Bisoprolol

[SpiritoftheFloyd]

I've just been copied in to a letter sent by the Liverpool Heart and Chest hospital to my GP.

I'm booked in to have an ICD implanted in August and the letter says " will implant a dual chamber ICD to facilitate uptitration of beta blocker to the max tolerated dose of 10mg.

I'm currently on Bisoprolol 2.5mg

Couple of questions if anyone has been in this situation.

1 - Why after fitting an ICD would my Bisoprolol dose go up to10mg?

2 - I've got continually cold hands and feet, which I understand is a side effect of beta blockers. Has anyone had this as a result of taking Bisoprolol, if so did you get it changed to a different beta blocker and did that solve the issue?

I'll be seeing the GP next week and will ask these questions then , but would be grateful for any comments anyone has please

[Fortepiano]

Betablockers like bisoprolol are one of the most important drugs in treating heart failure and it can be difficult to uptitrate them to the doses found to be protective in heart failure trials as they can have the side effect of slowing your pulse too much. Since an dual-chamber ICD incorporates a pacemaker it will make it more possible for you to reach the target dose.

My husband had his ICD changed to a dual-chamber one to help get his betablocker to the target dose.

There are only a few betablockers that are licensed for use in heart failure - you could try carvedilol, but cold hands and feet are par for the course. I was on 10 mg bisoprolol for other reasons and have icy feet and hands with or without betablockers; to be honest I think it's quite a minor problem compared with their benefits!

All the best with your ICD - and it is really worth it getting your medications to the maximum.

[SpiritoftheFloyd in reply to Fortepiano]

Thank you for your reply. I'll have a chat with GP, HF nurse about carvedilol. I'm not just cold,I'm freezing, currently got the central heating on

[Fortepiano in reply to SpiritoftheFloyd]

I had the central heating on yesterday and I don't have heart failure and am not on betablockers! But body thermoregulation is more difficult in heart failure anyway so you are likely to feel the cold ( and heat) more. Frustrating, I know.

[House28 in reply to Fortepiano]

Been on bisoprolol 10mg for 2 years now also have an ICD Dfib it helps with the populations and I'm also constantly cold

[IanMK]

The letter states that the reason for the ICD is to allow your Bisoprolol dose to be increased. You don’t say why you are taking Bisoprolol but it would seem that the benefits of the Bisoprolol are the aim rather than the benefits of the device. In my case, a CRT has been fitted after AV node ablation to correct my rhythm with the aim of improving my cardiac performance and resolving my heart failure. If all goes to plan I would then hope to stop taking my daily dose of 7.5mg Bisoprolol.

I continually had cold fingertips, toes and nose over winter and early spring. I considered it to be a small inconvenience and decided to live with it rather than ask for an alternative and risk something worse.

[SpiritoftheFloyd in reply to IanMK]

Thanks for your reply. As I was admitted to hospital with heart attack I had a cardiac arrest. The consultant said that they thought that in the future I could develop an abnormal heart rhythm so they want to fit an ICD as an insurance to prevent a further cardiac arrest.

Sadly I don;t just have cold fingers/feet/nose, they're freezing - I'm current;y sitting here with the central heating on. If a dose of 2.5mg is doing this to me I dread to think what 10mg will do.

[IanMK]

People tolerate it differently and your body gets used to it, to a greater or lesser extent, which is why they ‘uptitrate’. You can’t be suffering with cold. Ask for an alternative.

[BTGodwit]

Interesting. I was raised likewise from 2.5mg to 10mg bisoprolol after a dual ICD fitted 1 year ago.

I’ve feel the cold in my feet and hands and just live with it. I’m 76, go to gym 3 times a week doing 20/25 mins cardio on various machines then 20 minutes weights. Had HA 5 years ago then another 1 year ago. Keep my heartbeat max to 120bpm and BP is down to 110/70. I feel great but I can’t be complacent how serious it was after breathing stopped.

I thank God that my wife had once been a responder and I’ve promised her another 20 years.

The ICD fitting was easier than having a tooth fitted.

[SpiritoftheFloyd in reply to BTGodwit]

Thanks for your reply.

My BP is normally around 110/60 and resting HR of 58. On one occasion after rehab gym went down to 98/60.

I'm not sure what increasing med from 2.5mg to 10mg will do to these figures.