Diagnosed May 2020 with PAF, ended up on bisoprolol 5 mg daily.Had 1 discernible episode since 2 yrs ago that lasted approx a day other than that get occasional ectopics that don't bother me.
Swim 2K 3 times a week and can still walk up hill and down dale, knees permitting that's another tale.
HR between 50 and 60 at rest and no SEs from the bisoprolol.
Should I look at reducing the dose or leave well alone, pharmacist said maybe reduce to 3.75 mg/day and no more.
No comorbidities and take appixaban, no intentions of stopping that one
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pd63
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I would want to come down to the lowest dose possible, as quickly as possible. I couldn’t tolerate Bisoprolol at all though. It has to be your decision but Pharmacist advice sounds good.
Snap! I suggested the lowest dose of Bisioprolol to the doc who wanted me to take 2.5mg daily and she agreed but didn’t arrange a follow up appointment! However, the pharmacist took my number and said he would call in a week to check how I was getting on but to pop in before if I had any problems with it. So, after three days of less energy, I popped in to see him and having taken my pulse, he told me to stop taking it and a different doc at the surgery agreed! Nothing else was suggested which is how, as recorded here before, I got introduced to having a smartphone and Kardia, and following sending a reading of my heart in AF, the EP I saw privately, sent a prescription for Flecainide to my surgery for me to take as a PiP. Now that I take it regularly, I am virtually AF free and have even reduced the first dose of the day. Good luck finding what works for you.
I think, for a person such as yourself, and based on some 12 years on Bisoprolol 5mg dose, I'd be inclined to drop to 3.75mg. In fact over the years I have done this BUT I've gone no lower than that. If you decide on this route do take time to read the paper in the packet re cutting back the dose. I had no problems with doing so.
Do remember though Bisoprolol is a heart rate control drug with some properties that help with control/stabilisation of blood pressure. Not withstanding your brilliant exercise activities it is unwise to monitor your HR alone ......... what is your resting blood pressure ?, after you settle down after an exercise activity. The two go very much hand in hand.
Although it might be frowned upon in some quarters, initially - if you have a pill cutter, just chop a 5 mg in half = 2.5mg, then chop a half in half again = 1.25mg, thus 2.5 and 1.25 = 3.75. Just experiment and note any changes in HR and BP. From your post it would seem that your body is much healthier than mine (I'm a couch potato ) when I was on 5mg Bisoprolol so I'd be very surprised if you didn't feel better AND have no ill side effects.
Yeah, I know all about knees 😱😂 and good luck with that !!
Seems to me you are not being treated for AF but have a cautious (possibly over-cautious) medic who is covering worst case scenario ie v fast HR & blood clots/stroke risk.
Fine you may say but all medicines come with a downside and your post shows you have some doubts. I would have a private appointment with a trusted cardiologist (if funds allow) to get an idea of your options. I would also double down on lifestyle changes often mentioned here incl reading 'The Afib Cure' by Dr John Day MD.
Bisoprolol made aerobic exercise feel like I had the brakes on. My advice if you start reducing the dose is not to take your heart rate above the max level you reach on your current dosage when you exercise (which is my own AF trigger). When I weaned myself off Biso, I switched to a low dose ACE inhibitor to keep my BP down, and your BP looks as if it’s being kept very low by your Biso dose, so I suspect getting down gradually to 2.5mg will still be OK. You’ll find it easier to experiment at 3.75mg if you get your GP to prescribe 2.5mg pills cos they are designed to be split in half. BenHall1’s advice is very sound in my view.
There's the 'if it ain't broke, don't fix it' approach.
But taking the least meds to do the job is also sensible, and if you do run into any issues you can go back to the 5mg.
What's your age? What's your CHADS score ? Apixaban with just 1 episode this last 2 years seems a little excessive to me. Yes I know better safe than sorry, but maybe the risk of a bleed is higher than your current risk of a stroke from AF ? But the Apixaban is obviously a wise precaution if you think you might be having asymptomatic episodes.
Hi, I am also 67 years old and was diagnosed with PAF in August 2019 following a stroke. I had a successful ablation in March 2020 and fingers crossed have had no further episodes.
I am on 7.5mg bisoprolol a day and also on apixaban. Like you, I am not aware of any side effects. I am not as active as you but also have a resting heart rate of 50 to 60.
I was given the choice as to whether to come off apixaban but opted to stay on it as I have a family history of stroke. I did suggest to my cardiologist that a reduced dose of bisoprolol might be appropriate but his opinion was to keep it at the current level to reduce the likelihood of future problems.
Based on what you have said I would leave well alone but certainly not make any changes without the full support of your cardiologist.
Be careful what you wish for. I have a few arrhythmias with AF being my least common one at the moment. I’ve recently dropped from 12.5mg of Carvedilol twice a day to 6.2mg under the guidance of my cardiologist. My left bundle branch block and PVCs went crazy about 10 days later. I was very breathless and instead of feeling more energetic as I’d hoped with the reduction, I felt very unwell. I almost took myself to ER for the very first time!
I’m still persisting at the lower level and still waiting to speak to my cardiologist, but everything seems to have settled again for now.
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BLOOD PRESSURE TOO LOW but HEART RATE TOO HIGH - SHOULD I TAKE BISOPROLOL or NOT?
Flecainide and Bisoprolol.
Bisoprolol 
Upcoming abalation concerns
Bisoprolol 1.25 mg
