Bisoprolol to fix ectopic beats?

[Equilibriumseeker]

Hi everyone, I’m new here and have found reading lots of your posts really interesting. Thankful to have found this community.

I have been having irregular beats for a year plus, although I’m convinced it’s been happening for years and has just got worse in the last year. I finally presented at A&E last week as I was feeling dreadful, heart beating/skipping like crazy. I was monitored and they could see ectopic beats, roughly one in four. After blood tests to rule out some other things, I’ve been given Bisoprolol.

I started with 2.5mg for the first week and went back for a follow up check. Had begun to experience new chest pangs on day 3, definitely new. Not bad pain as such, but repeated momentary feelings of discomfort. Was told I could move to 5mg and they weren’t concerned about the new chest discomfort. Found this odd but followed their advice. Have taken 5mg for two days and feel more breathless than before.

My question is, has anyone been through similar? I’m on a cardiology referral list to be seen and have an echocardiogram but told this will be a three month wait. Heart beat has slowed nicely on the Bisoprolol but I’m so worried it’s causing other issues and no one is really keeping an eye on me now, I have to try and get a gp appointment if I want to check anything.

My palpitations have slowed in line with my heart beat slowing down, however they’re just as frequent as before. Does Bisoprolol rectify irregular beats? They said it wasn’t AFib. At the moment, I’m still experiencing everything as before, just a bit slower. I can still feel my heart beat in my throat, crushed chest and breathless feeling, swimmy headedness and feeling of a heart just not beating normally. All tallied by an Apple Watch which mostly shows inconclusive results,

I’m so confused and concerned, and would love to hear any similar stories or wisdom from those with more knowledge. I’m 38 female by the way, not in great shape but busy and active in daily life.

thanks

[DodgyTickerMum]

Hiya,

Sorry to hear you’ve not been feeling well. I’ve been on Bisoprolol since my open heart surgery last year. I’ve suffered with an erratic heart beat / ectopics and extra systoles for a long time both before and after my op. (Which I’ve been assured aren’t damaging to my heart).

My surgeon said to me that Bisoprolol is ‘the heart’s friend’ as it will calm it down, to preserve it for longer. So whilst it might not beat as fast and it will lower your blood pressure - it sadly won’t resolve other issues.

Maybe (finances permitting), you could look into seeing a Cardiologist privately? I know at our local clinic they accept self referrals.

I hope you get it resolved.

[Equilibriumseeker in reply to DodgyTickerMum]

Thank you for your kind reply. I don’t think private is an option having looked at costs so hopefully it won’t take too long.

‘The hearts friend’ is a nice way to put it, I hope you are feeling well again after your surgery.

[Sb1171]

I had a STEMI in 2022. I began to notice ectopic beats, confirmed by watch. They were not that bad though, not like yours and only seemed to occur in the mornings or when I was in a restful state. I was already on 3.75 Bisoprolol and started to take a third of the tablet in the evening, instead of all together in the morning (logic being it would smooth the delivery of the drug) this did seem to reduce them considerably. I then switched to Nebivolol, taking 2.5mg AM and PM. I no longer get them at all (that I can perceive).

[sandandkev]

Hi bisoprolol although great at getting heart rate down still has side effects, I found it lowered my rate too much,I would get a gp appt as they can explain a bit better,unfortunately these days you have to wait for anything which is scary at times,I had af last July,but got lots wrong in heart,still waiting for more tests,but there is so many more people living longer with heart conditions than ever before and just not enough drs

[EmmJayTea]

Hello. Ooh yes, I can identify with the shortness of breath since taking bisoprolol, but only if I ramp up activity too quickly e.g. start walking/stand up too quickly if I've been sitting/resting for several minutes. If I start walking slowly and very gradually increase pace, I can reach normal walking cruise speed after around 3-4 minutes (I'm a fast walker!). That's the effect of beta-blockers - they will calm the response of the heart and slow down the rate at which its pace increases. So if you try to increase activity intensity too quickly, you'll feel a swift lack of oxygen and become breathless. Ease off and the effect should pass. You may need to experiment a bit as everyone is different.

Boom! The drugs work. 😃

I take bisoprolol to suppress ventricular ectopics and to prevent dangerous arrhythmia. I was getting runs of bi and trigeminy (every other beat and every third sinus beat respectively). I was also getting several couplets each day and have had one dangerous VT corrected by my ICD. My dose has been gradually increased and this seems to be reducing the frequency of these ectopics and arrhythmia, although not completely suppressing them.

Everybody is different and, in my own case, a few breathless moments is a small price to pay for being alive or not being shocked by my device.

I hope you start to feel more comfortable soon and get some answers. Take care and don't hesitate to ask more questions. There is a huge amount of lived-experience to tap into on here. 🙂

[devonian186]

Ironically bisoprolol slow the heart rate and smooths out ectopics but arguably makes them feel worse.

For example, to take an extremer example, if you had a heart rate of 120bpm and this was slowed to 60bpm the gap in the ectopic would be doubled so instead of it being over in a flash it would be extended. its probably an effective drug and you need to persevere before knowing how well it works for you

[Prada47 in reply to devonian186]

Hello Just a question are you sure that the gap in ectopics would double if HR dropped from 120 to 60 ? I think for a statement like that you would need quite a lot of information. i.e. Bi geminy or Trigeminy would change that assumption. I may be wrong but information on the type frequency etc of the Ectopic would be required. Ectopics are a very complicated issue even though it is often said they cause no damage except in very rare cases.

Regards

Not looking to fight just seeking information

[devonian186 in reply to Prada47]

The apparent gap would double if you are taking half as many breaths. also bisoprolol tends to make the heartbeat stronger so you might feel it more. I agree there are many nuances so this is just an observed generality and not a medical fact..

[Cliff_G in reply to devonian186]

It's not quite proportional to the heart rate. What counts is the "non-refractory" period. Refractory means the period just after the heart's normal contraction, when it can't be re-stimulated by an electrical impulse. Once the heart has recovered from the previous beat and is ready to be restimulated, that's the non-refractory period. The heart then waits for the sinus node (and then sino-atrial node) to initiate the next beat, but during this non-refractory period, other stimuli can also cause a contraction. e.g. If there is a "focus" of electrical activity in the ventricles, for example, such a stimulus can precede the sinus/SA nodes' instructions and cause an ectopic beat, in this case a PVC, or premature ventricular contraction.

I certainly have found beta blockers such as bisoprolol tend to make my ectopics worse, but it's not a huge effect with me. What is clear for me is that beta blockers don't stop ectopics. BBs will however reduce the force of such ectopics and may make them more bearable.

[devonian186 in reply to Cliff_G]

Very interesting. For a condition that causes so much anxiety to patients it is strange that few GP's seem that concerned by it and the amount of research is limited compared to many other conditions.

Do you know of any medication or other treatment (deep breathing etc) that will "stop" or substantially reduce ectopics?

[Cliff_G in reply to devonian186]

Also few cardiologists really realise, in my view, how disruptive ectopics are.

In my experience, the only drugs which can stop/reduce them are genuine anti-arrhythmics, which fiddle with various electrolyte behaviours. Post-ablation but before my dissection and heart attack I was on Flecainide which I found pretty good. After that, I found Amiodarone (which you don't want anyway) didn't suppress them, and my cardio also said Amiodarone was not good at stopping ectopics. A long time back, after my ablation, I found diltiazem was causing ectopics, again through the slowing of the heart beat. Dr Sanjay Gupta has videos on ectopics too. Magnesium is one non-drug, deep breathing another, and I found that having normal potassium level but in the low half of the range was not as good as being in the upper half of the range.

[devonian186 in reply to Cliff_G]

Yes, its not taken seriously enough through all levels of the medical establishment, but is of great concern to those who suffer from it.

Generally there seems no reason why they start (other than the well known "obvious" triggers. Also they seem to go in phaases.

i do wonder how much modern life is to blame, from the blizzard of electro magnetic fields from our various devices, through cleaning products to traffic pollution.

[AH31]

Hi

I have recently had open heart surgery and valve replacement, they took my old valves out which I had three and brand new one put in.

Before this I had chest discomfort, numbness in my left side of body and irregular beats which had been happening for a good year aswell.

I have been put on Bisoprodol 1.25mg so far all good no new irregular beats but I’m not sure if that’s because I have had surgery to correct it or because I am on medication.

[Lexi72]

hi Equilibrium seeker, I am not as knowledgeable as most of the other posters. I have 20 per cent ventricular ectopics and am on biospropol 2.5 which has made no difference to the level of ectopic beats and I cannot have an increased dose as I have a very low heart rate. I am lucky as I cannot feel them like you which I understand is very upsetting . Ectopics are generally supposed to be benign ( I have been told) unless you have a really heavy ectopic load like me. I was told by an electrophysiologist recently that biospropl is usually prescribed first to reduce the ectopic beats. There are other drugs but they can have more side effects. If you cannot sort with biospropol or other drugs cardiac ablation may be an option mine is scheduled for next month if all goes well. Ideally you may need to see a cardiologist or electrophysiologist (I think) who will be able to advise what itreatment best for you as everyone’s conditions can be different Dr gupta’s videos are very helpful on triggers for ectopics . Most nice things may trigger ectopics such as coffee tea chocolate alcohol and spicy food which seems very unfair. Hope it is all sorted for you and the biospropol gets everything under control and your appointment comes through soon. Best wishes

[brads27]

I was breathless on a different med and changed to bisoprolol and have been ok

[Parkhome in reply to brads27]

Hi, hope you are doing well, you say you changed to bisoprolol & have been OK, as your breathlessness gone altogether. I've just been but on bisoprolol for breathlessness & ventricular bigeminy, also stenosis of aorta valve.

[Equilibriumseeker]

thanks everyone, very valuable helpful replies, I guess I’ve just got to try and be patient and wait to be seen. I haven’t had any of the horrible episodes since taking the bisoprolol so although ectopics still happening, I guess I can’t feel them as much. I went back to 2.5mg today and haven’t had any chest discomfort.

I do overthink things, but I can’t help but wonder if the meds mask rather than address the issue; and also worry that ectopics raise one’s risk of issues later down the line, but I must try to stop myself thinking that and just wait to see what the expert says

[Choccie55]

Hi, I’m on Bisoprolol 2.5mg for an arrhythmia called SVT. I’ve also suffered with ectopics for about 25 years. The ectopics got much worse around peri menopause and then I was diagnosed with SVT six years ago. Ectopics can trigger SVT episodes. However, Bisoprolol has really reduced my ectopics. It’s now less effective for my SVT so I’m now on the waiting list for an ablation. Bisoprolol can make you feel a bit light headed as it lowers blood pressure - mine is naturally low so I make sure to keep well hydrated and eat regularly to reduce symptoms.

[Ersilia2]

Hi , I’m taking Bisoprolol for Afib,started with 2.5mg,then 5mg.I was having too many side effects ,one was my heart rate would go up to 125bpm, then I would feel very weird in the head maybe lightheaded, then my heart rate would drop to 42 beats per min.rang the Cardiologist and asked him if I could cut back to 1.25mg twice a day, he said ok.Had 9 very good days,no side effects then suddenly it happened again, high rate light head then drop to 42 bpm ,it’s very scary, can’t lower the tablet any further.Seeing Cardiologist in 10days, hope he will take me off the Bisoprolol as I can’t cope. Hope you get sorted out Equilib

[Crossworder]

I've been through a lot of the same symptoms and sensations that you seem to be having. I hope you get things sorted a bit better for you. I would say that it is reasonable to be reassured that this is a nuisance rather than a concern if that makes sense. Beta blockers I've found stop my heart being as reactive to the adrenalin that my worried brain sends around, so may potentially help a bit, but also there are some downsides in being slowed down. By far the best thing is to consider if anxiety, stress, indigestion, lack of activity might be factors that help trigger - lots of reassurance and relaxation exercises can go a long way . The less I think about my heart the less they bother me.