My previous posts were related to my mum and her anxiety. Mum has permanent AF. We ended up going private to see a consultant and mum had a monitor for a week to monitor her heart rate. The results did show that her heart rate was high - around 160 was the higher results. The consultant increased bisoprolol to 2 doses a day- 3.75mg.
Mum has still been getting episodes of anxiety pretty much most days. We’ve finally got a Kardia monitor today, I’m hoping the Kardia will help us work out if anxiety is related to fluctuating heart rates.
I wanted to discuss possible medication changes as I remember reading from previous responses that some people had terrible side effects from bisoprolol. The GP did say if mums heart rate is still high, he could increase the bisoprolol to 10 mg. I can’t determine whether it’s the bisoprolol causing side effects or whether it’s heart rate.
Mum just doesn’t feel right most days so I’m hoping with the help of the Kardia, we can determine if heart rate is the reason behind mum’s anxiety. Mum has awful symptoms of anxiety- she feels restless and unable to relax, she struggles to sleep. Hardly eats anything- possibly a small meal at best in a day. Mum has other conditions too including diabetes so is on quite a lot of medication.
Has anyone changed medication from bisoprolol to a different beta blocker?
I just was hoping to see if anyone felt better with different medication.
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Nickybhf
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Sorry to hear your mum is going thru such a rough time. I was prescribed Bisoprolol in Oct 22 when first diagnosed and have persistent AF. I was taking 2.5 mg, then as it wasn’t controlling my heart rate, then to 5mg, then 7.5 mg then 10 mg…although at 10 it controlled my heart, my BP plummeted and was circa 80/60 on average.. I felt awful all the time, debilitating tiredness and dizziness…docs said this was prob what was causing my symptoms…
we tried over months of every possible mix … taking only at night, taking split dose in morning and afternoon, nothing worked, upping the does lowering the dose…so I was moved after 9 mths onto calcium channel blocker. Cardiologist told me it wouldn’t control my rate as well as bisoprolol but would likely let my BP go up…
After 3 mths of finally getting a dose that keeps my rate down (but not as low as Biso)… it’s stable at about 180 mg x 2 (max dose) a day.. at about 88BPM, but I would be lying if I said I actually felt any better…
Sorry I can’t personally give you any better news but for me has made little difference … now considering a Mini maze surgery … as seems only wa6 to potentially get off meds…
I think the stock response from anyone on here Nicky is “everyone is different” and they are absolutely right. Responses here can only be broad brush personal experiences… what is terrible for one person, works for others, so please keep persevering and I am sure they will get the right pill for your mum, it’s just unfortunate it takes time… really hope they can sort it for your mum soon ….
Not sure how old she is, but another thing to consider is her menopausal state. She's probably menopausal and therefore has low oestrogen levels (testosterone too). Low oestrogen gives many of us horrible anxiety. It could be that the AF finally pushed her brain over the edge (you said she has other issues too) and with low oestrogen the anxiety has set in.
It would be worth considering this and reading up about HRT and hopefully trialing her on some to help. I recommend the balance-menopause.com web site for up to the minute information and a ton of reading material.
Hi Nicky - it's worrying for you to see your Mum so uncomfortable and anxious.
I was prescribed 2.5mg Bisoprolol and had real difficulty walking around. I was breathless, lethargic and miserable but thought it was just part of having AF. Even when the dose was halved, I still was very breathless.
My GP changed me to Nebivolol 2.5mg and it was like a breath of fresh air. I am no longer breathless and can do most tasks an 80-year old can do. I believe Nebivolol is cardiac-specific and does not act on lung tissue in the way that Bisoprolol does. Some people can take Bisoprolol without difficulties but I certainly couldn't.
It might be worth while discussing this with your doctor and pointing out the difficulties which your Mum is experiencing. Best wishes to both of you.
Thank you so much, I will mention this to GP. Mum has never had asthma, yet since being on bisoprolol, she’s been prescribed an inhaler which she needs sometimes due to breathlessness. Does Nevibolol help control your heat rate?
My AF is controlled with Flecainide, so high heart rates are very rare but I reckon that 2.5mg Nebivolol reduced my heart rate slightly. In my case, the Nebivolol is prescribed because I take Flecainide, rather than to lower my heart rate.
I’ve done some reading up on Nebivolol, from what I’ve read, it says it can make HF worse which mum also has. I will still discuss options with GP, I have a telephone appointment next week.
You will have a lot of questions to put Nicky and only a doctor can weigh the pros and cons of any treatment. I hope you get a good outcome from your discussions.
Has anyone changed medication from bisoprolol to a different beta blocker?
Generally, bisoprolol is one of the most well tolerated beta blockers. The key is how well it is maintaining her heart rate and whether other medications may interfere with her other health issues.
Have you discussed her anxiety issues with her doctor ? Perhaps he could recommend a therapy program.
Yes, I’ve discussed the anxiety and the GP has prescribed Promithazine to help with anxiety episodes, but I remember from my previous posts that people mentioned side effects of it. Mum has still been taking it as and when she needs as it helps her to initially relax. I’m concerned about changing medication but at the same time, it’s really difficult seeing mum having so many symptoms on a daily basis.
A beta blocker like bisoprolol did not agree with me either and anxiety was one of the more troublesome side effects.
Because of that, my doctor switched me to a calcium channel blocker called Diltiazem. I felt better right away and the anxiety disappeared.
No reason your mom should suffer because of medication's when there are alternatives. Diltiazem serves essentially the same rate control function of bisoprolol, but many of us tolerated better.
Sometimes doctors are very nearsighted and only consider what the drug is doing to one particular thing like heart rate and ignore what it's doing to the rest of the body and the mind.
I would definitely ask your mom's doctor for a trial on Diltiazem over Bisoprolol and see how she does. If your doctor is not amenable, then See got a second opinion. Good luck.
Thank you for your reply, that sounds promising. I’m so glad that you noticed the difference straight away. I will speak to GP about this. I just hope it’s okay with the other medication that mum takes. I really hope we manage to find something that helps mum to feel better.
I was evemtually taken off Bisoprolol, it slowed me down so much , not my heart rate, but everything, I felt as if was slipping out of being! Awful feeling . I sympathise with your mum. Have been on Digoxin for years now. We all react differently medications. I hope she finds one that suits her.L
Sorry to hear about your mum. When did the anxiety start? Was it with AF starting or just on commencement of taking Bisoprolol? If it's just the meds, then as others have said there are others and she can ask for a review. If it's more about the AF, maybe she could ask the NHS talking therapies service for some sessions from a therapist trained in helping people with long term health conditions.
The symptoms began just before she was diagnosed with AF. I’m certain that the AF was the cause of the anxiety. When mum was diagnosed in 2022, and initially put on medication, the anxiety was controlled, but I think when her heart rate increased, the anxiety was back.
I completely understand that. Any strange feeling in the heart can be anxiety provoking, sometimes knowing what it is and that it isn't life threatening can help but not always. Would it help to speak with a cardiac nurse, or have some sessions with someone who can help with the anxiety from managing a long term conditions therapist? I wish her and you the best.
hi I have have recently had my medication changed from bisoperol to verapamil as bisoperol made my asthma worse I was fine on on bisoperol apart from breathing issues I am perfectly fine now on verapamil consultant told me I may get swollen ankles but this hasn't happened to me
I started with Bisopropol when first diagnosed with AF but gradually realised it was causing loose and irritated bowel. After years of suffering side effects of Metformin (for diabetes, now controlled instead with insulin) I could not tolerate this and my GP agreed to switch to Atenolol. No problems since, although heart rate is low, about 50, can live with that.
Mum also takes metformin, she only has very small amounts to eat and say she feels bloated all the time. I wonder if the bisoprolol & metformin together cause tummy issues. I’m glad you’ve found a solution.
Bloating is no fun, and sounds more like a digestive issue. Many older people are short on stomach acid (Betaine hyrdrochloride) and that could cause her to be short on B12. The anxiety could come from the lack of that. I suggest you get some Betaine Hyrdrochloride from a health food shop, and give her a tablet with each meal. Also helpful could be 'digestive enzymes' which will improve her digestion generally. Buy them from the same place, and again, give her one with each meal
Also, eating carbs and proteins separately can improve digestion. Protein in the morning on an empty stomach really helps. Carbs can be eaten afternoon and evening because they tend to make us feel sleepy.
I assume your mother is on an anticogulant. Some people find they cause digestive issues. I take Apixaban and I find it gives me bloating so I feel full quicker.
Mum is also on Apixaban- twice a day. After reading your reply, I’m questioning whether this could be the reason for mum’s loss of appetite? Honestly, she sometimes has 1-2 spoonfuls of food and says she’s feeling too full.
Hi, wife was on Bisoprolol for years for her paroxysmal AF. CVs failed, so treatment was by medication alone. Last year she went into persistent AF, and increasing dose of Bisoprolol didn't help. Eventually, via a private consultation, she was put on Nebivolol, as per some others who have replied to you. For her, the Nebivolol has worked well. She still gets out of breath on stairs and up slopes but normal life is OK, and she can walk quite far on the flat. Good luck.
Thank you for your response. When we went private, the consultant just increased the dose of bisoprolol. That’s brilliant that you mention your wife can walk quite far after medication change.
GP had increased dose of Bisoprolol twice, and then switched her to Atenalol but to no avail. They gave her an urgent referral to cardiology, but we were told it could take 6 months hence we got a private consult.
Private consult only cost £140 and happened in 2 weeks and then all tests done on NHS. Was on Nebivolol within a month. Wait for cardioversion (which failed) was still 6 months.
Has the consultant you went to privately suggested that you have a follow up consultation to see how the new dose of bisoprolol is working or that you go on his NHS list so that you can continue to see them?
No, he wrote to mums GP and said if there are any further issues, would the GP refer mum to her cardiologist. When I questioned whether mum could go on waiting list, I was told by GP that they have just suggested cardiac rehab but no follow up appointment.
You should ask at the private appointment If your Mum could go on the consultants NHS list for follow up as she could wait months and months to get to see her NHS Cardiologist.
Hoping you find a medication at the right dose that will work for your Mum and also something that works for her anxiety. Anxiety and AF can cause a "vicious circle" with the anxiety bringing on AF and the AF worsening anxiety.
For me none of the beta blockers, calcium channel blockers or any rate/rhythm medications worked and I did try about 6 different medications and combinations of medications over the first 9 months or so after diagnosis starting with bisoprolol. All medications and combinations and doses of the medications made me feel more breathless and fatigued than just the AF alone. I seemed to be fine for about the first 3 - 5 weeks on the medication and then the dreadful fatigue and breathlessness would start. Every time I changed medication I would be OK for a few weeks and then back I would go. Eventually a new cardiologist put me on Digoxin 125 - again these worked for about 4 weeks and then the side effects started again. Hadn't realised I was on the higher dose and when I did asked to be changed to a lower dose - again this worked for the 6 weeks without side effects up until my first successful cardioversion. I never went back on any of these medications after that first cardioversion despite going back into AF. I do wonder if the lower dose (69.5) digoxin would have worked longer term. No need to find out now as I am in permanent low rate AF so am quite happy just taking the anticoagulants. It seems that if you have problems with medication you have to be very proactive in getting things changed - it seems to me that I spent weeks in the GP surgery or in A&E trying to get things right.
Thank you for your response, I think due to mums other health issues and limited mobility, no one has ever mentioned cardioversion or anything. They’ve just said that medication should help control/manage symptoms. I also am constantly trying to ask GP about what they could possibly do regarding medication. Seems no one is taking action, the only thing our GP has said is we can increase bisoprolol to 10mg if required.
My GP would never change my medication without the cardiologist or EP telling them to do so I always had to access my cardiologist or EP and discuss with them first or the cardiac and arrhythmia nurses who would ask either the cardiologist or EP for their confirmation on a change of medication and then call me back and notify my GP.
You say that your mum is in permanent AF, so you will probably find that the kardia always records AF. I regretted buying mine for this reason. I too am in permanent AF.
I hope you manage to find a suitable medication for your mum: she’s lucky to have you as an advocate.
Yes, I didn’t think about that till we got the Kardia, when we first used it yesterday, straight away it showed mum is in AF. I’m just thinking as it records heart rate, maybe we can determine if higher heart rates and anxiety correlate.
Seems a lot of people struggle with bisoprolol, it’s annoying that GP hasn’t suggested a medication change themselves, even though I’m constantly explaining mums symptoms.
Sometimes the GP's are not knowledgeable enough about the interactions of our meds. Perhaps it might be worth asking your local pharmacist about other options and you can then be forearmed to ask the doctor to change to something that may be more suitable? We often have to advocate for ourselves and not expect the doctor to be as proactive as we'd like unfortunately.
I have Chronic AF.. My consultant put me on slow release Diltiazem 200 to start with. Pulse stayed around 90.Then upped it to 300 mgs . My heart is well controlled now in 60s even lower at night..It’s still irregularly irregular though but at a slow rate….which I must say is better than a fast one..lol..
Feeling anxious makes life tough going, and sometimes unbearably tough. I hope your poor mother can find some relief from it enough times during each day to still be able to enjoy her life sufficiently.
I'd be surprised if her anxiety were not heart related but it probably arises from her personality type, too. She will have what is called "cardiac anxiety", but it might not be only that, or even that. Anxiety is such a deep and complex feeling and one thing can easily be blamed when the real cause is deeper, perhaps unadmitted or hidden.
The Kardia is, I suspect unlikely to prove either way but let's hope it does help somehow. And, of course, bisoprolol might not be the answer, either. Chronic anxiety ("general anxiety disorder" or GAD) is a very hard feeling to overcome or help. If anything, and I think this will be the case, it will reduce on its own as your mother's mind accustoms itself to the feelings it produces and, perhaps comes to tell herself something like, "Well... despite the feelings that the end is nigh, I am still here!"
Bisoprolol, given at 10mg, is a high dose and it might cause side effects. The problem for me is that when I took that dose I also had persistent arrhythmia from my atrial flutter and high levels of anxiety from that, so unpicking the bisoprolol side effects (if there were any) from the other feelings just wasn't possible.
I recommend you buy a book for your mother by the late Dr Claire Weekes called, if I recall, "Self Help for the Nerves". Even though it's now a rather old, self-help guide it has helped - and continues to help - probably countless people, worldwide, because the writer knew her topic well from personal experience. It will give your mum confidence, comfort and strength. She needs that much, along with the care and love you provide for her.
Thank you for your response. We are willing to try anything that could possibly help mum. Anxiety is an awful condition, hope we find a solution to help manage it.
I totally agree with you about Claire Weekes! Another option is The DARE Response by Barry McDonagh: again written from personal experience. It’s more recent. I seem to remember he actually states that his theories are based on Claire Weekes’ book. There is also an app for the DARE Response. I highly recommend.
I imagine that most people with AF experience some degree of anxiety. I certainly do.
I too was put on Bisporol when first diagnosed nine years ago aged 58 and felt awful, so bad is was difficult to do anything. I was taken off Bisporol and put on digoxin which I’m still taking (along with other medications). I’ve been in permanent AF for several years now and have heart failure controlled by medication as an ablation failed and cardio versions didn’t last. At the beginning I was desperate, anxious and depressed but now life is good, I’ve just come back from a tour of Australia and New Zealand, I never thought I’d be able to travel far when first diagnosed.
That is so good to hear. Mum also has HF along with the permanent AF. It is lovely to read that you’ve just come back from a tour. We really want to take mum on holiday, but she always says that this will not be possible at the moment due to her symptoms. It’s lovely to read something positive and hopefully we will be able to travel again.
Hi I don’t have AF but I’ve got ectopic heartbeats which I could feel all of the time & I was anxious & not sleeping. Bisoprolol didn’t suit me. My GP suggested amitriptyline which I first refused as I know it’s used as antidepressant & can cause irregular heartbeats. I then decided to try it just one 10mg each night & it’s been a miracle, I’m hardly feeling my weird heartbeats & I’m sleeping so much better. Not sure it would work for your mom, I’m 73 .Best Wishes
Oh that’s brilliant, I’m glad you feel better. Mum is 71. She really struggles with sleep, just hope they find a suitable medication to manage this awful condition.
I think it's a vicious circle. The anxiety probably aggravates the AF and the AF causes anxiety. This is particularly true if she has palpitations. I had permanent palpitations for a few months and they made me feel restless, anxious and fidgety and I found it difficult to sleep. Unfortunately palpitations don't show up on a cardiac monitor.
If you can break the vicious cycle, I expect that would help a great deal. Maybe try some yoga, pilates or a relaxation app? Also taking ginger root capsules and magnesium helped rid me of my palpitations which I now only get occasionally. Read up about the vagus nerve. Unfortunately modern medicine is all about treating the symptoms not the cause.
I’ve heard that nevibolol (think that is the spelling) is a good alternative to bisoprolol.
My husband was put on digoxin and I have to say after my pacemaker my bisoprolol was raised from 1.25 to 2.5 and since then I have put on weight, breathless. I gather it is still a low dose but I did wonder if my afib/tachycardia has kicked in again snd pacemaker not really coping
Consultant on annual leave and Gp can’t help
I do hope your mum feel better soon snd they get her on the right medication.
That sounds rough. I too have permanent AF. I was worried about Bisoprolol and thought it might be causing the horrible neuropathy in my feet. So I switched to Nebivolol. I'm fine on the Nebivolol although I suspect I should be on a slightly higher dose, but I just make do as don't want to be drugged due to already being exhausted from hypothyroidism.
The long and the short is that I noticed not one bit of difference between the two beta blockers.
Unfortunately women tend to suffer more from the side effects of medications than men do. This is because our physiology is different . It is a factor that is not recognised by most doctors or taken into account . Part of the problem is that for old medicines licensed before the 1980s women's participation in clinical trials was not mandatory and mostly did not happen. They did not even use female lab animals for the pre clinical trials. Reason - their pesky fluctuating hormones messed up the results! Even now that women have to be included there is virtually no sex differenciated reporting of side effects. If your mother is taking a cocktail of different drugs it is not surprising that "she does not feel herself". As each new drug added will take her further away from how she felt as " herself. " Bisoprolol and the ever increasing doses is likely the straw that broke the camel's back and tipped her into this feeling . That is probably because Bisoprolol makes many people feel awful physically and mentally and seems to be particularly badly tolerated by women - even women who are not taking lots of other meds . I did not feel "myself" on 5mg of Bisoprolol - I felt like a Zombie and told my doctor that if I had to live feeling like this for the rest of my life then I did not want to live. My dose was lowered and then I changed to Nebivolol which is a lot better but does not lower heart rate as well for some people . This does not matter so much for PAF but would for permanent. As others have said betablockers are not the only remedy for a raised heart rate. They just happen to be the doctors' "favourites" .
An additional problem is that one of the side effects your mother is feeling is anxiety . It is a big mistake to mention anxiety in the context of med side effects to doctors - especially if you are female as that reduces the chances of being taken seriously. Lethargy or sluggishness, lack of appetite , breathlessness are all more likely to be taken seriously. To some extent having a persistently high heart rate can make one feel restless and unable to relax but often anxiety will arise from simply feeling physically awful. Again this is a factor that often doctors fail to acknowledge. You are going to have to insist that your mother be trialled on other medications rather than Bisoprolol. I think you also need to talk to your mother about how with this new condition of permanent afib and the necessity for medicating it ( I assume she has not been offered other treatments) it is possible that she is never going to "feel herself "again and perhaps some counselling might help her to accept the "new normal".
Come on Auriculaire her poor Mum has an uncontrolled Heart Rate.
I struggled with just that for 2 years 3 months. Demanded a Public Heart Specialist. A change from Metoprolol to Bisoprolol. Then up and up it swent to 10mg. No control still. 156 level is difficult to dea with.
Enter a private Heart Specialist. He was interested.
Introduction CCB Calcium Channel Blocker. 180mg Diltiazem my heart rate went from 156 to 51! scary I spoke to NZ Healthline on Sunday and Nurse at NZ Heart Foundation. The latter got it right reduce Diltiazem to 120mg have AM and keep reducing Bisoprolol to 2.5mg and have PM.
Its important to separate them.
Bingo I have this regime for 2 years 4 months.
Anxiousness comes with a rapid heart. Not because she needs counselling.
1st step CONTROL the heart rate.
2nd step RELAX and feel better
Keep to the regime of meds and see how it goes.
We are all different but it is so important to get Heart Rate and BP under control. No point in up and up med dosages which are not working.
It is a question of whether the heart rate can be controlled sufficiently without feeling awful due to the side effects of the controlling agent. If it can't then what do you suggest to deal with this dilemma? So far not enough med options have been tried and hopefully a combination will be found that works but that is not guaranteed. Nicky's mum is a very complex case. She has several comorbidities and different medications. Anxiousness does not just come from having a rapid heartbeat. It can also come from feeling crap due to medication side effects or the condition you are suffering from ,not being able to do the things you used to and an inability to come to terms with that. Having chronic physical health problems can leave you feeling anxious and depressed. Counselling might help with that.
Well. I would hate to be diagnosed with anxiety when I'm taking everything on board. I've never been diagnosed that way.
Change of med or lowered to add a new one finally happened to me.
Strangely at Night 47avg is my stable range. I've always had cold shoulders at night!
After Stroke with AF was started on Metoprolol which I didn't want, couldn't exert myself, tired 186 H.Rate Day without exertion. The heart was the exertion! And left. No follow up on Stroke.
24-hr monitors H/Rate are excellent as they show what effect the med has on the body. It showed this lady has a rapid heart rate. Which is not being controlled. Plus a daughter extremely amxious.
Councelling in Rehabilitation- welI I did the course. Satisfied that I wouldn't be a "next please" worker but whilst folks into work, work with them to conquer anxiety, gain confidence etc.
Start with the problem like finding the right med for her.
I still have limitations because of Heart structural problems which are most probably caused by a 2 years 3 months of rapid uncontrolled heart rate.
Thank you so much for your response. Mum has said the same thing to me on some occasions, that she doesn’t like living with the anxiety symptoms. It’s so difficult to hear that. The GP has offered counselling but mum has been a bit reluctant but maybe it’s something to consider.
I think that's a cop-out from the GP. I had "counselling" for something once. I lasted less than 2 sessions before I binned that off. What I needed at that time was HRT and more thyroid meds. I had to self medicate to get those right. Still do with thyroid but HRT is now on the NHS.
I have a reasonably high HR, especially if I am walking, it goes up to 145bpm sort of level. Normal resting rate is around 80. BUT I feel perfectly normal. Perfectly me. The only time I get down about it all is if I can't find the stamina to finish a task. I feel like me. It took some time to get there though. Keep going. Don't get fobbed off with councilling.
As I was reading through all these posts I was just thinking that you need to get a full medication review. Ask your pharmacist to do this with you and your Mum. If you have a pharmacy attached to your GP's surgery do it there if you can. Get your Mum to tell them how she feels on her medication. If they feel there could be changes made they will suggest them and can let the GP surgery know. I would also let them know how this is having an effect on your life and the rest of the family - as I am sure it must it may just spur them on to suggest changes and provide help.
Have you tried a magnesium supplement? I found this very helpful for anxiety. It is normal to to feel anxious when a heart related condition is diagnosed and it can be difficult to accept that one has this condition and it is unlikely to go away. I think you need to try and get to the bottom of what is making her feel anxious- is it the afib itself and the symptoms it generates or is it a side effect of the medication? This is where a counsellor might be useful - to get your mother to delve into how she feels about all this rather than just tinker about with the medication. Getting the medication improved is necessary but getting to the bottom of what is causing the anxiety is necessary too.
They usually say that if the magnesium supplement gives stomach issues to take a lower dose. I believe it is magnesium taurate that can help with AF - I do not take it but hear good reports from others on it. When my wife was told to take this for a different condition she was told to start on a low dose and work up until she experienced stomach/gut issues and then go back down to the dose where she didn't experience stomach issues. That would then be the highest dose she could take but of course could take lower if it was still of benefit. Don't know if that would be worth trying as your Mum is on other medication that this may intefere with anyway and shouldn't really take any supplements without advice from her pharmacist.
That might have been because you got the wrong magnesium salt or too high a dose or both. The saying "to go through like a dose of salts" actually refers to the laxative effect of Epsom salts- magnesium sulphate! Magnesium oxide and magnesium citrate also have a stronger laxative effect than magnesium biglycinate or magnesium malate. With magnesium it is best to start off low with capsules that contain 100mg or 150mg and build up rather than take the recommended daily amount of 300-350mg for females all at once. For those who cannot tolerate any oral magnesium there is transdermal. Epsom salt baths or foot soaks or lotions that can be rubbed into the skin.
I did change bisoprolol to nebivolol. Bisoprolol made my life miserable . It was terrible for me . I feel much better now. Hope you mum feel better soon!
Hello, is your mother being treated for anxiety? GAD is mostly a separate condition entirely and unrelated to medication, I had it long before AF was diagnosed.
No, mums been offered counselling. Mum never had any anxiety issues until the AF began. That’s why I believe this condition is what has caused the anxiety.
Brosely mentioned palpitations which means ‘awareness of your heart beating’ and is a word that upsets people when used by a doctor because it seems to trivialise their symptoms and put them in the ‘Victorian lady with the vapours’ bracket. Does your mother have palpitations in the sense of being aware of what her heart is doing? That makes me feel anxious and seems to be the worst aspect of AF for many people. Luckily people with permanent AF don’t usually seem to feel palpitations (only luckily if they are diagnosed and anticoagulated of course!) so maybe it’s something that will wear off in time. Best wishes ❤️🩹
If your mum’s heart rate is the issue she may need a combination of Bisoprosolol and Flecainide. Combined she could go to much lower doses if well tolerated. Or like others suggested here asking the cardiologist to try a different BB. Metropolol is another example. You and your mum need to sit down with the cardiologist to explore what’s better. I couldn’t tolerate the drugs so was glad to be referred to a cardiac electrophysiologist who suggested cryoablation. It’s a huge learning curve but never sit back and accept the dosage given. Go back every week if necessary as your mum’s quality of life is dependent on the specialists getting it right. Sending you and your mum a virtual hug. You’ll get there, don’t give up!
As I said previous Beta Blockers did not control my high Day Heart Rate. Exertion was fatiguing me so much that I collapsed into bed and slept.
Regardless of changing from Metoprolol to Bisoprolol I still was uncontrolled.
2 years and 3 months of not being anxious but sweating profusely over summer ended up having cold showers.
The fact that your mum's heart rate is so high mine was 156 on 10mg Bisoprolol did nothing to control.
I feel that a CCB Calcium Channel Blocker is worth a try - but I caution that Bisoprolol should be given at night and only 2.5mg which will control her BP if necessary.
I started on 180mg Diltiazem slow release. What is her Night avge H/Rate???? BP Day and night????
180mg 1/2 dose was too much and I have taken 120mg Diltiazem for 2 years 4 months.
I haven't looked back but forward. CCB was a life saver.
In UK it comes in 30mg 60mg 120mg 180mg up to 360mg.
So Diltiazem 120mg AM
Bisoprolol 2.5mg PM
This was balanced over night.
The Specialist should be thinking of a different approach. Your dear Mum having to be going through this. Resting heart rate and avge Day and at Night is all there after the 48hr monitor.
Any Heart Rate over 100 is abnormal and needs to be controlled. An anaesthetist would not operate on anything over 100, whilst my thyroidectomy was done with an uncontrolled heart rate the surgeon prescribed 2.1/2 bags of saline and last Blue dye - one way to reduce heart rate!
I have had 3 operations (not heart) since Stroke in 2019 when I was diagnosed Rapid and Persistent AF.
I'd be inclined to change your specialist who is interested.
BBs are given for anxious folk - it blocks too much Adrenaline getting into the heart.
I'm sure that your Mum is anxious because her heart is too fast rather than it is the Bisoprolol which for her and me won't control her heart rate.
Worth a try. Reduce Bisoprolol to 2.5 mg PM and introduce Diltiazem 120mg AM.
I started with 88-96 heart Rate Day but I lost 3kg and another 3kg and since November 22 my heart Rate Day is 60s.
Regardless of meds my Heart Rate Night avg is 47. Always know at night I get cold shoulders. Always need sleeves!
We are all different and Heart Specialists should know that.
See how you go. Fingers crossed. I can't help thinking of how I felt and I can sympathise that your Mum needs settling with a 'under 100' heart rate at Rest.
I have only a BP Monitor Microlife. Excellent, and all I need. Relax.
Thank you so much. We’ve already gone private once to see a consultant, maybe we need to book with a different one who can help to review and change medication.
Not even the hospital heart specialist thought of trying CCB Diltiazem.
High heart rate and anxiety go together. As one Auckland H/Specialist explained multiple out heart beats to minutes, to hours to days to weeks to months - your heart is too rapid with no rest during the day. You can't exert yourself.
Do some demanding.
I thought that it was my lot but if I had started on CCB my now heart wouldn't be in such a state.
Take a step back and look at the situation.
1st step to get her heart rate under control.
BBs are supposed to be in themselves anti-anxiety meds. I was reading a book and this lass was given a BB to pop in before she faced her date night.
You worrying for her strengths the anxiety.
Have your Mum on the right med to begin with. Rapid heart rate made me shakey, loose confidence and become frustrated.
There is a range of blockers that I know of.. ACE, BETA, CALCIUM.
When a Specialist can't look further except put her 'not working' med dosage up he/she is not showing the right interest.
What did her ECHO read. You can get a simplified printout and the long one. An ECG showed my heart under stress. The 24-hr heart monitor showed a true picture of the med on my heart.
What did that 24-hr monitor report say. Her Dr should be a part of 'getting this situation corrected, rapid heart rate makes one unfit, a zombie, belittled and exposed to all sorts of wrong diagnoses side effects.
When I was 'pulled free' I was an elated soul.
***Like Humpty Dumpty ...Mum needs to be put back together again. Think back to when she was 'normal'.
My Mum after my father died was diagnosed with alzeimers diagnosis. When I took over her care at my abode but built Mum a self-contained little Unit the Senior Consultant couldn't believe it and removed it from her records. Mum at 87 could count backwards, could recite her birthday, what day it was, todays date and President etc. I was present.
It is sad when you are labelled with the wrong diagnosis.
After the stroke the speech therapy told me to sing. I did softly and a Junior student Dr heard me, put down in his report "I had to check 'sanity' in her history. When I read this report out of hospital I rung him up and guess what I said!
It is so frustrating with an unhelpful diagnoses. It's degrading and the world is against you, personally.
Have an interested, specialist non judgemental and recommended person review her history thoroughly. Try her on CCB carefully.
Thank you for understanding, I am definitely going to do my best to try and get the help for mum. It’s very difficult seeing how she’s struggling on a daily basis.
It would be best if you saw an Electrophysiologist this time if you can and if you can be put onto his NHS list so that you can continue to see them so that they can follow your Mum's progress. I really hope that you can sort this out as this must be having an effect on your whole family and I feel that you need to make someone aware of this aspect too.
I couldn't cope at all with bisopralol but mainly because it totally knocked me out. It didn't make me anxious. It dropped my BP so low all I could do was sleep. It was changed to candesartan.
Early on in my a-fib journey, a new EP changed my Bisoprolol to Flecainide. Further on, another EP told me the symptoms I had that I thought were anxiety, were in fact my heart not beating correctly which mimics anxiety symptoms, i.e. not a-fib causing the anxiety. I personally think they're intertwined. Can you get a prescription for an anti-anxiety med for your Mum?
Mum has been given Promethazine to use as and when she gets bad episodes of anxiety, but the tablet info says take with caution if you have a heart condition. I’ve asked for something long term for anxiety but GP seems reluctant.
Many years ago I took Paroxotine (Paxil) which helped. However, I don't know if you have it in the UK. I certainly hope you can find a good solution for your Mum, Nickybhf. Best of luck to you.
l changed to Nebivolol. The side effects aren't as bad. Hope your Mums medication can be adjusted, so that she doesn't feel so poorly. I am nearly 88 years old and l am afraid that pills don't work as well as they do on a younger person.
Have been on 10 mg bisop for 12 years no bad side effects lowers heart rate puĺse can go to 50 s or high 40 s sometimes can make you a bit tired at first sometimes we are all different ho. Good luck.
I was prescribed bisoprolol, 5mg twice a day for my heart problems when in hospital. Since taking it I have found that the crippling anxiety I used to suffer from has became more like vague apprehension and I cope much better with many situations. Other than fatigue I have no other side effects.
Yes, we are all different. I was diagnosed with persistent AF six years ago and have been taking 10 mg Bisoprolol daily ever since - no problems. Good luck!
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Has anyone else had a steady heart rhythm but changing rate?
Withdrawal from Bisoprolol help. 
Flecainide has anyone else had good results with this medication for AFIB?
