol for rhythm control and who may have experienced bradycardia...how low has your heart rate been that was acceptable to your cardiologist?
Hi, my understanding is that bisoprolol is a rate control drug and for some can be a mild rhythm control. A small dose definitely makes a big difference at first. My resting HR was in the 50s while NSR before bisoprolol and 1.25mg dropped it in to the 40s. In my experience you do adjust to it in time as your body gets used to it. It’s all relative to what your HR was before.
link to b-blockers info sheet api.heartrhythmalliance.org...
Best wishes
On Bisorolol 5mg my resting hr was down in the mid 40bpm. It would increase with activity up into the range of 60 to 100 bpm.
You need to let your GP or consultant know that your heart rate dropped to 50bpm, some people can have that low rate naturally. Your dose of Bisoprolol might be decreased or the experts may think that rate is of no concern but please you must ask them.
Usually I'd say that around 40bpm is when the experts get concerned. It is important that you let them know of your 50bpm. None of us on this forum are experts but gain a little knowledge from our own experience with AF. Our hearts when in AF can beat very differently to that of others and it's only by an expert having seen exactly how yours is beating that a conclusion on what medication may help can be formed.
Jean
Mine goes to low 40s regularly during the day and sometimes into the 30s while sleeping. Doctor said the only time this would be concerning would be if it was accompanied by symptoms of dizziness or chest pain.
Hi
Bisoprolol for me was BP control.
Diltiazem CCB for me was H/Rate control and it helps with rythmn control.
I found 51 bpm scary and had the Diltiazem reduced to 120mg AM. Also the Bisoprolol down to 2.5mg PM.
You are probably better to take your BB Bisoprolol at night to cover you over the peak BP at very early AM.
It's how you feel rather than being aghast at the numbers Cat.
Cheri JOY. 75. (NZ)
Thank you. Yes I will try taking it at night. Good advice.Later yesterday my HR dropped 5.5 hours after taking bisoprolol to 44 bpm.
I tried to contact the consultabt and xardisc nurse but to no avail. I was considering ringing 111 but I didn't feel ill with it. Not dizzy so planned to contact 111 if it dropped further.
I will speak to my GP today.
Thanks
Hi
It does point to the Bisoprolol.
Surely ringing your Dr could get you halving it but you would need a pill cutter.
And yet it did not get my h/rate down lower than 154!
5.5 hours is a long time.
Are you taking any supplements? Sometimes these can make meds more potent.
cheers JOY
If she gets the heart shaped Biso pills you don't need a pill cutter, they Break in half easily. Here in South Africa the lowest strength Biso pill available is 2.5 mg and I take 1.25mg. Apparently there is no brand available here that is not heart shaped. I take Cardicor by Merck - perhaps she could ask for hem as they half easily by hand .lol. lol.
my HR has dropped to 39 but then shoots over 100. Going to make an appointment today as very concerned
What was your usual resting heart rate before taking Bisoprolol ? I had short runs of Tachycardia and my Bisoprolol dose was increased. This drug is primarily to reduce rate not control rhythm, although it can have some effect on that. My resting heart rate is now anywhere between 50 and 65. GP says it’s all about how you feel and as long as you don’t feel faint or have chest pains you are OK. However, as as been said on this thread, it’s best to mention it to a medical professional. It would put your mind at rest anyway.
Annie.
Thank you Annie. I will ring gp today.
as said bisoprolol is a rate control meditation. Saying that I’ve a few arrhythmia’s including paf. I’m on bisoprolol which lowers the rate and can make it more difficult for the arrhythmias to breakthrough ( as explained to me by my EP). I was on 7.5mg but due to side effects had in lowered to5mg divided into two doses. Which is apparently better for 24 hours dampening effects 🤷🏼♀️. I’ve had a 5day monitor to check if 5mg was enough of a dampening effect so the arrhythmia’s don’t cause too much burden on my heart . It’s working well for me
As for heart rate it goes down into the 40’s at rest but responds well when I move. At night it was recorded at 38 on short occasions, as I’m not symptomatic the consultant is happy with that .
I’ve had a heart attack so rhythm control drugs wouldn’t be the right thing for me anyway as I’ve got some muscle damage.
Good luck with things
My pulse dropped into the low 40s at times with 2.5mg bisoprolol, but I was told that unless this causes symptoms, it was perfectly safe. I now take 1.25mg daily, and the lowest I have recorded is 46bpm, I think.
Steve
Only suggestion I can bring to the table would be to ask whether you are getting Ectopic Beats. Ectopic beats will cause your HR checker to report low and appear as a missed beat if you are checking your pulse. If you are in NSR then, I believe you drop 10bpm for most beta blockers.
Here's my take on it. Doctors, amazingly, don't seem to ask what your normal levels (HR/BP) are. Maybe most people don't know?
Personally, I track my HR & BP and when I saw a cardiologist about a year after my PAF started he prescribed me 2.5mgs of Bisoprolol without any questions. My normal resting HR is in the 50s without medication, going down to mid 40s and lower at some point during every night. Knowing this I halved the 2.5 mg Biso and an hour later I had to lie down for several hours, I felt so light headed, nauseous & dizzy. Even taking it as a PiP it doesn't work for me as it seems to take quite a while to kick in, by which time my HR is back down to reasonable levels anyway, and then it seems to stay in my system for hours after I actually need it.
None of this may be applicable to you, but I'm just suggesting that the prescribing of these meds seem to be a bit of 'one size fits all' unless you tell them otherwise, so don't be afraid to speak up. I personally can't see any reason for prescribing a medication that puts you into low HR or BP, unless they are unable to find an alternative that does the job without the unwanted side effects.
I started on 1.25mg then 2.5mg. At the beginning my HR was dropping to around 45 overnight on my watch. 6 weeks late only dropping to around 52. 9 months later only around 60. 2 years later now been asked to titrate up to 5mg due to a dangerous VT and ICD intervention. Now the same all over again....They know in time you level off a bit reason for the larger doses all the way up to 20mg. This amount is rare and most only ever go as far as 5mg due to side effects. But these even go with time if you persist although at times I think Bisoprolol side effects can make you feel a bit miserable in the beginning while you adjust.
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