? Pulse following cardioversion

[JFJ131]

Hi all… i just had my first cardioversion last Thursday and thankfully returned to sinus rhythm.

(thanks to all those who gave tips and reassurance before i had this procedure, when i asked for advice etc.) So, all fine following the cardioversion last week as now - Fingers crossed it holds. After the procedures, the nurse then reduced my bisoprolol from 10 to 7.5 mg and said to speak to my GP if pulse goes too low. I have been monitoring it, with bated breath each time, fearful I would go back to AFib… all good up to now however. Anyway, I am sure I am having more headaches ..? And do feel very tired. Wondering if this is from the bisoprolol, since the cardioversion, in that may not be needing it now?? Also my pulse has lowered to mostly 60 or upper 50’s…the lowest it went when resting was 52. (Was over 100 … up to 120 prior to cardioversion). I have not thought the rate of upper 50’s would warrant contacting the GP to request they lower the bisoprolol further…. .? However I would like to reduce it…but fear this might trigger AFib back?!?

Any views/thoughts would be very much appreciated.

[mjames1]

Glad your cardioversion worked out!

Unfortunately beta blockers like bisoprolol, have become a default afib drug. Meaning that if you have atrial fibrillation, some docs automatically put you on a beta blocker long term, irrespective of your afib burden.

Beta blockers certainly have their time and place, but they are weak antiarrhythmics and come with their own set of side effects, as you are finding out.

I was prescribed a beta blocker type drug for a week after my first cardioversion. Then I was told I could stop. This allowed me to live my life, side effect free while I was in normal rhythm.

A good topic to talk to your doctor about.

Jim

[Smokas in reply to mjames1]

Interesting. My doctor decreased bisoprolol to 2,5 mg (from 10 mg) after cardioversion and after two weeks gradually removed amiodarone and canceled bisoprolol. Strange why beta blockers are used for AFib.

[JFJ131 in reply to Smokas]

Hi, thanks for your reply. Interesting how different doctors take things forwar,d although this actually was the nurse. I hasten to add she seemed quite experienced and said ‘we just best not drop it to 5 in case AFib starts again’, or words to that effect. I wonder how long I can leave it before I reduce.. can I ask…are you now not on any medication? And how long ago did you have your cardioversion?

[Smokas in reply to JFJ131]

I had 2 cardioversions, only second (end of June) was successful after month of taking amiodarone after first one. Afterwards I got coronary calcium scan, amiodarione was removed I got one week “trial” for flecainide tolerance. There were no problems and flecainide was canceled too with advice for “pill in the pocket” - 200 mg flecainide dose. Currently I am only on edoxaban.

BTW my doctor is cardiologist.

[JFJ131 in reply to Smokas]

Thanks for sharing your experience.best wishes

[mjames1 in reply to JFJ131]

I had 4-5 electrical cardioversions over a span of around 40 years. The last was about five years ago and since then, instead of electrical cardioversion, I converted at home using either Rate drugs and/or rhythm drugs like Flecainide. Something I recommend to most everyone because is going to the A&E is not fun and electrical cardio aversion is not without some risk.

During those 40 years, I only took beta blockers or similar (calcium channel blockers) sparingly, either for a week or two following a cardioversion or later to control rate when I converted at home. Never took them long enough to have to withdraw gradually, but it certainly can't hurt and it's a good discussion for your doctor.

A year and a half ago I had a catheter ablation which was successful.

Jim

[JFJ131 in reply to mjames1]

Thanks for sharing and good to hear of your success. Best wishes

[JFJ131 in reply to mjames1]

Thanks for your reply Jim. Interesting that you just stayed on beta blocker for a week! Can I ask…did you then taper off or just stop? And have you remained off meds and in sinus rhythm ? Hope so…

[Ducky2003 in reply to JFJ131]

Just to chip in, it's usual to taper off Bisoprolol rather than stopping it all in one go. 😊

[JFJ131 in reply to Ducky2003]

Thanks…good advice

[Ducky2003 in reply to JFJ131]

If I remember rightly, I had to reduce the dose over 2 or 3 weeks. I was on 10mg at the time.

Ps....... glad to hear the DCCV worked. 😊

[Coco51]

Hi. Good news about the cardioversion.I'm not surprised that now your pulse is lowered that you feel tired on 7.5mg of Bisoprolol. That's a pretty high dose.

Like you I had persistent AF that took my HR up to 150 pretty often and regularly over 100.

Before my ablations I was given 1.25 mg and the rate settled between 60 and 80 (still in AF but the lower rate made it easier to deal with). My husband is on 2.50mg. I was put up to 3.75mg but felt really lethargic on that. My dose went back down to 1.25 and I felt better. If I feel my heart rate is going up I take an extra 1.25mg as a PIP. That works nicely.

Maybe a chat to your doctor would put your mind at rest. It's a bit of a balancing act to be honest.

[JFJ131 in reply to Coco51]

Many thanks for your reply...it is reassuring to think that with tweaking, it can settle and find a comfortable place...ideally with a PIP if needed.

Best wishes.

[Fannyphasbees]

I am very interested to hear replies to you as I am due to have my first and hopefully only cardio version on 12/11. Good luck with your progress. X

[JFJ131 in reply to Fannyphasbees]

Thanks and good luck for yours in November

[Donogh]

Definitely talk with your GP or cardiac doctor. Bisoprolol seems to be used to treat hypertension and therefore reduce the heart rate. I have had a couple of Afib sessions and have been on Apixaban (an anticoagulant/blood thinner) since the second episode with no issues - but I do not have hypertension and my normal HR is low 40s. I don't believe Afib is particular to the HR as it is an electrical issue.

[maurice2]

I gave up biso in the end because it restricted my motivation to keep fit...but I discussed it with doc first 😃

[JFJ131 in reply to maurice2]

Thanks for your reply. Curious… did you taper off slowly, and when you say affected motivation, was this tiredness that you experienced?

[maurice2 in reply to JFJ131]

No just stopped them. And it was a feeling of lack of energy, even before I was doing anything. I found I was sitting around a lot in a bit of daze really.

[JOY2THEWORLD49]

hi

I have been asked to comment.

But Bisoprol though lower tha n Metoprolol did not bring me down even on 10mg to control level. 156 in fact from M. and 186.

I found that the CCB introduced by a private heart specialist did the trick. but 51 was too low Day.

I ended up bisoprolol 2.5 night for bpand

120mg Diltiazem morning for 60s pulse to 79 Day better @ 120mg not 180mg.

So you are different if it lowers your pulse under 100 to control.

cheri JOY 75 (nz)