Paroxysmal atrial fribulation

[Aprilla12345]

Hi all still on this journey wondering does anyone get really emotional sometimes for no reason at all wondering if it's bisoprolol or the afib I am a. Building worker so to suddenly well upper and have a few tears for no reason fid it a bit odd as no sign of a afib comming or any other events at the time who knows

[Cavalierrubie]

Hi Aprilla. Sorry you are having this problem, which must be difficult. Depression can be a side effect of Bisoprolol. If you read the leaflet inside the box, it does list that, although not for all. You don’t state the dose you are on? I can’t tolerate this taken regularly, as it lowers my blood pressure too much. I have it as a pip. I do, however, get occasions when l feel down, so don’t really know if that relates to AF or not. Living with AF can have its moments, as you must know. It would also help if we could have some good weather instead of all this depressing rain. Maybe speak to your GP and see what he suggests. There are other beta/blockers to try rather than go on antidepressants, which are addictive if taken long term. All the best.

[2023AFibber in reply to Cavalierrubie]

Read the side effects 4 all your meds, most say mood swings, depression etc etc. I have taken about everything except amerodidone(sp) and they all say the same. It's been a little over a year snd the weepies are less often. There is hope. Nothing wrong with a good cry

[Aprilla12345]

Only on 1.25 mg lol

[Cavalierrubie in reply to Aprilla12345]

That’s a low dose so that’s good. If you have been like this for some time, and it’s getting worse see your GP and don’t suffer in silence. Take care

[Aprilla12345 in reply to Cavalierrubie]

The nhs have at the moment no medication that I tolerate ie beta blockers calcium brokers as well I am on there last ditch plan which is off to see cardiologist in early July so was told grin and bear as that's all the types of meds they have so under my suggestion and there observation I am adju meds to see what happens as early on I was having no rate control ectopic and multiple beats off and on and for several hours at night horrible getting moment blackouts ck outs when first put on 5 mg bisoprolol thank goodness I kept on at them and after a while they put me on digoxin that was hell couldn't move with out bpm upto 150 plus so now on 1.15 mg. Bisoprolol and 60 microgammes of digoxin I can just get by on with minimum side effects what a journey thanks for your advice will monitor my self

[Cavalierrubie in reply to Aprilla12345]

What an awful time you are having. It’s no wonder you feel emotional, who wouldn’t? It’s not long before you see a Cardiologist and the sooner the better, so that you can get stabilised. It would probably be better for you to eventually see an EP (Electrophysiologist) who deals with arrhythmias, medications etc. We are all different and it is a fine line to get the medications that help most. Ask the Cardiologist if he will refer you. If not ,you could go privately, initially, and then transferred back to nhs. I can’t tolerate most of the drugs so don’t be fobbed off. Only you know how you feel. My friend’s son passed out with this so, it’s not uncommon, but must be very scary. Remember it’s not life threatening. Hope you soon get some professional help and you are feeling lots better, as l am sure you will do eventually, when you get the correct help.

[Aprilla12345 in reply to Cavalierrubie]

Thanks will keep all updated

[BevCynfelyn in reply to Cavalierrubie]

I wished people would stop saying AF isn't life-threatening. For some people, myself included, the burden of being in constant, very symptomatic, AF has put me in serious heart failure and I now need major heart surgery.

Unfortunately the damage to the heart is so bad the the cardio-thoracic surgeon doesn't belive I will actually survive the surgery.

So AF, in my case, even with the cocktail of drugs I'm on including Apixaban, digoxin, Valsartan, Angitil, Rosuvastatin, spironolactone, is well on its way to being fatal.

[Cavalierrubie in reply to BevCynfelyn]

I am sorry to hear that you are so unwell. When l was first diagnosed 6 years ago the Cardiologist whom l saw told me that AF is not life threatening and this is what l believed. I was also told by the lovely people on here the very same. There seems to be some wires crossed here, so who is right or wrong?

[BevCynfelyn in reply to Cavalierrubie]

AF is a very weird condition that affects people in a lot of different ways, but it is progressive for many people. The NHS here in Wales restricts people to only 3 cardioversions, I had my third in 2022 so when I went back into AF in Oct 2022 I've been in full-time and very symptomatic AF ever since then. The cardio-thoracic surgeon doesn't believe he will be able to bring me around after open heart surgery, so is aiming to do as much as he can through a transcatheter procedure which was only introduced to the NHS last autumn. Other than that, I will be on the waiting list for a heart transplant. I'm currently off sick from full time work which I'm desperate to get back to but some days I'm too ill to even get out of bed.So, yes, if you're AF makes your heart race for a couple of hours once or twice a year, as is the case with many people with paroxismal AF, then no, it's probably not life-threatening but in others it can be.

[Ppiman in reply to Aprilla12345]

That’s still quite a strong dose because it’s a powerful drug on the heart with people varying in their response. I’ve gone down to 1.25mg after going to 2.5mg a month or so ago. That gave me cold toes, a light head and a slow heartbeat.

If this is a new state of mind and you are in other ways okay, then this is likely the bisoprolol. There are beta receptors in the brain (well - in many organs), apparently, and the effect of the drug varies somewhat across individuals, although it’s a well tolerated drug overall.

I’m thinking of asking to switch to nebivolol since it acts differently and many here have spoken highly of it.

Steve

[pusillanimous in reply to Ppiman]

Medications are a mine field of different opinions. I am mildly asthmatic and here I read that Bisoprolol should not be prescribed for people with the condition. I have asked 3 highly qualified Cardiologists about this and every one has told me that Biso is Cardiac specific and it is fine for me to take. I asked one if I could have Nebivolol instead, he said I could, but it is broader spectrum and not as efficacious for cardiac conditions. Cutting down to 1.25mg Biso has minimised side effects for me. Please don't get the impression that I eat Cardiologists for breakfast! One moved to an area that was too far away, another was just so busy, it was difficult to get an appointment. My current one is lovely, nearing retirement, he paces himself perfectly and does not overbook, mind you for my annual routine check which is due every September, I have to book in June !!

[Ppiman in reply to pusillanimous]

Mine told me that bisoprolol was the best choice by far. I have reduced mine to 1.25mg daily, but I also take losartan as a cardio-protective rather than for high BP, so the extra bisoprolol (when at 2.5mg) seemed to make me a little light-headed presumably because it brought my BP down too far. That said, I don't feel much different on 1.25mg and think it's likely my heart rather than the drug. I did get cold toes when I went up to 2.5mg but that hasn't changed on the lower dose.

The problem is that the condition itself can itself easily deteriorate or change, it seems to me, so what is the condition and what is the drug is hard to tease out (and, indeed, what part anxiety plays in it all).

Steve

[Aprilla12345 in reply to Ppiman]

Thanks bisoprolol is quite harsh have booked a private appointment with a electroligst for next week fingers crossed

[Ppiman in reply to Aprilla12345]

I think all beta-blockers likely are. I just read a fascinating article on Medscape online entitled "The Tyranny of Beta-blockers" that explains a good deal about these drugs.

Steve

[HGates in reply to Ppiman]

Thanks for mentioning this. Just read it. V. Interesting.

[Ppiman in reply to HGates]

It was a good summary of beta blockers, wasn't it? They clearly are a very useful drug but they do come at a cost in terms of side effects.

Steve

[pusillanimous in reply to Ppiman]

As far as I'm concerned, anxiety cannot be blamed on any drug, it is in the nature of the beast'. I have suffered from it since childhood, and no, I was not abused or mistreated nether was I bullied by my classmates or friendless !

[Ppiman in reply to pusillanimous]

Same here completely! I meant that unpicking the role of anxiety is nigh on impossible for me when considering the symptoms (although cold toes is not anxiety!).

Steve

[Cavalierrubie in reply to Ppiman]

Steve, What are your views on the above reply from BevCynfelyn? Hope you don’t mind me asking you, only l am rather confused, as it’s contrary to what l have been told, not only on this forum, but by my Cardiologist. Thank you.

[Ppiman in reply to Cavalierrubie]

I think that the hearts in some people react differently to the stresses of atrial arrhythmias or there are other complicating aspects that aren't being mentioned here. Those I know with AF, mainly two friends, but a couple of relatives, cope well. In my case, the LBBB is a complicating aspect, it seems, for example.

Steve

[Cavalierrubie in reply to Ppiman]

Thank you for your reply. I think l will write a post on this topic. It will be interesting to read other’s experiences.

[Ppiman in reply to Cavalierrubie]

It will indeed. This is such a valuable forum.

Steve

[Auriculaire in reply to Aprilla12345]

Some people find even this low dose hard to tolerate. Others can take 10mg with no problems. There are other rate control drugs and there is the option of PIP if your afib is not persistent. If you feel lethargic or have any problems of breathlessness when in NSR my money would be on the Bisoprolol.

[mjames1]

Yes, it definitely could be the bisoprolol and a trial off of it might be something to discuss with your doctor.

If you're not actually in atrial fibrillation, or if your heart rate is normal, there are a number of recent papers suggesting that beta blockers may not be necessary on a daily basis.

But if you do need to control your rate and atrial fibrillation, there are alternative drugs you can use such as as Diltiazem, which may have a fewer side effects.

Jim

[Aprilla12345 in reply to mjames1]

Thanks it just seems nhs don't have a lot of medication to try money perhaps

[mjames1 in reply to Aprilla12345]

I have read a number of people here with NHS have used alternative medications to bisoprolol, including different beta blockers and the calcium channel blocker Diltiazem that I suggested. Doctors tend to keep you on the same medications, so often it's up to you to bring up the issue in terms of side effects and the desire to try alternative meds.

Jim

[Teresa156 in reply to Aprilla12345]

Hi Aprilla,

Jim is right - there are quite a few different medications you can take for Afib under the NHS. Bisoprolol is the first one they give out to everyone, but it doesn't suit everyone. You need to tell your GP or cardiologist that you think it might be affecting you and they can try another beta blocker, or a calcium channel blocker.

[Aprilla12345 in reply to Teresa156]

Yes I did they tried calcium blockers then digoxin still lots of side effects no on 1 .12 bisoprolol and 60 microgammes ot digoxin still side effects ie tired short duration of effects but it just gets me through off to see private cardio next week

[Teresa156 in reply to Aprilla12345]

I really feel for you Aprilla.

I first started getting palpitations ( or what I thought were palpitations) at just over 40. They never happened often back then, I’d go years without them, so I forgot about them. If on,y I could have those years back.

Heart meds can be difficult, from what I’ve learnt on this forum. I’m glad you’re progressing and seeing an EP privately, I’m sure they will be able to help you get through this.

Please come back and let us all know.

All the best.

[Aprilla12345 in reply to Teresa156]

Yes will do if not drop me a reminder lol as Brian like a sieve

[Ppiman in reply to Aprilla12345]

I think the majority of cardiac drugs are available on the NHS. Perhaps it's more that NICE has protocols that doctors tend to follow regarding which is first line, and so on. All beta blockers are listed by NICE and the Ca++ agents such as diltiazem and so on.

This gives a lot of useful information: nice.org.uk/guidance/ng196

Steve

[pusillanimous in reply to mjames1]

Yes we are all different. I am on 1.25mg of Biso, because the Cardio who initially treated me when I was sent to him at the time my GP diagnosed Afib ,kept me in hospital for two days and considered my blood pressure was low enough and removed my PB medication. Anyhow with fluctuating blood pressure, but with Biso keeping my HR fine, I was at one stage prescribed Valsartan. I wanted to cry all the time for the few days I tried it, I was still on Biso and still am - the moment I stopped the Valsartan, I stopped crying

[AKatieD]

Yep, cardiologist put me on bisoprolol and when I told him of side effects he was not surprised, agreed and said it was common on people with low underlying heart rate! Seemed like a bit of forethought on his part before prescribing could prevent problems!

[bean_counter27]

mjames1 AKatieD

Although suspected, the link between β-Blockers and depression is possibly coincidental rather than causal (refer below). Having said that, given that we're all different trialling alternatives to bisoprolol would seem to be an obvious option.

The following extract is from a paper titled "Do β-Blockers Cause Depression?"

"β-Blockers are important drugs in the treatment of cardiovascular diseases. They are suspected of inducing various psychiatric adverse events (PAEs), particularly depression, affecting cardiovascular morbidity and mortality. We performed a systematic search for double-blind, randomized controlled trials investigating β-blockers to analyze the risk of PAEs or withdrawal of therapy due to PAEs..........

Despite being the most frequently reported PAE with a total of 1600 cases, depression did not occur more commonly during β-blockers than during placebo (odds ratio, 1.02 [95% CI, 0.83–1.25]). β-Blocker use was also not associated with withdrawal for depression (odds ratio, 0.97 [95% CI, 0.51–1.84])........

Among other PAEs, only unusual dreams, insomnia, and sleep disorder were possibly related to β-blocker therapy. In conclusion, this analysis of large-scale data from double-blind, randomized controlled trials does not support an association between β-blocker therapy and depression. Similarly, no effect for β-blockers was found for other PAEs, with the possible exceptions of sleep-related disorders. Consequently, concerns about β-blockers’ impact on psychological health should not affect their use in clinical practice."

[Shopgal67]

it can be an emotional, worrying time .

I developed heart health anxiety four years ago , PAF is notoriously difficult to diagnose and the hospital could never catch it , I was sure I was going to die of a heart attack every day !

Being told you have a serious health condition is shocking and clearly your symptoms are adding to the stress and worry .

I’ve paid privately for a consultation with an EP who specialises in afib she put my mind at rest answered questions on medication, further tests , my risk of stroke and ablation. £250 well spent.

I’ve also had CBT through my GP surgery, it can be accessed via silver cloud and is done virtually, you are then assessed and put forward for talking therapy. I found this so helpful in coming to terms with my diagnosis.

I wish you all the best and hope you find some relief soon .

[southkorea]

yes I do the same but I tell myself how lucky I am and it soon passes. Having to take any tablets every day is depressing !

[Popepaul]

Just a thought. I wonder if you have low testosterone. For many of us levels drop with age. Low testosterone is associated with emotional lability and indeed low mood.

[Aprilla12345 in reply to Popepaul]

Yes I do been on the referral list for 2 years slow here

[ainslie in reply to Popepaul]

This a important point, low testosterone is very common as we age and optimising it can make a huge difference to our mental and physical health, i say that from experience

[Canteringon]

I joined the AF club in January this year… I felt awful on Bisoprolol and was switched to Nebivolol, which seems fine. Like you I was on Digoxin and felt awful. With difficult to control paroxysmal AF. Taking advice, I had a private consultation and then a cardioversion with him. My meds, since then, are Nebivolol, Apixaban and Flecainide. I seem stable and feel completely fine on the meds. Almost like normal! Not sure if that helps? But just to say, there is hope. My life seems pretty normal again now, after a six week period of hell…. I lead a very active life, on my farm with my horses, riding regularly.

I do hope some adjustments for you will make you feel well again - mentally and physically. All the best. 😊

[Aprilla12345 in reply to Canteringon]

Thanks will keep pushing them

[Cat715]

I do. Most of the time I just get on with everything but the AF and the Bisoprolol make me feel washed out at times which I find debilitating. Also the worry that the AF will get worse and the undergoing all the treatments but then I have to STOP myself and be grateful that I am having the treatment that can save my life.Maybe in your case you should go and see your GP as the diagnosis might have caused you to feel depressed?

Everyone gets upset sometimes. Its ok to cry.

[Fishingqueen]

I think it is just the stress of it bc I do. I had been in aflutter for 12 weeks and finally got cardioverted this last Wed the 12th. I went into afib for a short time this evening and I just instantly started crying. I don't know about you but it so affects the quality of my life that I had just been worrying that I would go back out of normal. Especially since the longest I have ever been out of rhythm before was 48 hours. I don't have to worry about going to work bc I retired 6 years ago when I was 53 so that is nice. I have an Echo and a nuclear cardiolite stress test on July 31st and have an ablation scheduled for Oct 16th(they are so far out bc they don't have enough anesthesia people to do them) my ankles swell if I sit too long and bc of the heat. I have a lot of chest discomfort and horrible headaches. I have had 4 ablations starting back in 1992 but never had one for afib. I have never heard of the meds causing emotional issues but not saying they can't. I an on diltiazem and was on atenolol until Wed when I was cardioverted and my heartrate went down in the 50s when it went from aflutter(120) to nsr so they stopped the atenolol. As soon as I went into afib tonight I took one. My rate has slowly been going up. It was in 70s and 80s tonight. I was a nurse for 30 years so I told mu husband that I was going to self medicate 😳. I had been on up to 50mg twice a day so I don't think 25mg was going to hurt me. I have the little cardia monitor and check my BP. I see a lot of people on here on bisoprolol. Rarely saw anyone on it during my nursing career here in the US. Hope you feel better on it.

[Aprilla12345 in reply to Fishingqueen]

Working on it thanks

[Ppiman in reply to Fishingqueen]

In the US, metoprolol is the favoured drug, I believe, but in Europe it is most often bisoprolol.

Steve

[Singingforever]

I had to stop bisoprolol because it made me depressed. I am now on metoprolol.

[Aprilla12345 in reply to Singingforever]

Going private now to see if meds can be changed

[Vonnegut]

Poor you, getting this affliction while still quite young- very unfortunate. I’d had my “three score years and ten” before it got me. Please go easy on yourself and try some gentle breathing or mindfulness stuff and remember the advice of the Hitchhikers Guide - “Don’t panic!”

[Jetcat]

hi Aprilla, when was your AFIB diagnosed.? I only ask because when I was first diagnosed I did slowly slip into anxiety and depression because of me overthinking about my AFIB.!

Best wishes.

Ron

[Aprilla12345]

January this year