Can a high dose of Bisoprolol cause palpitations?

[Babs39]

I have been taking Bisoprolol 10mg for over a year because I was getting a very rapid heartbeat, which seemed to work till a few weeks ago.

Now I feel a very strong thump every 11/2 -2 minutes and I can't think what might be the cause.

Ive read some other posts and most people seem to be on low doses.

Might I be taking too high a dose?

Any answers gratefully recieved.

[Prada47]

Hi Babs

I was on 10mg and after a Holter Monitor which showed some Bradycardia 33 bpm and Pauses lasting for up to 3 seconds I was reduced backdown to 7.5 mg. I have been pretty reasonable since. ( I do also take Entresto which has also changed my heart beat ) so the Heart Nurse will need to tell me what to do next, which I believe will be Entresto to maximum dose !!

At 7.5mg Bisoprolol my HR is between 60 and 75 I do also have moderate Heart Failure !

Regards

[Thecyclist]

Interesting one, I was titrated up to 10mg in December from 5mg. I'd had a couple of ectopics prior and was originally put on them after some tachycardia, doctor thought best to up me to 10mg after these "new" ectopics/palpitations. Subsequently I have had so so many more, way more than I ever had before and I am now thinking may possibly be down to the extra Bisoprolol as well? Having them all day now. Loads at night.

I asked for another ECG as they had become stronger and more frequent and am currently connected to a 7 day monitor, so I will know more soon, but having them daily at the moment.

I asked over on the Afib board and it seems Bisoprolol is not necessarily linear in its effect when titrated? Not sure how true that is.

Have you had another ECG done?

[Babs39 in reply to Thecyclist]

I had an EGG over a year ago, and was told that my palpitations were due to something I was born with and not life threatening, but I'm worried now because they have started again, and are different than before. I'm also on Enalapril 20mg and Sertraline 100mg

[ILowe]

Bisoprolol has several effects. The main ones people usually think of are rate control, blood pressure control, and as a limiter on flecainide. It also has antiarrhythmic effects. pubmed.ncbi.nlm.nih.gov/186...

That means I think, that it can worsen rhythm, though I do not have time today to track that down.

Simple reasoning would support this hypothesis. Think of two controllers, monitoring each other, one for rate, the other for beat. When the rate gets too low, beats get more irregular in order to provoke the rate controller into speeding up to correct the irregularities.

I have asked the question before -- do some people get AF because they are on bisoprolol!