After a successful ablation in 2021 & a couple of small blips, the AF returned on Wednesday & lasted until the afternoon the following day. My gp has put me back on bisopropal. This has resulted in my heart rate going down to between 50 & 55 bpm. This is making me feel exhausted & quite poorly. I didn't take the bisopropal last night, but my rate is still around 53 bpm. Its hard as there doesn't seem to be anyone to turn to now.Has anyone had anything similar? Any advice would be so welcomed.
Many thanks
Sheena xxx
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Shiney1959
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Bisoprolol often takes your heart rate too low. Min on occasions went down to 35 when on bisoprolol so eventually I had to stop and now only take anticoagulants. I couldn't find any rate or rhythm control that would work well for me at all beta blockers or calcium channel blockers. It may be that you need a different dose or different medication. You should contact your Cardiac nurses or ask to be referred back to the cardioEP who did the ablation.
Thank you so much for that. It helps alot. They discharged me after my ablation so I have no one to contact as yet. My gp is writing g to them so I can go back on the list. Soon I hope
Hi Wilsons, I'm only taking 1.25mg. I did take it at night, but felt awful until the late afternoon when I started to feel human again..Hope your ablation goes well. Thank you for replying xxx
Really sorry to read it’s come back, which must be very disappointing for you. I was going to say exactly the same as Wilsond - it could be the dose you are on that’s lowered it that much, though now and then my HR goes to that too, on 1.25mg, particularly when sitting down.
I was initially on 2.5 mg but found that too high a dose.
It can also also take a few weeks to get used to Bisoprolol and you may adjust to it.
I hope you manage to get a referral back to your EP. If you can stretch to it, you could get seen quicker of course, if you saw them privately ( which many of us unfortunately have to resort to). You shouldn’t need to feel there’s nobody to turn to and ideally your GP should refer you back for further investigation.
Thanks for your reply Teresa. I've made the initial appointment privately as the waiting list here in Lincolnshire takes forever. I need some advice from him. I took bisopropol prior to my ablation. They had to drop the dose then, but I don't remember feeling that bad. It seems to me that I need something to take when the AF appears. Who knows.Thank you so much. It really helps to talk to someone who knows how it feels xxx
I’m glad you made the appointment and yes, it may be better to take something when you get an episode only to help revert back. Saying that though, Bisoprolol has helped calm the amount of episodes I get generally, but I’d still rather not take it every day.
I hope the appointment gets you back on the right path again. Do let us know how you get on 🤞
It is possible to take a beta blocker as a PIP when the afib kicks off. It is pointless taking it eveyday when you are in NSR if it makes you feel bad because it is dropping your heart rate too low.
You have to learn to be less anxious about it. Anxiety makes the symptoms worse. BobD constantly tells us that medications are to improve QOL. If the meds are making you feel worse than the afib then action to change the meds or modify the dose is needed. A lot of doctors don't seem to appreciate this. They dole out Bisoprolol often at a standard dose of 5mg and a lot of people are completely floored by that- especially women who seem to tolerate Bisoprolol less than men do. I have come to regard my afib as a nuisance rather than a nightmare.
Take 2.5mg Bisoprolol and my heart rate will drop into the 40’s for short periods of time especially when sitting relaxing and lying down. Went back to my AF nurses even though I had been discharged in November 2023 who organised an ECG. This didn’t show a low heart but they said my heart is working well and they wouldn’t be too concerned if my heart rate was in the high 40’s or 50’s at rest. She also said to go by how I feel and not by what my watch (Garmin) tells me. I am non-symptomatic and wouldn’t know this was happening if it wasn’t for my watch. If I am still concerned they said I can go back and they will organise a holter monitor.
I hope you get your issues sorted. Maybe worth calling your AF nurses direct which I was encouraged to do by my GP and they took me back straight away - ECG organised in two weeks of my call to them. I’m lucky as I have found Brighton Cardio services to be brilliant. I hope you get your answers and the help you need.
They stuck a pacemaker in me set at 60 and i take a blood thinner .,diltiazen. Also to control the arrythmia , diltiezem 120 but i am see ing the doc this week to reduce that dosage or something as it seems to stop me from excersising well.
I've always had a low heart rate around 50/60 but they have still put me on 2.5 Bisoprolol. It doesn't seem to do much as heart rate has stayed the same and has no effect on my health or fitness. EP says it's for when I have an afib episode to keep rate down which it does.
Bisoprolol takes about an hour to start working but will not have left your system for likely a day or so, meaning it will depress the heart rate for that length of time. Also, as the heart then has to work without the beta-blocker, you might feel it is a bit too racy for a while, over-reacting to any emotion or physical shock.
The lowered rate from bisoprolol isn't always dose related or linear so a small dose of 1.25mg often seems "strong". The heart does adjust to he presence of a beta blocker and the tired feelings might well have reduced or even disappeared.
Once cells in the heart muscle have turned arrhythmic and set off AF, say, then the evidence is that this is likely to recur at some future point, as you have found. Doctors are at a something of a loss what to do to treat AF except with a "rate reducing" drug like a beta-blocker. An alternative is a "calcium agonist" such as diltiazem. That acts differently and might suit you better. Other drugs that try to stop the arrhythmia itself ("anti-arrhythmics") are stronger and more potentially toxic than either of these, so are always started by a specialist and reserved for where the AF causes debilitating symptoms.
Thank you, Steve. That is very interesting. I've booked an appointment on 16th Aoril with cardiologist. I was on Amiodorone for a year before & after my ablation. I don't want to go near it again
It could be that the Bisoprolol is making you feel rough - a lot of people don't respond well to it - but I wouldn't think that it's the actual HR making you feel unwell, what you're reporting is not that low.
I had been put on metoprolol sometime before my successful ablation. It was not good! It dropped my heart rate dramatically, so thank goodness the doctor took me off of it. And speaking of an ablation, I had a break through episode yesterday for several hours while in the middle of eating a frozen yogurt. I took pill in the pocket (Flecanide) and an eliquis. I may continue to take the eliquis for a short time and then I will go off of it again and pray that I never have another episode again. Now I am wondering if the cold yogurt actually was the trigger...
I live with alow heart rate made lower by a BB. Ive tried several BBs and found carvedilol gives me the best control, and leaves me less fatigued, but I still sit in the low 50s on average. Ask the doctor to review.
I would definitely ask to have a PIP ( pill in pocket) rather than take a daily med. You have only had one AFIB attack post ablation it could be a one off or maybe just one or two a year.
I was put on amiodorone after a particularly bad attack last summer in Mallorca, my UK consultant then switched me to Flecainide but I didn’t feel so good on it and I felt I was getting more arrhythmia with it . So I stopped the flecainide. Have only had one Afib attack in the last 6 months since stopping and that’s when I had covid AND most importantly took flecainide and was back in NSR within 2 hours.
Now I feel I have a way of controlling my Afib without taking a rhythm drug every day ( I still have to take rate control drugs and anticoagulants) .
I believe only EP or a cardiologist can prescribe flecainide. Good luck
I’m on 2.5mg bisoprolol daily (plus extra if I go into AF) and while in sinus rhythm it has always kept my resting heart rate at around 50-60. I’ve recently lost a lot of weight and when having my BP taken my GP was concerned that my heart rate was under 50. It’s now hovering at 39-50 resting rate.
Luckily I had a phone appointment due with my EP (though it was actually one of his team who phoned). I explained my heart rate and said I’d like to reduce my bisoprolol, but he said no, i need to stay on the same dose as the low heart rate is good for my heart and protective. I was pretty shocked - and disappointed! I argued my case but he was adamant it was best to stay on it.
I do hope you get some helpful advice and support to adjust your meds the best way for you. Btw, you probably know this, but if you’re reducing Bisoprolol, it’s much better to reduce it down gradually, don’t just make big cuts in doseage. Jx
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