Verapamil v Bisoprolol

[Pippa80]

I have been on Bisoprolol for years . A few months ago the dosage was increased to 10mg in order to bring my heart rate down to under 100 bpm. I have persistent AF and after lots of cardioversions and 2 ablations the cardiologist says the only option left is rate control since he doesn’t recommend ablate and pace, only a 30% chance of success. Bisoprolol has kept my heart rate down but a different cardiologist has stopped this and put me on Verapamil suggesting I won’t feel so tired and breathless. Since I have been on this, however my heart rate has increased to above 100bpm . He also stopped Amiodorone , he believes it’s not necessary since I am now in permanent AF.

Advice would be welcome on pros and cons for Verapamil v Bisoprolol

Thanks

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I’m not sure how helpful my reply will be, but I switched from bisoprolol to verapamil for rate management and SVT. They thought the bisoprolol was to blame for a prolonged bout of symptomatic bradycardia, but having been on verapamil for 3 years now, my resting heart rate is lower than ever, I’m just not feeling ill with it. They won’t put the dose up as a result, even though I would probably benefit from it at the other end. The main benefit I’ve seen from the switch is that I’m no longer living with very regular and quite intense orthostatic hypotension, and I get no side effects at all. However, I don’t think it ‘caps’ my heart rate quite as well as the bisoprolol used to. My rate has been very reactive since the SVT began, just talking routinely increases it by 20-30bpm, and I can quite easily hit 180 when doing cardio exercise. The bisoprolol seemed to stop me getting much past 160, but it’s worth pointing out I was a lot bigger then, too, and I’m also convinced I have other heart issues (inappropriate sinus tachycardia, for one) but I’m struggling to get anyone to listen because even though the slightest movement takes me up or over 100, my daily average remains below 100bpm due to having a low resting rate and then dipping into the 30s overnight 🤷‍♂️

As I said, probably not much help to you. What dose have they got you on? There may be scope for increasing it and seeing if that brings it down a bit more.