I have been on Flecainide for over a year , very few Afib episodes and feeling fit and healthyAfter a sudden episode this week , my heart up to 170 beats a minute , and three days in hospital , I find myself on 500mg Bisoprolol Fumarate and 200mg Amiodarone Chlorhydrate
Pulse now hovering between 40 and 45 and blood pressure 9 over 6
Based on all your experiences , should I decrease the bisoprolol dose ? Seems a bit over the top to me
Thank you as always for your advice and comments
Sorry but I think your bisoprolol dose cannot be right. Decimal place wrong?
Sorry , not that ott , 5mg 2.5 mg twice a day
Hi Summerlily
Please review your figures for Bisoprolol, should this be 5mg?
If your blood pressure was 9 over 6, I think you'd be at deaths door. Do you mean 90/60 or 190/60?
Jean
Hi Jean ,Sorry , I live in France and they always report it like this.
It is 95 over 62
2.5 mg of Bisoprolol twice a day
Think I better write this post again !
I must say I think Buffaflys comments are right on the money. Certainly your medication needs a professional review. 😊
Yes BP too low. See your medics please to find correct dosages.
I would get in touch with your doctor because those numbers are far too low for comfort.
Both your resting pulse and BP seem as low as one would expect to be normal but might well be normal for you and will depend on whether you are currently experiencing symptoms as a result. When I was taking 2.5mg bisoprolol, my resting rate often dropped to around 40bpm, with my BP around 105/60, which were likely too low for me and produced some symptoms. I now take 1.25mg and that has improved, and I shall tomatoes be stopping bisoprolol altogether and move to a trial of flecainide, initially 50mg bd (awaiting an ablation for my atrial ectopics and AF).
Amiodarone should only given for a good reason as it is far from a first-line drug choice, so there must be medical background to that decision, I suppose? Also, becoming hospitalised for AF is not usually required, except perhaps for the first episode, even with a heart rate of 170bpm, so I am presuming either the protocol in France is different or there is medical background requiring it (or programs the fast AF was causing you to suffer some form of haemo-dynamic instability, i.e. a symptomatically low blood pressure with potential risk to, for example, your kidneys).
I believe that bisoprolol given at a dose of 5mg is the norm if it can be tolerated. Normally, it will later be reduced to a half or a quarter of that if symptoms allow, but that is a medical decision.
Steve
I was kept in hospital for several days after my first afib attack until my INR had gone up. My heart rate was in the low 60s and the afib had stopped within a few hours of admisdion. Things are different here! 5mg of Bisoprolol seems to be the standard dose here for hospital cardiologists.
I sit here envying you the French health care system (how things change - in my days in the pharmaceutical industry up to the 1990s, the French system was much less admired).
I think hospitalisation is likely the same here for a first "fast" episode to preclude other cardiac issues and you'll be discharged with bisoprolol 5mg and, if required, edoxaban or similar. I think 5mg is the dose of bisoprolol that is deemed therapeutic, and even up to 10mg. I was given 5mg in 2019 to treat my atrial flutter. After my ablation, when I was told to stop taking it, I had a single very fast episode that lasted until I took myself to the specialist's clinic at a nearby hospital where he diagnosed it as AF and put me down for an emergency cardioversion. That proved unnecessary after a 5mg dose of bisoprolol calmed things down and I was then fine for maybe over a year.
Steve
Hi I take bisoprolol 5mg a day but increase when I'm in fast heart rate. I've always been told that I must not exceed 10mg. I also take amiodarone 200mg.
The lowest dose of Bisoprolol, 1.25mg was too much for me to take daily and now taking 100mg of Flecainide twice daily has virtually put an end to my episodes. How different we all are! Hope you get something more suitable to help you soon.
I am hoping for a similar result starting flecainide (50mg bd) tomorrow. I could have started yesterday but didn't want to risk having any bad side effects during a weekend.
My fingers will be crossed.
Steve
Did you know you can edit what you have written if you get any accidental errors in what you write? It comes with the drop down menu that appears. I was pleased when I found it!
Thanks u! I have just shaved, in fact! 
I do edit each post but sometimes, especially if typed with my large fingers using the Apple "slide" text input, and likely for reasons of distraction or age, along with my constant tiredness from insomnia, sometimes the most crazy auto-correct typos slip through.
The problem with modern autocorrection software, as opposed to he much more useful spell checking, is that a proper word is always put in, with no squiggly underline to show it has been "corrected". Really - there should be a red line for an error, and a green or yellow line to show where autocorrect hs been used. Otherwise, only a through read through will show them up - and only then to an alert mind.
Thank you, again, Vonne (or is it Yvonne?)!
Steve
I’m actually Sandi, but when asked to provide a name to use here and it was suggested to use a favourite author, I looked at the nearest bookshelf and saw Kurt Vonnegut- a great favourite since a friend’s husband introduced me to his “Cat’s Cradle” almost 60 years ago now.
Aha - Sandi! I ended up calling myself "Ppiman" crazily as I couldn't use "Steve". I take PPI drugs for an acid reflux problem and, goodness knows why, but that came to mind when I signed up in 2019. I think I'd just read a post here from someone about them.
I can't recall reading Vonnegut's Cat's Cradle, but it's on our bookshelf so it will be next on my list. I enjoyed Slaughterhouse-Five many years ago. I think Vonnegut was well regarded for his social insights as well as writing.
Steve
Yes, “Slaughterhouse 5” was brilliant. We actually made a point of finding and visiting it when we were in Germany and it was great to see how much of the beauty of Dresden has been so well restored.
So do you have chronic fatigue as I do or is it the “rare side effect” of the Flecainide?
I have a hiatus hernia too but do a daily exercise that a friend found online and take the odd swig of Gaviscon as don’t like the idea of taking any more drugs on a regular basis. I’ve agreed to Statins though my cholesterol problem, if any, must be familial, as I have never been overweight in my life and have a very healthy diet.
I only feel constant fatigue from my awful sleep - a kind of "sleep duration" insomnia, meaning I wake too often and struggle then to get back off. I start flecainide tomorrow and hope for a better result than I get from bisoprolol, which it will replace.
I take statins as I believe they do reduce atherosclerosis - I hope so. My cholesterol was 6-7 but is now 3 or so. I did stop them for a long time as I wondered if they were causing this or that (I get peripheral neuropathy for instance), but nothing cha ged so I went back on them, to my GP's pleasure.
I hadn't realised that statins were one of the things, like covid vaccines, that the conspiracy-minded folk see as one of the many fakes we duped sheep are fed, but they are. I'll stick to the science.
Steve
Well, we know that we are all different and have different reactions to drugs as a result- common sense but doctors don’t think that way- it’s more of the one size fits all which it doesn’t!
I used my Kardia to record the blood pressure I just took on my machine and as it is based on American standards it came up with “elevated” though it is considered fine in the UK. Then I was asked to give a review of the Kardia but it had to be under an assumed name as we have to use here but all those I tried had apparently been taken!! I assumed they didn’t like what I’d written! Back to watching the tennis now.
Heart rate is excellent if you are a professional athlete ?!! otherwise bit low and BP excellent so I would see doctor for review
9 over 6 blood pressure? Not quite sure what that means and have you the dosage correct saying 500 bisoprolol. Do you mean 5? I should get back to your EP or cardiologist as heart rate is a bit low but don’t do anything without speaking to medics
Feel better soon
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