HiAs the last post I am concerned re my body's reaction to the first dose of Bisoprolol 2.5mgs as my HR has dropped to 44 bpm. ( thank you to those who replied).
But my next question is why would the consultant tell me to start the betablockers when the 2 week monitor has not been fitted yet? In fact I don't have a fitting appointment yet.
If the consultant wanted to get a better picture of what my heart is up to, I would have thought that the monitoring came first before commencing betablockers?
He did say that the 8 AF episodes that I was aware of must have been severe ones so thinks I must have had more than 8 ( since Mid November 23).
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Cat715
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Hi Bob. Yes of course yet why then do a 2 week monitoring of my heart. Thinking it wouldn't show AF if protected by Beta Blockers and if not, why do it?
Why would beta blockers not allow AF? They are to keep heart rate down when in AF not stop it. Anti arrhythmic drugs like flecainide are designed to prevent AF.
This question should really be directed to an expert like your consultant. You could ring his secretary or AF nurses and see if they could ask him, They would probably have to get your notes or look at your online records to see your history. We can only make wild guesses with the little information you have told us.
Did you go to hospital when you had your AF attacks and do you know how many beats per minute your heart was doing? Did you feel ill in any way when having them?
Do you yourself have any device that records what your heart is doing now?
We all panic a bit when first told we have AF because consultants don't generally have the time to explain to us all we need to know.
I can tell you now that in general AF doesn't kill people. I've had it for 19 years and in my early days spent quite a bit of time in hospital when I had severe attacks. Now I lead a fairly normal life with the aid of betablockers.
Does you consultant know when you had those 8 attacks? Uncontrolled AF if left at a very high rate can cause the heart to enlarge, so that is probably why you're on beta blockers to prevent that from happening. Just guessing really as we are all so very different with our symptoms and the effect they have on us.
Wishing you well, feel free to ask any questions. We will do our best to help but as I said we are not professionals and can only guess at a lot of things which is not generally a good thing to do.
Thank you Jean.Well yes the consultant does know about the 8 episodes that were captured on my scan watch and agrees it is AF. I felt ill yes, I was lightheaded and fekt a sense of dread as my heart felt lije it was beating out of my cgest and my scan watch showed the HR bouncing down to 40 bpm up to 180 bpm. The ECHO showed a dilated left atrium. The 24 hour holter didn't capture AF but the chances that it would were slim due to the epidodes being intermittent.
I had my first consultation with the cardiologist and as you say its all very brief but he said if I couldn't tolerate betablockers it would be surgery but he wanted me to have a 2 week monitoring device fitted.
I started the Bisoprolol yesterday and then thought yes this is to prevent further episodes but then why have the monitor fitted whilst on bisoprolol. Thinking it maybe should have been that whatever is happening to my heart would have been better captured before BB.
Its reassuring Jean that you have had AF for all those years and ok.
Now that you have told your complete story, know that we all understand just what a hateful condition AF is. For the first 10+ years of having attacks I fretted about every attack I had. When they happened in the middle of the night and my heart felt like it was trying to get out of my chest I used to think I'd be dead by the morning. I'd text my youngest daughter to say 'check on me in the morning please'. As soon as she switched her phone on she would call me and by then I was usually back in normal sinus rhythm.
I then discovered that certain foods could trigger an attack if they contained artificial additives. I'd been eating all sorts of things that contained artificial sweeteners, thinking that I wouldn't get fat and they were certainly a trigger.
I took note of what others on this forum said about food triggers and over time my AF became so much better. Two surprising things I was told to stop eating by a member here were porridge and yogurts. Did as I was advised and yes felt so much better. I asked in my health food shop what I could use for breakfast instead of oats and was told rolled buckwheat, now I make a hot muesli style breakfast with rolled buckwheat, organic sultanas, dates, pumpkin and sunflower seeds alongside a little ginger or cinnamon powder. I use lots of milk and cook it in the microwave for 2 minutes take it out and stir and then back in for another 2 minutes. I feel so much better and can lead a fairly normal life again.
Also, I never used to sleep well on a Sunday night and just put it down to having work next day. but the surprise was it continued when I retired. I wondered what was different about Sundays - roast dinner day! Yes, the gravy powder I was using was the cause, it was full of additives. I now make my own gravy and no longer have the problem.
Don't wear tight clothing anywhere around your torso it can put pressure on your internal organs that are near your heart. Also try and cut down on your meal sizes. If needed lose weight, doing that is known to reduce AF attacks greatly.
Wine and many other drinks contain sulphites and for several people on this forum, including me, that can trigger AF. I can usually get away with one glass. Try not to slouch when you are sat watching tv or on the internet, it puts pressure on your stomach which is near your heart and your heart will complain with odd beating.
Hope this information will help you like it has me.
Starting off, I was left. Too high H/Rate day avg.
When I demanded a Heart Specialist I was lined up with ECG, and 24-hr heart monitor. On Metopolol.
Found 185 avg,Day couldn't exert. Night 47 avg with pauses.
Changed to Bisoprolol and told that Dr can up and up it.
Within a few weeks ECG, and 24-hr Heart Monitor.
Under Bisoprolol Monitor 156 avg Day. Night 47 avg NO pauses.
LEFT.
10 months still uncontrolled. Dr asked me to go private.
Private the interested Heart Specialist introduced CCB Diltiazem 180mg whilst still on Bisoprolol. And forward thinking I reduced the 5mg x twice to 5mg once.
Within 2 hours H/Rate reduced to 51 within 2 hours.
A weekend I rung our NZ Healthline and got the Dr there. She told me to reduce the Bisoprolol further.
By Wednesday with me still dropping to 51 I rung the NZ Heart Foundation.
This nurse had worked with my Private Cardiologist.
She rung him and my Dr and my prescription was altered to 120mg. She also warned me to separate a CCB and BB.
So for the last 2 years I have taken Diltiazem 120mg AM for H/Rate to control and down to Bisoprolol 2.5mg PM for BP.
47avge Night no pauses stays the same and the Private Cardiologist asked public Heart Cardiologist for her to do another 24-hr Heart Monitor.
All was well.
Done so it does take time how ever you want it to be and I feel for you.
Be patient, check in with your medical staff as you go through the journey. Tell them of your fears.
That's a good question, and does seem rather counter-intuitive, but I would trust that the specialist knows well what is best for your particular case having examined you. I found 2.5mg of bisoprolol slowed my heart to a similar level although it wasn't symptomatic (or I don't notice) and now take 1.25mg. each morning.
Hi I have managed to contact the consultant cardiologist and he tells me that when my HR is low ( it was 44) if asymptomatic uts ok, if not to halve the tablet. I will consider halving if become symptomatic or HR goes even lower. Thanks for your reply.
I would halve it and see, having been given that advice. It would depend a bit, I would be thinking if I were you (and I went through a similar thing) whether the slowed heart bothers you psychologically, too. When I went to 1.25mg, it didn't make a vast difference (just a few beats increase). I don't like to see a rate below 50bpm, myself - just a feeling, though.
Bisoprolol is available as 1.25mg, too, to save splitting, if you stick with the lower dose. I think the effect of bisoprolol is different in some people, and I have read that the dosage isn't linear in its effects. The trouble with treating arrhythmias is that the condition waxes and wanes so much that it's hard to know if a treatment is working or just that the illness has gone away for a time.
Well Cat, I'm sure you appreciate that all of us are different so my comments might not apply to you in the way they do to me. When they first discovered my a-fib I also had Brad a cardio I was immediately put on one point two five of by soprolol and that prevented my heart from going to high for stop however at night my heartbeat fell to as low as 38 39 which was very worrying and the halter monitor showed the same pattern. My consultant said it should settle itself and indeed it has. One year later my heart rate rarely falls below 58 even at night. Mind you I have completely stopped alcohol so that might have helped stop
The above comment got posted too quickly! Here are a couple of corrections. Bradycardia. Bisoprolol. Remove two words of "stop". Hope that helps and is understandable!
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