Reducing Bisoprolol after ablation

[JoDogBlue]

After my AV node cryo ablation at the JR on Friday the consultant said I could reduce my bisoprolol dose from 5mg to 2.5mg. I'm thinking I'll get through the recovery period before I do that; I've seen reference to side effects of bisoprolol dose reduction on here. I'm not sure what those might be but thinking I should delay throwing anything else into the mix just yet. Any thoughts or advice?

[Morzine]

well I’d do what he says. It not like you’re going down to nothing. I’m in 2.50 bisiprolol in 24 hours to keep the beast at bay so I think you’re still covered

Sue

[Leggylady]

My consultant said I would come off Bisoprolol about 5 months after my ablation. I was on 2.5 mg daily. I hated Bisoprolol - it made me tired out, so I asked if I could come off it about a month early, which I did, without any problems.

[JoDogBlue in reply to Leggylady]

Thanks for your reply. The consultant said I could reduce my dose straight away by cutting tablets in half. My heart rate is still up following the ablation which is why I'm holding off. Hoping I can get off bisoprolol for good as, like you, it wipes me out.

[Buzby62]

Apparently some can reduce or stop it without withdrawal symptoms and some need to taper it off, you won’t know which group you’re in until you try.

I stopped 3 weeks ago from 2x1.25mg per day as instructed at my 3 month cryoablation review. I felt better for it within a day or so but had an anxious day about 3 days after when my body realised it wasn’t getting anymore. HR and BP was elevated for a day or so and then settled and so far feel much better without the low resting HR I was getting.

Best wishes

[Model52]

I started taking Bisoprolol every other day instead of daily, because it made my heart rate sink to 46-47, and I did not suffer any negative consequences.

[Ppiman]

The trouble is that if the ablation has worked, then the bisoprolol is, essentially, acting on a healthy heart, and thus will be affecting your heart in unnecessary ways. And yet (as in my case following an AFl ablation), when I did as I was told and stopped my bisoprolol (5mg) a week or so after my ablation, I was shortly greeted with a day of the most awful AF and tachycardia that took a hospital visit and a further dose to calm it down. But then it did all go away (well... it crept slowly back) without any further drugs at all.

Steve

[JoDogBlue in reply to Ppiman]

Thanks for your reply. I've gone into AF after my ablation 3 days ago and really feeling it. Was in NSR before and immediately afterwards so disappointed is an understatement. Hopefully it will settle...I won't be reducing the bisoprolol unless it does.

[Buzby62 in reply to JoDogBlue]

It’s quite common to have episodes early in the blanking period, I know how you feel, happened to me at day 6 and although you know it can happen you hope it doesn’t. Try to stay positive and just put it down to the blanking period, I contacted my arrhythmia nurses in the EP team to let them know, you might want to do the same, that’s what they’re there for. Hope it settles soon for you.

Best wishes

[JoDogBlue in reply to Buzby62]

Thanks. I left a message as they triage calls so hope they'll get back to me at some point. Did you avoid caffeine to help things settle?

[Buzby62 in reply to JoDogBlue]

No, I usually only have one coffee a day with my breakfast, maybe two or three teas in the afternoon and I drink plenty of water throughout the day. I stopped having a cup of tea before bed some time ago and just have water now. I think hydration is underestimated by many and I keep a glass or bottle of water to hand throughout the day.

I don’t think there’s much the nurses will do initially except maybe reassuring you but they indicated to me they might want to intervene if it persisted for 72 hours or more but I was back in NSR the next morning.

I did read on here that some believe that a slow heart rate can trigger AF so there may be something to think about in reducing the bisoprolol depending on your rate in NSR and AF post ablation. I certainly feel better since I’m off the bisoprolol the last three weeks and hope I don’t need to go back on it.

[Ppiman in reply to JoDogBlue]

I think that sounds right and yes it surely will settle down. I saw a recent study which suggested the “blanking period” seems to be around six weeks, after which any recurrence becomes at least a pointer to recurrence of future episodes. Most people, however, were shown to have either none, far fewer or much less symptomatic episodes after their ablation.

Steve

[JoDogBlue in reply to Ppiman]

It's been several months since my cardioversion and to be honest I'd forgotten what AF felt like and just how limiting it feels so it's a painful reminder

[Neil2020]

I take 1.25mg daily; not sure why exactly, the last time I asked I was told precautionary and I haven’t needed any procedures like those mentioned on here. If ever I see the cardiologist again I’ll try to find out why.

Looking at the side effects on the NHS website I don’t think any apply particularly. Weakness is probably the closest but I put that down to a sedentary lifestyle which I need to change.

Good luck JoDogBlue, I hope your treatment proves uneventful.