palpitations

[Prosecco1997]

hello I have reduced my bisop to 1.25 twice per day , felt ok but having palpitations, had a run of them last night ,heart 100bpm and extra beats for few hours , today doctor said take 1.25 three times a day , took my second dose and got lots more palpitations? He said this should stop them ? I have also not took my flecinide for a week , trying pill in pocket , but can this help palpitations? Last time I took flec I felt ill

[Ilovedogs12]

Hi,I think you might need to give it more time to start to work, at least a few days.

When I first started my medication it took about a week before I saw any benefit.

Try not to worry about it (I know it's not always easy but doing something that takes concentration usually helps) and give it a little more time.

[Blearyeyed]

It will take time for your body to adjust to the increase in medication and loss of daily Flecainide which will cause palpitations and other symptoms.

The return of symptoms may well be your body telling you that you require the medication daily , but that it will also take time to adjust to it.

How long had you been taking your medications before you chose to stop?

It can take 6-8 weeks for your body to get used to a new drug and systematically produce full control over your symptoms, and it can take a number of weeks for side effects from medications to reduce to mild levels or completely because your body needs time to adjust to processing and using a new chemical.

Sometimes , patience is required and you will have the odd bad days when you first start or change medication which can make you feel anxious that it isn't working or isn't right for you before it's had chance to work. The added Stress you may feel about taking a medication can also cause things like palpitations and a higher heart rate or BP caused by Health Anxiety triggering your symptoms.

And did you stop Cold Turkey?

If you have been on a medication daily for more than a week or two , other than things for infections or taken as short course treatments it's usually better to taper off it and not just stop . This is especially true with things like pain killers , Neurological medications and cardiac medications that you haven't received a new treatment for because the instant halt, especially if you still have the same health condition causes Withdrawal symptoms which can be things like Palpitations, Dizziness. Headaches and Stomach Upset but can also trigger a flare up in your aFib or whatever you took the medicines for.

Yoyoing taking medication which has prescribed for daily use , and only taking it when you feel symptoms come on (unless it's specifically been prescribed as a pill or spray when required) can also confuse your body and have your heart reacting like a bouncy ball bumping about in metal box.

If you've discussed only using Flecainide as a PIP after taking it for some time it's better to take it on alternate days for a week then every two days , then every three days over a ten day period before doing the PIP method.

If , however, you find your symptoms are returning and increasing without the drug you may need to go back on it , or an appropriate alternative, and find ways to reduce the side effects by making other changes in diet and daily pace of activity.

The same would be true for your Bisoprolol, increase to twice a day for several days consistently then go up to three times a day. Take it consistently for 4-6 weeks. If you find the side effects are still too much or your symptoms still aren't improving you can return to the GP with proof that it's not suitable for you and request to try alternatives appropriate for your condition and medical history.

Try using deep breathing exercises and relaxation techniques to reduce the palpitations and help control how Stress may be effecting your symptoms too , especially at night. Creating a relaxing bedtime routine, having more rest breaks during daily activities, and keeping well hydrated daily also helps when you start new medication or change the doses you are on.

Hope things improve soon , take care , Bee

[Prosecco1997 in reply to Blearyeyed]

Hello been on them for 13 yrs , but getting awful side effects now , I’m now tachycardia and don’t know what to do , as flecinide gave me palpitations when I took it last week and made me feel un well

[Blearyeyed in reply to Prosecco1997]

Although palpitations and feeling unwell occurred close to taking medication it may still not be the root cause of the tachycardia. We often assume one condition or medication is responsible for new symptoms when it could actually be a different issue or change in an existing problem that is causing the symptoms we have.This is particularly true with cardiac and autonomic health issues, AF can change , but Tachycardia can also be caused by various other health issues and we assume it's the AF or medication causing it.

I had Chronic Dysautonomia, a Tachycardia related condition for most of my life but it took decades for it to be diagnosed. The Tachycardia Syndrome caused me to develop aFib rathervthan the other way around.

I assumed for some time that it was the Dysautonomia getting worse rather than the possibility that I had developed something else.

I also went through a nasty few years when both my Tachycardia and aFib got worse , with the Cardiologist and GP tinkering about with my medication with no result.

Then I checked through my old blood and requested tests and discovered that I had Vitamin B 12 and Folate Deficiency Anaemia .

You can have these issues even if you have a good diet and take supplements as I did, especially if you take certain necessary medications or have chronic health issues.

I now receive B12 injections and Folate infusions and the increase in my symptoms was solved.

Anaemias of all types and even vitamin D , B vitamins and Folate , and Electrolyte range can cause very serious symptoms including changes in your cardiac function and your reaction to medication but most GPs and Specialists often forget to check for these things and a simple cause for some serious symptoms isn't spotted

It would probably be advisable if this changes has recently occurred even before you began coming off the pills to get referred to Cardiology for a proper assessment. Requesting a Cardiologist with experience of Tachycardia issues, as even the Specialists can be less knowledgeable about Tachycardia conditions.

A Cardiologist can request more tests and make better suggestions about medications that you can take if it turns out that your current drugs are adding to the symptoms now that you body has changed since they were first prescribed.

You could also request the GP to give you a 72 hour Holter test to help get evidence of when the Tachycardia is happening and why . GP surgeries do have their own devices but don't utilise them as much as they can because of costs.

You would need to take your current medications at the dose and times recommended each day for a few weeks prior to the Holter and during the tests to get the most accurate results, unless something is definitely causing serious side effects.

You should also start a symptom diary and take your heart rate as well as your BP , after 15 minutes sitting with legs raised in the morning before getting out of bed and in the evening 2 hours after a meal .

Note anytime you spot symptoms, not just cardiac ones, but also symptoms after physical activity, joint pain , headaches, toilet routine changes , insomnia because this record is invaluable to show your doctors and help them rule out possible causes of your change in symptoms.

Have you had a full set of blood tests to rule out other causes? Including tests for possible vitamin insufficiency like Vitamin B12, Folate, Iron/ Ferritin, Vitamin D , Full Blood Count, Kidney Function ( Electrolytes) and Liver Function.

You can request your GP to do these tests as part of your cardiac health monitoring especially if you are on medications long term.

In fact , they should assess all patients on medications according to the guidelines every six months for most of these tests, and every 12 months for Vitamin D.

Request a copy of your results.

The GP may say they are normal but very low or borderline results are classed as normal but are a record of insufficiency and can still be causing the patient symptoms so changes in diet or short term supplements may be needed to improve your general health.

Often simple treatment of vitamin insufficiency, electrolytes imbalances and dehydration with evidence from test results to guide us is enough to improve new symptoms and existing health issues.

Tachycardia and Palpitations are a common symptom of so many different types of short term or long term health problem it's hard to pinpoint what's causing them and it can delay diagnosis or often quick solutions when we all get into the habit of assuming it must be because of our aFib or medication but it's a trap most of us fall into at some point.

Hope you get things sorted soon, as a person whom lives with permanent Tachycardia and Orthostatic Heart problems everyday I can empathize with how you feel. Good Luck , Bee

[bean_counter27]

Making both changes at the same time makes it difficult to pinpoint which change (if any) has caused your symptoms. It is also possible it's a combined effect.If possible, try single changes when making changes.

Reducing Flecainide alone resulted in increased palpitations for me so I reverted to previous dose. I plan to try again. If it occurs again then I'll be confident palpitations increase is because of dose change.

[Prosecco1997 in reply to bean_counter27]

Hello I have been having lots of palpitations all afternoon not a break between them , took 2.5 bisop without flecinide this morning, then they started in afternoon , my heart rate dropped for a bit then went back up , took flecinide at 5.30 and it has helped , so think I need my flecinide, I spoke to af nurse she said it’s fine not dangerous, but it’s an awful feeling , just got my medication sorted from feeling so ill , but now have to go back to the start again , says no af which is good , so I realy don’t know what’s causing it

[Prosecco1997 in reply to Prosecco1997]

Everytime I move I’m getting palpitations now

[Peony4575]

Coming off bisoprolol lowest dose for a short time caused various tachycardias especially at night and on waking lasted for months but settled eventually

[Ppiman]

Beta-blockers are not that effective at reducing palpitations, I have found and read, but they can and do. I would say taking bisoprolol more than once a day shouldn't be needed as it soon reaches a constant blood levels at its optimum once-a-day dosage.

I think you'll need a fortnight or more for it to achieve its maximum effect on the heart, though. That's what I seem to have found, but I can never tell as these things wax and wane at will.

Steve

[Vonnegut]

How different we all are! As I have recorded here before 1.25 mg taken once a day was too much for me and I was told to stop taking them after only three days. They reduce the heart rate but do nothing for the irregularity of the heart rate which is our problem. Flecainide does that. I first took 100mg as a PIP with a 1.25 mg Bisoprolol added on the very rare occasions when my heart rate exceeded 140 twenty minutes after taking the Flecainide. Now that I take Flecainide twice daily, I have not had an episode for well over a year now and the last episode must have arrived when I had covid with no other symptoms but a positive test and the heart settled with an extra Flecainide. Hope you find what works for you.

[Gfern]

I think it sounds like you need to speak to your doctor about stopping and starting these meds, peoples experiences on a forum can’t replicate your individual needs in this regard.

[Autumn_Leaves in reply to Gfern]

You’re absolutely right.

[Singwell]

It does sound as though your issue might be due to you changing 2 meds at the same time. Stopping one altogether except as PiP and then reducing g the other (then increasing as suggested by your GP). This makes it extremely difficult to identify the culprit and coincidentally increases your anxiety. Ideally you should be doing this with an arrhythmia nurse. Is there one at your local cardiology department?