Hi all. First post here and I wish you all well.My story:
55 year old male. Overweight and desperately trying to change that! 6 ft 2 inches and 17 stone 7 currently.
Diagnosed with AF after a bout of COVID in April 2022. A period on apixaban and bisoprolol and then a successful cardioversion in August 22.
My heart remained in normal rhythm for just under a year, and my AF returned June 23. Another cardioversion restored rhythm in November 23.
Currently I am in normal sinus rhythm.
6 weeks after last cardioversion I stopped taking apixaban, and my medication was 5mg bisoprolol daily.
As I said at the top, I'm trying to get fitter. I have joined a gym and regularly play badminton at high intensity.
I believe the bisoprolol is making breathing difficult and struggle when playing sports. I also find mid afternoon I get bad fatigue at work. To the point I feel I will fall asleep! At this point my heart rate is between 45 and 55. My average resting heartbeat is around 55 to 60 daily. Blood pressure high side of normal, usually around 130 85.
Doctor has just reduced my bisoprolol to 2.5mg daily. Very little change in BP and heart rate.
Apologies for the long message, and here is my question... Is it feasible I can come off bisoprolol completely? My heart rate is good. No afib. Blood pressure is getting better as my weight drops. Does bisoprolol actually help the heart beat in good rhythm or am I on it purely for heart rate and BP?
Many thanks in advance.
Tony
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Jacko68
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It is feasible, however, it is wise to do so very gradually and in consultation with your doctor. Be prepared for some effects, may not happen but some people experience withdrawal symptoms.
Know that the dreadful symptoms of Biso, which for me were worse than the disease, do pass and I can’t tell you just how much better I feel for not taking any of the meds! Good luck.
Thank you. Yes I was grateful to get back in rhythm and stop all the feinting feelings, but bisoprolol comes with it's own set of issues. Appreciate the response 👍
Bisoprolol is a heart rate controlling medication not a rhythm controlling medication.
Please talk to your EP as we are not medically trained and everyone is different.
I can tell you I was on Bisoprolol and Flecainide (rhythm control) but my EP stopped the Bisoprolol because I have conductivity disease causing a slow heart rate. The Bisoprolol was slowing my heart too much even at 1.25mg a day.
Totally understand. Was more asking whether biso actually keeps afib at bay. Or just there to drop heart rate and BP. Both are pretty good for me so am hoping to drop biso altogether, but wasn't sure if that would bring the afib back quicker.
Thank you all. Your responses tell me biso is a heart rate controlling drug, not rhythm monitor. I will discuss with doctor, keep monitoring BP and rate daily, and try to come off slowly. I'm on the books for the ablation, even though I am in normal rhythm currently. Apparently I'm a good candidate for it. Fingers crossed!! Take care all, and thanks again
Good luck, hope ablation is helpful for you. Be sure to read the ‘recovering from ablation’ leaflet from the AFA which Bob and a few others who actually have had ablations helped to write.
Have you been checked out for sleep apnea? Afternoon sleepiness is a classic sign and with your weight and age it could very well be an issue. If in fact you do have sleep apnea, getting that under control could really improve your energy levels and help with the Afib.
I second getting checked for sleep apnea. Had afternoon sleepiness for many years and saw this as my new normal until tested for sleep apnea and treated for. Energy levels greatly improved and markedly less afternoon sleepiness.Wished I had known about treating sleep apnea 2 years earlier as was thinking it was all related to my cardiac medication. Do get checked, you have nothing to lose!
Sleep apnea check.For 4 years I thought tiredness was related to mitral valve repair.Got treated for sleep apnea and overnight felt more energy and no longer sleeping in afternoon.A game changer.Please get sleep apnea assessment at earliest opportunity.Wish I had!
I’ve had a few cardioversions, the first in 2022 I went on for nearly a year and removed from all drugs after the initial 4-6 week period. Then 9/2023 another CV and did same protocol then stayed on Metoprolol which is similar to Bisoprolol. The Cardiologist suggested it wasn’t so much for HR control rather to tamp down the adrenaline spike which can sometimes kick off my AF.
I was on the equivalent of 1.2mg of Biso so not much. I self reduced as my HR was getting into the 40’s I took it down to about .8mg which he suggested was almost a homeopathic dose! Fast forward to 7 weeks ago and I had another CV. I’m now back on about 1.1mg equivalent of Bisoprolol twice a day.
Basically everyone is different and it’s work in progress finding what the right balance is. I’m fortunate to have a doctor who works a bit with me. He also added Flecainide and when combined with the Metoprolol took my HR down to early 40’s. He’s adjusted that now down to about 20mg.
You’re doing great losing that weight with exercise. Bad diet is also very important and one of the triggers of AF. Alcohol and caffeine are also triggers.
I can only speak from personal experience but I was in a similar situation . Two ablations have made my PAF very infrequent with short lived episodes. I found my dose of 1.25 mg of Bisoprolol brought my HR down to mid 40’s which left me feeling very tired so with the agreement of my cardiologist I used it as a PIP at the onset of an episode of AF only . Likewise with Amlodopine , once I was put on statins I found my blood pressure fell to a point where I felt unsteady so after speaking to my GP we agreed to stop them and monitor my BP daily for a month . The statins seemed to bring my BP (138/78) on average down to a healthier (124/78) average so I have not taken them since but take a reading weekly to keep a check . As others have said it’s an individual experience but I’ve always involved the professionals along the way. My latest change was stopping Omeprazole( taken for over20 years) and replacing it with Nizitadine which has been successful . That was after listening to advice from this site (Bob and others ) regarding the long term use of PPI’s and again after chatting with my GP . It’s always worth considering your medication and challenging the benefits verses the possible drawbacks . Good luck
I was on just 1.25mg Biso per day, but even that made me want to spend the afternoon sleeping! As I am asymptomatic and pretty stable, I asked my cardiologist, if I could take the Biso on a 'as needs basis' - he was quite happy with that- so I take my pulse daily and if it's into the 90s, I take my half a pill (here in South Africa 2.5mg is the lowest pill size available). I would, however, never give up my anti-coagulant. Having tried others, I am happiest on Xarelto !
It seems you have a chronic desease if it shows up again and again. I wouldn't stop without my doctor.
I stopped Bisoprol after 4 weeks and it was horrible. Even though I widraw gradually as my doctor said (2 weeks 2,5 mg, 1 week 1,25 mg and half of that the last week) and I had High heart rate, high blood pressure, I felt that my heart is exploding, dry eyes (I still have them after a month).
Now I have a normal heart rate and blood pressure but I don't know if it returns. I try to mentain my BR and HR under control with sport and diet. Also avoid stress. And Q10, omega 3, potasium, magnesium and hawrhorn tea (good for BP, HR and clean your blood - colesterol). Hope it works. If not, I will go to my doctor to take pills again.
Bisoprolol reduces heart rate and does nothing to stop the irregularity which is the main problem! The lowest dose of 1.25 mg was too much for me to take daily but I am female and have never been overweight. Flecainide has put an end to my episodes of AF but interestingly I did have a brief episode when I must have been infected with covid with no other symptoms but a positive test! That was well over a year ago.
Good luck finding what works for you as we all know how different we all are!
Agree with others, felt terrible on bisoprolol and worse coming off but at least it is temporary. Not taking anything now and feeling much better.
Comsultant said was because heart rate already low that it makes you feel bad and was happy for me to stop after cardioversion. He said if I needed it again would find better alternative.
Made me feel like a zombie and sleep in afternoons (face plant on desk though, could not even make it elsewhere) and exercise was difficult.
Hi I stated on Bisoprol @ 7.5 mg per day which is a massive dose, now 1.25. The initial dose made it impossible to move very far as it made me breathless and caused cramps due to my HR staying constantly 55 no matter what exercise I was doing. Bisiprolol acts as the brake when your HR rises due to AF and works in the background. The gradual reduction of dosage gave me back my energy but my HR lifted from an average of 55 BP to 70 when arrythmia kicks in. Very powerful drug and my GP offered to stop it as a trial, but as the thought of invasive procedures sits uncomfortably with me I continue taking it happily. My avge BP is 129/75 with HR of 80ish when in AF so I'm okay with that.... 76 and still here!
Hi. My experience with Bisoprolol was awful. Mot only the fatigue but struggled to walk further than 50m or get upstairs as it affected my breathing.I'd assumed it was the AF until a discussion with my pharmacist. He advised me that Bisoprolol can attach to receptors in your lungs as well as the heart, even though its supposed to be cardiac specific.
He recommended other choices of other meds to keep the HR down so I saw the consultant and insisted he took me off Bisoprolol and put me on Diltiazem. After 3 months of feeling dreadful, I finally felt reasonably well and had just the AF to contend with.
I was weaned off it gradually over 2 weeks and was so glad to be off the stuff, I can say I noticed any withdrawal symptoms.
Tempting though it may be to stop it, you must do it under supervision from your medical team. 🙂
Thank you all so much for the replies. What a great community this is. I will take all the comments on board and discuss with my GP. As I said before, so pleased to be afib clear I didn't realise how bad biso was affecting me. I will update this page on my progress to give others an idea of my journey. And thanks, I will check out the information on ablation. I think the waiting list is long, so won't be anytime soon!! Take care all.
Also see related posts on the right of this page or bottom on a mobile and try using the search bar at the top. There’s lots of helpful posts on here on the subject.
familiar experiences- way I look at it is if the Bisoprolol is making you feel how it is, get to GP - I got it reduced from 2.5 to 1.25mg at a point in time as felt like a zombie and Bisoprolol does not stop the arrhythmia rather brings your heart rate down some - bit better in terms of how I felt but still so tired - had a HA and hospital took me off it saying you should not be on it as it was still bringing my heart rate down too low (which I knew) but followed the doc. Go and ask and tell them what your heart rate is and how you feel - there may be alternatives that don’t bring it down so much. Out of interest why were you taken off the Apixaban? I’d be asking why as understand a cardioversion doesn’t change the fact you have AFib even if it’s not occurring regularly
For each of the cardioversion I've had, I was told to come off apixaban 6 weeks from the date of the procedure. Leading up to the procedures I was on them from the moment I was diagnosed with afib. They believed that due to my chad vasc score of 0 that it was more beneficial for me to be off them rather than have the risks of bleeding if I got into any type of accident/banged head etc.
I am experiencing similar problems on a much lower Bisoprolol dose. Prescribed 2.5mg by cardiology but only started on 1.25mg after discussion with GP, and will review next month. Feels like a speed limiter brake has been put on my aerobic exercise at the gym, so will be discussing whether to just put up with my occasional short-lived episodes of PAF (no more than 30 mins). Currently experimenting with taking my daily Bisoprolol pill at lunchtime after my morning workouts (had been taking it in the morning before my gym sessions) and feeling better during exercise as a result.
That's what I did after my treatment for atrial flutter, so yes - with doctor's say so and careful tapering to nil if deemed necessary.
Keep in mind that a heart muscle that has already gone into an arrhythmia might well still carry the weakness that led to that happening.
I was surprised you were taken off apixaban as I was told that one event of AF meant I was on it for life. However, you are ten years younger than I was at the time and your doctor will have calculated your "Chads2 score" to determine the stroke risk posed by AF.
A previous cardiologist told me that keeping the heart rate lower reduced the risk of going back into AF.
My heart rate was in the 40s and 50s for the 3 1/2 years I stayed in NSR after a cardioversion and my first cardio didn't want to lower my dose of bisoprolol. A new consultant agreed to a lower dose as I had shortness of breath on exercise. AF returned a year or so later - no idea whether I would have stayed in NSR on the higher dose.
It certainly sounds worth discussing with your doctor.
I take my 1.25mg of bisoprolol at bedtime. That way I think I avoid the sluggishness it made me feel if I took it in the morning. I don't know why my GP put me on it back in 2016. The cardiology report recommended apixaban, but that alone. I take amlodipine for high blood pressure every morning.
The problem is, it then becomes historical. You move house, change GPs and they just continue with your long term meds without question. It's hugely difficult to see a cardiologist (I never have) or even to get a holter monitor to find out if you still have a problem if you're symptomless.
You can come off it, whether you should is up to you and your medic. I was advised by a AF specialist that I didn't need it, so stopped. It can crater your life asi think CDreamer said it can affect you more than the AF itself.
Bisoprolol will slow your heart rate as you try to increase it.I was highly active and it made it difficult to push my HR during exercises.
I also have trouble starting awake during the afternoons.
I was on 5 mg and reduced to 2.5 and still have some difficulty elevating HR during exercise.
Mr cardiologist insists I stay on it but agreed to allow reduction to 2.5 as as long as normal HR and AFib didn't increase. I have been ok for about a year. I take HR and ECG readings during/after exercising.
But, I don't suggest you reduce yourself without consulting whoever put you on it.
Hi Tony, I was initially prescribed bisprolol 5mg twice a day. This was reduced after a while to 2.5mg twice a day and subsequently 1.25mg twice a day. Like you I had fatigue and more alarmingly low heart rate to such a degree that I was almost fainting. They said I had a sensitivity to the drug and changed me on to verapamil. That was even worse. My next prescription was flecainide from a cardiologist who himself suffered from AF. That has been a lot better. I take 50mg twice a day, although I believe some people can you this drug as a pill in the pocket as and when needed along with an anticoagulant. Everyone's different but wouldn't come off a drug without seeking medical advice first.
When I told my Cardiologist about the side effects of 1.25 g of Bisoprolol he agreed to stop it. No side effects from stopping it immediately and felt a lot better. Low heart rate was the main problem with more AF episodes in the early hours. It will suit many people but definetly not me.
My husband had same with bisoprolol, They switched to Diltiazem and he is much better, able to be more active and breathing easier. HR at rest still may go down to 45 but only when sleeping. His cardiologist has agreed to a BP of 140 / 70 as he feels so much better than when lower.
Approx calorie burn of 750 calories 4/7 days at the gym giving calorie deficit on pretty much the same meals has seen my weight drop by about 1.5 stone since Christmas. Diet barely altered, weight has and is continuing to drop 👍
Hi all. Just an update to my question after speaking with my local GP. A month ago I was on 5mg Bisoprolol, 2 weeks back I reduced this dosage down to 2.5mg. Another conversation after very little change to my average heartbeat has dropped this further to 1.25mg. I have to say sport/fatigue etc has got so much better. He agreed that if all stays within tolerance then I could come off the tablets altogether in approx a month, BUT has asked me to get in touch with the Cardio team to talk this through with them, as I am currently waiting on an ablation. However, getting any communication with the Bristol Cardio team is pretty hard going!! I will remain on 1.25mg until I speak with them. I will not come off totally without any agreement from a Dr.
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