Hi all, I have PAF diagnosed Sept 23, I’m taking 1.25 Bisoprolol and 5mg x 2. I recently had my Bisoprolol reduced from 2.50 as it was making me very lacking in energy. I’m 73.
We went out for a walk today, it involved a couples of inclines but nothing major, we stopped for lunch after about two miles and I had cheesy chips and southern fried chicken goujons ( I know that’s unhealthy, I do normally eat well) we then walked back home. I felt a bit tired as we’d walked four miles in total but I felt fine.
However when I looked at my Fitbit I was surprised to see my heart rate had tipped 134 although it was only for a minute, with 13 mins cardio and 32 mins fat burn.
This is my highest heartrate since September and I’m wondering if I’ve made a mistake lowering my Bisoprolol dose. As soon as I sat down my heart rate went back to normal, I don’t know if I should be worrying or not.
Fitbit chart attached.
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I’m wondering if I’ve made a mistake lowering my Bisoprolol dose.
Did your doctor concur/comment on the reduced dose ? Best that he know. Would also get his advice about your exercise regime.
Is 93-110 your average heart rate or lower ? My cardiologist advised and also I read that the goal is to be under 80bpm when you have afib. Not always attainable, but the goal.
Not a doctor, but since the rate was high for only a minute and came down quickly I feel there is no reason to worry.
Respect your exericse regimen, wish I still could.
Thank you, yes I contacted the consultant before lowering the dose, he said it would be okay, my resting heartrate is 59.
I would find it virtually impossible to keep HR at 80 during the day, when I’m active through the day it’s usually 58-95 but higher if I’m vacuuming or floor cleaning!
Normal heart rate is classed as up to 100bpm. I have fast AF. I often go higher than your peak if I'm slogging up a hill or doing something physically demanding. But it comes back down. I'd not worry. Who want's to feel drugged all the time.
Thank you, I’m tending to think that as it settled back so quickly. I would hate to have to give up my walking, we live in Cornwall and it’s difficult to walk anywhere without encountering a hill!
I'm in Cornwall too, drive a double decker bus on college runs and mine does this when driving particularly if something unusual happens on the road and I have to react suddenly, like emergency braking or threading my way through roadworks where the idiots haven't spaced their cone lane width correctly ... in these circumstances I regularly spike to 120 plus, BUT equally, it comes down to my normal driving HR of 75 to 80 and quite quickly too.
Do you know when the 134 bpm was recorded? The Fitbit chart shows your heart rate peaking at or around 111 bpm twice possibly coinciding with the 2 inclines you mentioned??
All these smart devices produce seemingly aberrant results at times. The question always arises whether it was a device/measurement error, especially if it doesn't align with your expectations.
That’s what I don’t understand with my watch, it only shows 111 on that chart yet on the daily summary graph it shows one minute at 134 … I think I’d be better taking my watch off as it really spoils my walks keep checking it!
That would be a good idea. I have no gizmos for this reason. If my pulse is up and I feel ok, I would gain nothing, except apprehension! If I'm symptomatic I know anyway. Very quick feel of pulse, regular or irregular ( I get both) and I have as much info as I need. Especially as cardiologist waved goodbye Feb 23 and 12 month Waiting List unless half dead!
I find similar, the watch says one thing but when I look at the daily graph on my phone it’s different, I plan to contact Fitbit to see why, does anyone know if Apple Watch is more consistent
I'd keep the watch on but check it occasionally, especially if you are going uphill.It helps you know that heart rate is getting a little steep and helps you to slow down your pace for a moment , take a drink or have a few moments rest and breath. It's just a helpful marker to help you make good exercise choices and that helps you extend your time doing an activity rather than something to get anxious about.
The higher rate wasn't for a long period, although it does show your body was doing something strenuous which could make you more tired .
I have a Tachycardia syndrome, so it's hard for me to say as even on the flat at a gentle pace my HR is usually about that level or higher. Not great , but as long as I listen to my symptoms and take regular drinks of water and breath breaks it helps to stop it getting too high.
The trouble could have been the combination of activities you did, were the higher readings after you had quite a heavy lunch?
Uphill walking or a big lunch can both cause a change in heart rate on their own. Doing both together is like a double whammy in your circulatory and nervous systems , even if you haven't got any health issues.
Your heart rate and blood pressure usually goes down after food , because you body needs to go into " rest and digest" mode so energy is diverted to digesting your food. It's one reason why some people can get dizzy if they try to move to quickly after a big meal or fall to sleep .
If you exercise straight after food it can force the heart to have to work a lot harder to help circulate oxygen to your limbs and it's not so efficient about it. Like all exercise you need to be in " fight or flight" mode to help the body perform but it can end up overdoing it on cortisol release if it needs to push your body to concentrate on movement when it wants to finish digesting food. The cortisol causes the heart rate to increase more than usual in this instance.
It's why you can get indigestion , cramp, numbness , heavy sweating or breathlessness if you swim or do cardio after dinner.
So , although in normal circumstances at a relaxed pace, you would probably be fine on your lower dose , your heart rate on a hill walk , especially if it was also hot will be higher, because your trying to ask your body to do too many things at once , but when you sat down and let it settle on just one job it would be ok.
It's a lesson to remember for another day , to pace yourself and consider the combination of activities you do together , which doesn't just include exercises but things like eating , drinking or taking rest breaks.
Basically don't combine Cornish hills with Chips and Cheese.😆😆😆
No matter what walk you do it's usually better to drink water before , during and after the activity especially when going uphill, and to eat lighter food options as well as allowing time for your meal to digest before you get going again.
It's all trial and error , but if you find it keeps happening, even if you make adjustments in your behaviour you can always decide to adjust to a higher dose on a day when you know you will be exerting yourself more.
The fact that you walked four miles is in itself very impressive. I am a newbie here, so I can't give you much advice, but it came back down quickly, like mine does, so that I would think is good.
I wouldn’t be the least bit concerned. I am really interested to know why people think they should be alarmed about a heart rate in the 130s. Has a cardiologist told you that’s a problem?
Thank you, no I haven’t been given any indication of how high my heart rate should go to be safe, although when I saw the consultant I asked him if I was okay to keep walking and he said ‘absolutely, do your walk and then walk some more’. I am a bit obsessive with my watch, I should probably leave it at home and just judge how I feel.
Walking up inclines will increase my heart rate , I always slow down otherwise it can take my heart rate too high. The rest seems fine to me. Four mile walk very good 😁
I thought mine was going up too much when walking. Doctor sent me for stress test and they said heart was behaving normally for my age. (75). I think it’s supposed to go up quite high when you put your body under pressure so as long as it comes down when you rest I’d say it’s normal and don’t overdo it.
Your max heart rate is usually worked out at 220- your age, so if my maths is correct that's 147 for you, so absolutely fine. My EP says it's more about how you feel, not the numbers. Our hearts are supposed to react when we need them to. If your AFib is otherwise controlled and your heart is not overworked then I wouldn't be worried.
Yes that’s how I worked it out too, but I’m wondering if taking the Bisoprolol changes that, I should probably go more by how I feel than keep looking at my watch.
It actually can make a difference with the individual circumstances and illness that a person has.Cardio measurement varies for everyone just as AmandaLouise77 says, it's not the same as considering your heart rate at rest.
On average a person can expect to have a BPM of 128-153 for moderate to vigorous cardio, and 153-162 for very vigorous , short interval, cardio for younger more athletic people.
It's the symptoms that are more key to whether the bpm is too much for you within these parameters. If you haven't exercised for sometime or you're in recovery a lower BPM may still give you symptoms and so you need to slow your pace and work up to your cardio level.
As you age , or with certain chronic illnesses which can make your body stress age higher than your chronological age , your maximum cardio rate reduces.
As your health and fitness improves and your symptoms are well controlled by medication and self care you can increase to a higher cardio output gradually until you find the pace you are comfortable with and unlikely to trigger Afib at.
For some this can be the cardio calculation for people on average , for others it may not be wise or possible to reach that cardio output.
It's the amount of time spent at rates over 140 BPM in one go that is the thing you need to be more mindful of as well as the symptoms you might experience.
It's usually better not to exceed 140-150 for more than 5 minutes at a time during high impact exercising even as a person with no cardio issues.
Alternating pace rather than going for the burn in long periods is better for improving exercise tolerance, fat burn and reducing the chance of an injury.
For people with cardio or other chronic health issues it's better to only work at the higher cardio exercise BPM for 1-3 minutes at a time and then scale back to ensure you keep your symptoms stable and don't trigger a rhythm event, and only workout at these higher rates 1-3 times during a workout , depending on your overall health and fitness.
That is the same whether you are walking or washing the car, golfing or gardening , lifting weights or lifting grandchildren.
No pain , No Gain is a myth .
This is when the watch or exercise machine pulse monitor can be the most useful because it can help you to ensure you are exercising at a safe pace and that you only stay at cardio level output for the amount of time that's appropriate for your individual health needs.
It also helps you to workout at a consistently safe level for you and to know when to take a moment to rest , breath and hydrate.
Thank you, normally on a walk including inclines I tend to peak at around 120 and I feel happy with that, I’m suspecting eating the (unhealthy) lunch then walking back caused the high peak, although it says it was only for one minute.
Years ago (have had AF for 19 years) I had to not walk anywhere after eating lunch or make it a very light one. If not my heart would race and make me feel totally worn out.
I'd take you Fitbit watch off and stick it in a drawer, and continue to walk, even though any form of exercise puts people's heart rates up. Exercise is good for us. Go on how you feel. If you feel really bad see a medic. When I took beta blockers, after 7 weeks I started with urticaria, which was bad enough to require treatment for 4 years. I also had an exacerbation of asthma requiring emergency admission to hospital, fortunately only for three days.
I was weaned off beta blockers. Now in my 30 th year of AF, it's permanent,though asymptomatic.
Don't worry about a minor increase in your heart rate that you didn't even feel.
Like Jonathan, I don’t think you should be at all worried. 135bpm is perfectly fine when you’re in active exercise. If your heart muscle is fine and it doesn’t precipitate PAF when you cool down, you should keep it up! I stopped bisprolol altogether once I’d had an echocardiogram and now regularly peak around 150bpm doing cardio and weights in the gym. Peak being the operative word. My resting heart rate is the same as yours (71 year old male).
Thank you, yess I soon go back to normal once I stop, I’m thinking what I ate for lunch probably didn’t help, I usually avoid salt and I always think food eaten in restaurants is salty.
I suspect all wrist worn HR monitors have "blips" that don't reflect the actual heart rate. I have read once that they can accidentally double or halve the actual rate on occasion but only as a blip which can be ignored.
My Apple Watch does much the same and I just can't see how a non-sustained value can be other than a mis-recording.
Getting the dosage right for bisoprolol can be difficult I find. I get a naturally low rate it seems anyway, so adding in bisoprolol is always going to take it lower - low to mid 40s is not unusual for me these days at times during each day, evening mainly. My cardiologist has told me that I can take an extra dose but to be sure it doesn't go too low - and that the low rate is fine of not symptomatic. I'm not sure how that can be done though since once a tablet is taken its effects last for well over a day. I'm currently taking 2.5mg per day, having increased from 1.25mg, and that from taking it only "as required".
Thank you, I’m pretty sure the 1.5 is generally doing the job, I feel better than on the higher dose, I’ve been offered nebivolol if I want to try it but I thought I’d stick with the Bisoprolol for now.
Nebivolol is a somewhat newer molecule, I believe, and has a different mode of action, so might be worth trying. Some have spoken highly of it, here. My own doctor said his experience was that it would be similar to bisoprolol for me, so I took his word for that and stayed. I recently asked if a Ca++ antagonist might help me better, but that idea was scotched, too.
My own experience points to a realisation that many issues that are put down to drug effects in AF are often down to the workings of the heart itself and, very much so, to the anxiety this can often cause. AF is, after all, the "visible" result of other often undiagnosed and even "invisible" processes, and these differ. For some, PAF is all there is ("lone AF"), with an essentially rather "normal" functioning atrium in between the episodes; for others, there is a more continuous background of atrial conduction issues. Slowing the ventricles when the heart is essentially "normal" is bound to cause "side effects" - whichever drug is used. It's a matter of getting the dose as low as will produce a useful effect, I suppose.
I'm also taking a blood pressure tablet (losartan, 100mg) , but not for raised BP but because the specialist said it has been shown to help protect the heart's pumping ability well. This does mean that even 2.5mg bisoprolol is making me feel a bit light headed if I get up too quickly, for example. It's a difficult balance and, in my case, the bisoprolol doesn't seem to be helping the AF and palpitations much. The specialist is going to try me on flecainide once I've had a scan to be sure it's safe, and then to follow up eventually with an ablation.
I walk daily, there’s a hill that I walk up briskly, while I was on 2.5 Bisoprolol I would rarely get above 110 bpm but if I really pushed I could get to 130s. Since stopping the bisoprolol 130-140 is the normal and I feel fine.
I don’t think 130s is that high if you’re exercising but as others have said the watch can also give false highs occasionally when swinging your arms.
For a year diagnosed AF now. With meds no AF anymore. Always when I start with serious excercise heartrate jumps up to 140 or so and after 3 minutes falls back to normal rythm.
I have a Fitbit Versa 2 and I do get frustrated with it at times as it will show a high heart rate if I'm doing something with that arm, like washing or brushing my hair or peeling and chopping veg even. I actually take it off now when showering and washing my hair.
I would think likely that it would have coincided with your strenuous bit of the walk or perhaps when you were excited about the cheesy chips and goujons 😁.
Well Bisoprolol can decrease energy levels definitely, I have found I’m better since lowering my dosage 2.5 down to 1.25. Or I have been offered Nevibolol which some folks find better.
I am on 25 mg metoprolol ER daily after being on carvedilol 3.25 twice daily. Periodically I have the same problem when walking for exercise or even when just showering or walking around at home sometimes. My heart rate will go to 125 with very mild exertion at times, for several days at a time. No other symptoms beyond feeling out of breath like I’ve been exercising much harder. Most days my heart rate is under 110 during heavier exertion. Mine also goes back to normal quickly. My doctor isn’t concerned. Says possibly I’ve gotten used to less activity since before an ablation. Is the 4 miles walk new for you?
I’m exactly the same, with the levels you described. I definitely haven’t walked as often as usual through the winter so I am still probably building up my fitness level.
AFib can be like that - up one minute and down the next. It sounds to me like you are in PAF. I will also say be careful of these monitors - they can give an incorrect reading and scare you death😱
I wouldn't be worrying, I'm 73, when I exert myself weightlifting my heart rate shoots up but nothing untoward happens. I don't worry about anything that goes away on its own, you'd do more damage by worrying and stressing than just accepting you're not at peak fitness.
I would recommend that you eliminate Gluten from your diet TOTALLY. No exceptions. Eliminate sugar if at all possible, although you may still get sugar in things like bananas and fruit and other good food. Clean up radically your diet immediately, and NEVER deviate. This is one of the solutions for the problem. And it is totally within your own power.
Thank you for the suggestion, I do eat a balanced varied diet, personally I’m not too keen on cutting things out completely, but that’s fine if you think it helps you.
Interested to know where you got the medical evidence for that or is it just your personal experience? You asked a question about this on a previous post and most answers you got, were advising GF diets made no difference to people's AF burden.
I have experienced lots of 'wild peaks' on my Fitbit since I started paying attention to it, and I've never managed to verify this apparently racing HR (I'm talking 180!) with a corresponding pulse. If it's a sudden peak that doesn't correspond to sudden exertion or feeling Weird then I'd put it down to an anomalous measurement. Fitbit is great for plotting trends but it can occasionally be fooled. Don't let a few anomalies on the graph rattle you. Easier said than done, I know, but after 6 months of anxiety about it (and occasionally taking it off and putting it in a drawer!) I've decided to Not Fret and I'm a lot happier.
When did you reduce your dose? That in itself will make the heart react until it settles down to the new lower dose. I reduced mine ever so slowly as each time I reduced it I could feel my heart fluttering much more, then I’d quickly go back to the higher dose. When I spoke to my pharmacists he advised me to reduce it REALLY slowly and that worked for me. I also found that even at 1.25 it controlled my heart the same way as it had at 3.75….. without any of the side effects! Who knew! 🤷🏻♀️
Thank you, yes, I do suspect that meal didn’t help, and we did start back virtually as soon as we’d finished. My resting pulse is about 59 so all good there.
I worry that I am on too high dose of bisoporol 5mg twice a day even though I feel fine on that dose my heart rate is very low. So I decided to cut the evening one to 2.5mg.
I think it’s always best to ask before doing anything as we’re all different. I had a chat with surgery pharmacist and he said yes to reducing my dose, but I still confirmed that with my consultant. I do agree though, why take more if less is adequate.
I am 73 and reduced my bisoprolol from 2.5 to 1.25mg and use an apple watch. I walk 5klms most days and noticed my heartrate staye steady at 80-90bpm for the first 3klms and then it starts gradually rising to around 120-135bpm in the last klm which is a sharp uphill walk. I feel ok when this happens and wouldent know other than my watch and a few ectopic beats. When I come home I immediately check my Kardia and it often shows Afib although its normal sinus rhythm in a few minutes and my heartrate is back in the late 50s in 10 minutes or so. I do not really worry about this at all as I have no dizziness or pain and possibly think the very short afib bursts are ectopics which I have had for the last 12 yrs or more.
That’s interesting, thank you for that, I think as long as you’re basically feeling okay these things are fine, we’ve may pre come a bit too conscious of every move now we have these fancy watches.
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