Increased episodes of AF

[ChrissieMT]

I have had paroxysmal AF for about 5 years. For several years I only had an episode every 6 months or so and was prescribed 1.25 of Bisoprolol just once a day and 5mg of Apixaban twice a day. 18 months ago the AF episodes got a little more frequent, my GP upped my Bisoprolol to 1.25 twice a day, no change and I was referred to a cardiologist. Following a long wait for an appointment with a cardiologist I have had my meds upped by him to 3.75mg of Bisoprolol. Since taking this higher dose my AF attacks seem to have increased and they seem different, more fluttering and a weird sensation in my throat and chest, they last anything up to 12 hours and leave me feeling awful. My BPM remains at around 65. Could the higher dosage be causing the increase in attacks? I must admit to be feeling very fatigued with aches and pains. Thanks everyone.

[Vonnegut]

Bisoprolol reduces heart rate which is why the lowest dose of it was too much for me to take daily as it brought my heart rate down to the low 40s! It does nothing to stop the irregularity which is the other part of our problem. Flecainide does that and works very well for me but we are all different The PIP dose was 100mg with added Bisoprolol if my heart rate exceeded 140 twenty minutes after taking it which it rarely was. Now that I take 100mg of Flecainide twice daily I haven’t had an episode for ages so no need for anticoagulants either! Good luck finding what works for you.

[Ppiman]

My bisoprolol was doubled in March and I can say the same has happened to me. When I look at the ECG traces from my Apple Watch, there are far more and slightly different shaped ectopic beats now. My specialist saw me a few days ago and saw these and said it was all from the atrium and is a part of the general AF problem. He did say that there might now be flutter waves mixed in (I had an ablation for this in 2019). He said that I could try reducing the bisoprolol, and have halved it to 1.25mg from yesterday but last night was pretty tough, palpitation wise (although not while in bed, thankfully).

He said that the ectopic beats can lead to a sudden momentary drops in BP inside the arteries that can't be measured by a BP machine and that these can affect the brain momentarily and cause distancing or panicky feelings. I was also told that palpitations from atrial flutter can feel worse than from AF for some reason.

Steve

[Buzby62]

Some might say the slow heart rate (bradycardia) in NSR that Bisoprolol causes can slow the heart so much that it allows the rogue AF beats to take over. There may or may not be any truth in this but food for thought. There does seem to be a lot of us with bradycardia that suffer AF episodes.

Some tolerate Bisoprolol better than others and some can’t tolerate the smallest dose.

Best wishes