Bisoprolol and missed/irregular beats

[zipperman]

I've been on Bisoprolol for 10 years because of occasional sinus tachycardia (short episodes of rapid beating). This was a side effect of having a leaky mitral valve. Following major heart surgery a few months ago I had a lot of tachycardia that was initially controlled with amiodarone. When I stopped taking this, the tachycardia came back but has since more or less disappeared. However I'm now getting a fair number of skipped beats and some irregular beats (early or late) especially after exercise.

Question is, does bisoprolol increase or decrease the chance of getting these irregularities? Given that my heart isn't racing these days, is bisoprolol still needed, or could it (by slowing my heart rate) be contributing to them? Have you had any similar experiences? My clinical contacts are wonderful but they are unwilling to commit themselves!

[Hidden]

Bisoprolol is a drug in the betablocker category. It will slow your heart down but not affect the rhythm. The amiodarone is an antiarrhythmic, meant to make the heart beat regular. You might want to call your doctor. It is not uncommon for people to develope atrial fibrillation after heart surgeries. Most of the time it is intermittent.

[road2ruin]

Hi Zipperman,

Very similar to you, I had a heart op (valve replacement) and then had AF tachycardia after. I was put on Amiodarone, but taken off it about six weeks after (not a very nice drug). I am on Bisoprolol 2.5mg and have taken that for about 4 years. I too have missed beats or extra beats, sometimes its difficult to tell which. It makes my chest feel funny for a second or too and then you stress about it for longer! They come and go, mostly early morning or late afternoon when resting. The doctors seem to think it's because of the surgery and I may, or may not, get over it. If you read the NHS or BHF websites apparently 'ectopic beats', as they are called, are quite common and sometimes come on with age. I am 50.

You are not alone..

Peter

[BenThom-Wood]

Hi Zman,

Bisoprolol should reduce the heart irregularities as it should stop the heart running away with itself if it realises it hasn’t beated. Amiodarone though, while helping with channel blockers elongates the QT which then maybe tricks the heart into thinking it hasn’t beated. I was on both before I met my current consultant who said to stop the amiodarone & increase the bisoprolol to 10mg. He also says he’ll be able to get to the reason for my arrhythmia. Good luck!

[zipperman in reply to BenThom-Wood]

Thanks - Amiodarone is very effective but also aggressive and toxic, which isn't good long-term. Looks like I have scope to increase Bisoprolol and it should help.

[BenThom-Wood in reply to zipperman]

yeah, Amiodarone is a contradiction but that might be because of my physiology. If I have Long QT caused by blocked channels then any drug which prolongs my QT would be a problem. However bisoprolol will just shut the heart down from torsades de pointes levels. Shutting down the Amiodarone & upping the Bisoprolol to sufficient levels means the symptoms (torsades, cardiac arrest) will be lessened. The original problem of what caused the original long QT is still there but the ICD & bisoprolol are safety nets. For me, either I try to prove my consultant wrong with more cardiac arrest data or wait for the investigation to find the cause of my long QT but then what’s the cure if it isn’t Amiodarone. Another drug to research?!