Hi all, apologies for the very specific question but I ask it because I think there could be a definitive answer as opposed to the understandably frequent one that we're all different. I managed my loan paroxysmal Afib with various supplements and lifestyle changes but I eventually succumbed to a beta blocker. I take 5mg of bisoprolol a day. I read not so long ago that beta blockers can affect the way potassium is processed in the body and possibly lead to an excess and that potassium-rich foods ought to be avoided in the main e.g. bananas, avocado, and spinach. I pretty much cut these out my diet. They had all been a regular part of what I had considered a healthy diet. But the other day I read that taking bisoprolol can lower your absorption of potassium and a supplement might be needed! Blimey, totally contradictory information...
Last night I had an attack come on in bed lasting all night and still going now (11 hours so far...). It's upsetting/worrying me because not only have previous episodes been maximum 3 hours long (with one 7 hours) , I have had symptoms of being dizzy and lightheaded which made me quite panicky. I hadn't eaten anything by 10am not feeling hungry at all, and it occurred to me that my blood sugar might be low. I then ate some oatmeal with some banana, pumpkin seeds and almonds to try boost magnesium as well as potassium and sugars. Anyway, the dizziness stopped and I definitely feel better even though HR still up to 110 instead of 60. I will probably take another beta blocker if it doesn't go back to sinus rhythm soon.
Sooo, any opinions or knowledge to impart on potassium-rich foods with bisoprolol, please?! Would much appreciate any advice.
Also, thank you so much all the regular contributors here who have taught me so much. One of the many pearls of wisdom I have picked up is not to waste time going to A & E unless you don't feel well on top of the Afib. I'm back to not feeling dizzy or worried with no other symptoms apart from weaknesss and tiredness, but would anyone say I should actually go to hospital if the episode lasts longer than a certain amount of time?? (Oops, that's two questions)
I'll go to the doctor's tomorrow anyway. I was there recently with a list of requests and all were denied. He said that since I had no comorbidities and was under 65 (I'm nearly 62) he wouldn't recommend an anti-coagulant, an anti-arrhythmic, and said I didn't need a referral to a cardiologist. He prescribed an extra 1.25mg of bisoprolol as a PIP but it does nothing.
Many thanks, Julia
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i cant answer to everything else but are you taking blood thinners? My EPs are adamant that if my episode lasts five hours or longer then it is imperative I start blood thinners to avoid a stroke. That may be a reason to go to hospital to get them quickly…i hope it settles down soon.
Thank you for this and for your kind words. Heart finally back in sinus rhythm after 15 hours.
No, I tried to refer to the fact my gp said I did not fit the criteria for a blood thinner. He said the risks inherent in them outweighed my risk of stroke. But of course it looks like my episodes are getting longer now so maybe I will now be prescribed them. Thanks again.
Just to say I’m in persistent AFib and have been for over a year now but, as I’m 59 with no comorbidities I have been told the same as you with regards to anticoagulants i.e. not needed until I reach 65. This was the view of both the EP I saw on the NHS and one I saw privately, They were both of the view that the risks outweigh the benefits until I get to the magic age of 65🤷♀️I take a daily dose of Nattokinase, plus Hawthorn anyway, just for my own peace of mind.
As for your GP saying you don’t need a cardiology referral, I would respectfully disagree with that assertion, you do! It sounds like you may need an anti-arrhythmic to kick you back into NSR if your episodes are getting longer. Only a cardiologist can prescribe those drugs, not a GP.
Just as a point of information, in the early days of my P/A/F I was 56 and cardiologist did not want me to go on to anticoags so recommended I take 375 mg of soluble aspirin daily. To coincide with this, when I did have pixilating in the eyes, like looking through a crystal glass and my first sign I was having a stroke, I was admitted to hospital but before I went advised by the emergency doctor to take soluble aspirin. I believe to this day, 20 odd years later, that this saved me from having a more severe stroke. My hubby, who is 84, occasionally gets this pixelation and I give him soluble aspirin, itself a blood thinner.
Unfortunately the evidence available now has shown that aspirin is only of use to people who have already had a heart attack and it is never prescribed any more to anyone who doesn't fit that criteria.
A person such as @joolzj who is under 65 and has no comorbidities will only have a CHADSVASC2 score of 1 if female and 0 if male, which does not fit the guideliness for taking anticoagulants.
Even though many people find taking these medications very reassuring it's important to realise that they do carry risk and the risk of stroke with a CHADSVasc2 score of less than 2 is considered less than the risk that comes with taking anticoagulants. Like all medications it is a risk/benefit equation.
Oh, okay, that explains it. It's so funny how I'm invariably wrong about the gender of people online! If you don't mind me asking, how long have you been taking anticoagulants and is that what your doctor/cardiologist has recommended?
Aspirin since November, Eliquis I shall start tomorrow three weeks before the ablation.so I have never had an anticoagulants but my instructions were(by my EP) if I had another afib attack lasting 5 hours or more then I must start it then, but I have not according to my Apple Watch. Aspirin was originally given by my ER doctor, discussed and continued by my cardiologist and two EPs.
It sounds as though you are conscious about what you eat and this is laudable. A poor diet can certainly encourage poor health and an optimal diet is likely to promote good health. I think that this includes conditions like afib. No matter how diligent you are about this you will always encounter varying advise, differing opinions and general discord about what constitutes a robust evidence base for any dietary plan. Keto paleo, vegetarian, vegan, high carbohydrate with low fat, low carbohydrate with high fat. Paradigms change , it is difficult enough with the macro nutrients. It is very easy to go down a worm hole when you try to manage micro nutrients. I think that many people supplement unnecessarily.From personal experience I have come to notice that spikes and dips in my blood sugar levels seem to bring on an increase in ectopic beats. Some suggest that prolonged ectopic beats can precede an afib episode. Anxiety tends to exacerbate these episodes.
Sorry I cannot give any advice re potassium. I guess that whole foods probably tick the box.
I guess that your GP is following a protocol via your CHADVASC score which I assume is 1 due to your gender. Most subscribers to this forum support the use of DOACs as a means to prevent stroke. I take edoxaban, it gives me a degree of peace of mind. If you are concerned about this you could arrange for a private appointment with a Cardiologist. If he/she recommends an anticoagulant your GP is likely to prescribe it.
Thanks much for this invaluable info and advice. That's of note that changes in your blood sugar seem to affect your episodes... Perhaps the same with me. And yes, that's right with the CHADSVASC score. In terms of being refused a DOAC, I'm hoping it might be different at this doctor's visit since my symptoms are changing. Much appreciate your help.
I have the same with blood sugar. I have had episodes start with feeling really hungry and also after eating a too sweet dessert. Often an episode that has started the evening before will revert to NSR after eating breakfast. You should insist to your GP that you wish to see a cardiologist preferrably an EP 15 hours is a long time in afib.
I would actually ask your GP for a cardiology referral if possible, as you are very much entitled to that as you have Afib - and especially now as things are changing for you regards the episodes. I think you might need to insist if you get pushback. You will then have an echocardiagram at the hospital so they can see what is happening with your heart. A cardiologist can also prescribe other meds for you as well as, or instead of the Bisoprolol which may be more beneficial, including an anti Arrythmic such as fleconaide ( if your heart structure is ok) which you can take too when you get an episode and it can help you to revert ( called a PIP - pill in pocket)
Was it your GP who prescribed Bisoprolol? Did you go straight onto 5 mg?
At 62, if you have no other comorbidities an anticoagulant wouldn’t be prescribed for you until you are 65, is this the case with you?
As regards potassium, I have read the same things and contradictory stuff on-line 😳 however, I was on 2.5 mg Bisoprolol and I know my potassium levels did rise slightly, but they’ve e been about the same since being in 1.25 mg Bisoprolol. I do avoid high potassium foods still though, just in case, but it doesn’t seem to have done you any harm. I do take magnesium every day which I think has helped me a lot. Might be worth asking your GP to check your bloods, which should include your electrolytes which will show your levels? Hopefully they already do this fairly regularly for you 🤞
Thanks a lot for your support and encouragement to push for a referral. It's so easy to leave the surgery and think, 'Why didn't I say xyz?'! I did have an echocardiogram at the very beginning of investigations and it didn't show anything and yes I was refused a blood thinner because I was not yet 65.
My GP started me on 2.5mg of bisoprolol then, when the epsodes were increasing in frequency and duration, he upped it to 3.75mg and not long after 5mg which seemed to work really well till I had a wine-drinking night (had hardly been touching alcohol) and that seemed to trigger a whole series of attacks which just kept picking up a pace. I could be wrong and maybe my condition was going to worsen anyway but needless to say I cut alcohol out again. I feel a bit sad about it as most of my friends equate a good night with a 'good drink'. It seems to be more bothersome to them than to me if I don't drink! "Surely one or two won't hurt?" etc.
You are welcome 😊 ah, alcohol. I remember that with fond memories, I used to like a nice wine with dinner or a few on a night out too. Sadly gone are those days. It does sound like a trigger for you, so very wise to stay off it. Yes, I still get asked now “a little bit won’t hurt surely?” if we are out with friends. It’s been over two years now for me and I’m now partial to a zero flavoured gin and tonic ( though tonic can be a trigger for some , luckily not for me).
I think as things are changing for you with episodes, your GP shouldn’t and can’t refuse to refer you back to cardiology. To get seen quicker, you could go privately as another reply said. A lot if us have done that, I have too. It cost around £200/£250 a year or so ago, but may have increased slightly.
Always make notes to take with you, make them over a couple of days as they pop into your head. I used to take my Filofax with my notes in so I was sure of getting answers rather than leave the consulting room and thing OH I should of asked that!!!
I read your edits to your original post. Do please insist you see a cardiologist tomorrow. Your GP has to change his opinion - and remember GPs know very little about Afib. He isn’t able to prescribe you an anti arrhythmic so I don’t know how he doesn’t know you need one. Only a cardiologist can prescribe those initially.
Hi Joolzj. As Teresa says above, maybe you should ask your Dr if Flecainide would benefit you. (Here in New Zealand Dr's (GP) can't prescribed Flecainide, it must be prescribed by a cardiologist).With AF there are 3 main types if medications that can be prescribed.
Firstly a rate control drug, e.g Bisoprolol. These basically act to slow your rate down, therefore should slow your bpm down from 110 to a normal range of approx 60.
Secondly a rhythm control drug, such as Flecainide. This can be a daily medication or PIP, depending on your situation.
Thirdly an Anticoagulant, a blood thinner as we AF people are at a much greater risk of having a stroke.
Whatever meds you are prescribed, a cardiologist should monitor you as some people have side effects to them. Personally I don't have any side effects, and have been on them for about 4 years.
I'm on both daily Bisoprolol and Flecainide, and have just started an Anticoagulant as I am booked in for a touch up ablation in May.
I hope this helps for when you sit down with your doctor. Hopefully you get referred to a cardiologist.
In terms of Avacadoes, my boss owns an avocado orchad so I eat them regularly. I don't know if it is reducing the effectiveness of the Bisoprolol. In fact I'm on 2.5mg Bis daily, and my heart when sitting goes down to about 55, and when sleeping will drop to 45bpm, so it's doing too good a job at slowing my heart down.. I will be interested to see what other comments are. Hopefully someone will chip in.
Recently told by a cardiac specialist nurse to have a banana a day to increase Potassium levels as on Bisoporal and to counteract the loss of Potassium. As for alcohol whilst taking heart meds, read the contraindications on all as I think it is quite specific in stating no alcohol. With regards to your GP, as he is so adamant about your requests ie none needed, ask to see a different GP as is your right, failing that the next time you go into A/F lasting several hours call 111 for advice and/or go to a walk in centre, usually in a hospital and seek their help. Most of all, don't give in, stay strong, make a list of your questions for doctors, research the condition and learn more about it, you will find everyone on this group most supportive, we have all been there, and what we don't know we ask. Remember, knowledge is power!
First off- you're entitled to see a cardiologist and should have an echocardiogram to check your heart morphology. Your Dr is short changing you! I'm sure others here will tell you that keeping your potassium, calcium, sodium and magnesium in good order is advantageous. I have to watch my sodium levels for example, which are often on the low side. Like you I've also found blood sugar highs and lows can tip me into AF. More than once in A and E an AF episode disappeared after a cuppa md tuba sandwich. So eating light and nutritious during an episode I've personally found to be important for me.
I have been taking a beta blocker (sotalol) for 25 years and have never heard or read any statements about potassium retention. I have read that with some blood thinners (mainly warfarin) you have to avoid green leafy vegetables and similar things which can make the tendency to bleed more likely, but this not apply to apixaban.
I would be very interested to know where you discovered this caution about beta blockers and potassium. I have never seen it mentioned in any of the information about side effects and so on.
I take 5mg bisoprolol, an avocado every day with nuts on a bagel for lunch and i have at least 1 banana a day. Just had my routine bloods done all fine. So not a problem for me.
Joolzj. My Mum at 78 had a bad stroke after a few hours of afib following a pacemaker being fitted. She was taking warfarin beforehand and was told by the doc to stop it before the operation. They didn’t clearly explain that she needed to restart the warfarin afterwards.
I would stop worrying about these micro-nutrients. Truly. Your reading of one thing that contradicts another shows how hard it is to find truly useful and scientifically founded information on the Internet. The online world is too often commercialised, monetised and utterly bereft of common sense such that finding genuinely worthwhile information is becoming ever harder.
My advice: resume your heathy diet (be sure it is truly healthy by following NHS guidelines and avoiding all sites based on pseudo-science and nutraceutical nonsense).
anyone with afib should be on an anticoagulant is my understanding. I think you should change your GP if you are able I personally don’t think he is helping you much
it’s no consolation but I have had up to 5 weeks afib and tachycardia until I had a cardioversion eventually a pacemaker but it couldn’t cope with covid and a then a stress induced attack I know it was only to stop my heart rate going under 30 but it had been brilliant until the covid
Regarding potassium when I had another spell in hospital pre pacemaker although I was on bisoprolol flecainide apixaban anticoagulant , I was given a potassium drip so presumably the bisoprolol didn’t raise potassium level
With all of my tablets I was never told to avoid any particular food
my tip? Don’t accept no referral. Protocols have changed, advice is that new lone AF should be treated more assertively these days and not just handled by GP. Insist politely on a referral to a consultant EP Cardiologist. If necessary pay for a one off private consultation with one, preferably one with links to NHS. Good luck!
Hi Julia,I am surprised you don't have an anti- arrhythmia drug as PIP, because my understanding is that Bisoprolol has limited effect on arrhythmia, it is for rate control.
I think you need an appoimtment with a cardiologist. If the NHS wait is too long, it's not too expensive for a one-off consultation privately. Where are you based?
Hello Julia. I have been on beta blocker sotalol for almost 3 years. Thanks to this forum and the book the Afib Cure by John Day, I changed my diet to food rich in magnesium and potassium and become a vegetarien, gluten free, alcohol free,,eating non processed food. I eat avocadoes and plantains almost daily. My frequent afib attacks stopped. I have managed to stay afib less than 2% of the time and my afib usually only last a few minutes.Concerning the blood thinner,I am now almost 60,. My cardiologist called me a few weeks ago about putting me on baby aspirin, I just had a colonoscopy. Until then I had declined any blood thinner. A week later I noticed my right arm was very swollen with the veins out. I went to the ER and they found a blood clot in my upper arm between my pacemaker and the elbow where they put the IV for the colonoscopy. So now I am on blood thinner Xarelto.
Hi Julia, at present I am 16 months on from an ablation and haven’t had a ‘proper’ episode for 16 months. But when I was having them mine would generally last 12 hours or more, overnight. My heart rate was never above 112. My GP said I did not need to go to A and E unless my heart rate exceeded 130.
In the mornings I would force myself to go out with the dog as usual for an hour’s walk ( not easy after no sleep) and usually by the time I got home I was back in sinus rhythm.
hi, I was told when I first got AF abut 10 yrs ago, aged 65, that prolonged AF can cause blood clots so I was put on warfarin asap. As far as I know I had no comorbidities, so I assumed it was standard practice, perhaps that has changed 10 yrs on.
With what I know now I’d be challenging your GP Re: not prescribing an anticoagulant- I know a lot of people with no other health conditions and some much younger and all are on an anticoagulant which I believe is key to reduce the risk of stroke
I have been on Bisoprolol 10mg for a number of years and I also take a potassium supplement (Sando-K)and Magnesium (Aspardose) both prescribed by my renal consultant with no ill effects unless I forget to take the potassium and magnesium then I get tired then AF plays up. I am also on Apixaban but then again I have other underlying problems. I now try to be calm and stop worrying which really helps as does this App. Hope everything goes alright for you.
In my opinion, you should insist on a referral to an EP. In fact, personally, I would change my GP for a decision to not refer me to an EP after a diagnosis of afib.
As for the anticoagulant decision, it needs to be an individualized assessment so I do not necessarily disagree with your GP on that count. It is always a balancing of benefits and risks. An anticoagualant never brings the risk of ischemic stroke to zero and never carries with it a zero risk of a hemorrhagic stroke.
Drs only increase or reduce meds from heart cardiologists so no joy there.
I had a recommended private h/specialist who was interested and intrduced CCB Calcium Channel Blocker. Together with NZ Healthline, NZ Heart Foundation I have been on my personal meds for 2 years 3 months.
Now controlled with H/Rsate and Hypertension I remain on Permanent AF but it's not rapid.
No more sweating uncontrollable or exhaustion.
123/69. 60s day. My usual low h/rate avge of 47 at night.
And of course PRADAXA 110mg twice a day.
A ECHO show heart damage left for 2 years so no ablation, cardioversion or anti-arrhymic meds. Anyway I still feel ablations and scarring left for life is barbarric. Wait for a way that is much more proven to make a mark on your AF.
Some after find their heart goes too low, others BP too high and others find no change or worse.
Sorry I have not replied to a lot of these pieces of wonderful advice. I am in hospital. Thank you everyone for helping me. I have learnt a lot but for me it was too late as I had a stroke on Monday morning. I am more than upset that my doctor refused to put me on an anti-coagulant when my episodes started being 7 hours and I had an appointment specifically to ask for that. Huge lesson here for anyone else like me with no comorbidities and under 65…
I got up from sitting down, went dizzy, hands shaking violently, right arm getting numb, couldn‘t talk at all. Thank God my husband was there as he is often away. He called ambulance. About half hour later it arrived. I was assessed as having had a stroke. Could hold arms out ok. Scan at my nearest hospital in Truro. Brain clot diagnosed. Dramatic risks explained before I agreed to a thrombolysis treatment (hour long infusion). It can reduce major damage if given within 3 to 4 hours and can dissolve clot but pretty specific criteria e.g. can‘t do if high blood pressure etc. Still no speech after treatment. Red-lighted to Plymouth hospital - ´Derriford‘. Team of at least 10 people waiting for me in the operating theatre in the neurology department. Quick catheter then Thrombectomy (general anaesthetic and mesh up through groin to attempt to remove clot) carried out, my husband terrified waiting for the result.
Came round in recovery unit - nurse asked me my full name, date, and where I was and my speech and language had miraculously returned.
2 nights at Derriford, now transferred to Treliske hospital at Truro.
Physio all clear, OT all clear, consultant all clear but I‘m being kept in because as an inpatient I can have an echocardiogram within 2 days instead of 6 weeks. Have aspirin for 10 days until risk of a bleed passes then an anti-coagulant, been put on a statin as well even tho cholesterol ok. If echo clear, will be put on an anti-arrhythmic like flecainide which I‘ve been asking for since day one a couple of years ago. They really need to change the criteria…
Feel pretty traumatised but thanks again for you lot who have been amazing help. And wow we are sooooo lucky to have our free National Health Service… I‘ve never even stayed in hospital before but this feeling of having my life saved… I couldn’t speak at all for 7 hours and talking is my life being a teacher, actor, director. One of my siblings said that the angels were watching over me what with the timing of everything - the whole thing being done 9-5.
I feel back to normal now so it‘s like the whole thing happened to somebody else. The consultant said that my fitness and very healthy diet has been in my favour. But that‘s the end of the booze as I’m petrified of having another episode before I get the meds. Thanks again Julia x
Oh wow Julia, how awful- I’m so sorry what you’ve been through. But also grateful for the incredible care and timing of it all so that you’ve come through it like you have. Those angels were indeed watching over you. Sending love, and hoping you go from strength to strength. Jane x
Wow, I am so very sorry this happened to you. I am glad that the outcome was not as bad as it may have been, but a very traumatic experience for you. Maybe you can make a new post so more people will see and learn from it. Take care and I hope you continue to make progress in your recovery.
Hi, if you have someone who can take you to hospital, I think it’s a good idea to be there in case a problem arises. Also, just being there waiting to be seen can greatly reduce anxiety even if you only get to see triage and then come home. Bananas and avocados are high in amines and can trigger histamine and adrenaline which will trigger heart arrhythmias. I avoid all amines, worst culprits are all aged/cured food: meat, fish, cheese, fermented food, vinegars, dried fruit, beer, wine/cider, nuts, tomatoes, spinach, aubergine, yeast extracts, soy etc. Lists available online. Try to eat fresh food freshly prepared, not leftovers. If you are prone to allergies, the histamine/adrenaline connection could be the cause of your problems.
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