Taking betablockers when you have a low resting heart rate

[Trixie66740]

Hello – I was diagnosed with AF 3 weeks and the cardiologist prescribed apixaban and a statin (atorvastatin). Yesterday I saw the cardiologist again for results of a 4 day heart monitor test and she said that over the 4 day I had had several episodes of arrhythmia so she wants to start taking a betablocker (Sotalol). From what I understand this works by slowing my heart rate, my resting heart rate (according to my fitbit) is 54 bpm and at night it drops to 45 bpm so what concerns me is that if the Sotalol reduces the heart rate further my heart rate will be too low. I did mention this to the cardiologist but she was very dismissive. Are my concerns legitimate ?

[sandandkev]

I was put on bisoprolol for af, I went back into sinus but heart kept going low,but it made me feel ill,so bisoprolol reduced

[Trixie66740 in reply to sandandkev]

thankyou

[Rockcake]

hi Trixie, I think your concerns are legitimate. However, as it was a cardiologist who prescribed it, you could take it and keep a close eye on your heart rate. Then call the cardiologist if your heart rate drops any lower.

[Trixie66740 in reply to Rockcake]

Thankyou

[Hrty]

From personal experience, I have a low resting heart rate and even low dose bisoprolol lowered it further. It often dropped into the 30s, even whilst awake, and I was walking round like an extra in the latest zombie movie. After 3 months my cardiologist took me off it and I felt immediately better. I'd definitely keep an eye on things and be prepared to chat again with the cardiologist if you find it's a problem.

[Trixie66740]

thankyou - I am nervous about trying it but will give it a try and monitor as you suggest

[Sheffield55]

If your resting heart rate is low please do not start beta blockers because it will make your heart rate drop further and you can faint or pass out. Why not try supplements that can strengthen your heart like Magnesium Taurate and do a blood work to rule out iron deficiency anaemia.

Please take care of yourself because you know how you truly feel. Doctors just prescribe but don't understand how these drugs can affect ones life especially the annoying side effects.

[Trixie66740 in reply to Sheffield55]

Thankyou. I already take Magnesium Taurate and Co Q 10 and blood tests show iron levels are Ok

[Lexi72]

hi Trixie66740, my resting heart rate is about46 on 2.5 mil biospropol high 30s overnight. The beta blocker reduces my rate my about 5 beats. heart rates do vary and a number of hearties on the site have very low rates . Athletes often have very low rates My cardiologist was keen I should go on it. He was not concerned in my case as long as I did not have symptoms like fainting breathlessness really tired . Lexi 71

[Trixie66740]

Thanks Lexi - that's very helpful and reassuring. I am an ex competitive swimmer and now play tennis 3 times a week so I have assumed thats the reason for my low resting heart rate

[Hrty in reply to Trixie66740]

Whilst in no way competitive I was quite fit and active pre-HA and regularly swam 2km+ at least three times a week. I'd also done a lot of cycling at various times (doing lands end to John o Groats for example). That may have something to do with why mine is quite low.

[Trixie66740 in reply to Hrty]

Wow Lands end to John O'Groats 💪- As a competitive swimmer I trained twice a day 5 days a week for about 5 years so I'm sure that has something to do with it. Of course that was a long time ago - I've just turned 66 but I've remained quite active. Thanks for taking the time to reply

[Carriefarm]

your concerns are legitimate. Like you my pulse could drop to 45-47 through the night. I was prescribed Bisoprorol by cardiologist when I had a NSTEMI. I had 9 notifications on my Apple Watch of my PR being below 40 for 10 minutes nine times. Six were when I was sleeping and 3 occurred when I was in A/E, which caused me to have a raised troponin level. This med caused me extreme tiredness and chest pain. I no longer take beta blockers. Everyone reacts differently to meds but it is good to know the possible reactions that may/maynot occur and deal with them accordingly. Good luck.

[Trixie66740 in reply to Carriefarm]

Thanks for taking the time to reply

[Sanmo]

I have a RHR of around 38, when sleeping it drops to 33, the 33 was the reason I wasn't put on beta blockers. I have no adverse effects from the low heart rate, I use the gym every other day and have long intense walk on the other days. I do a lot of hillwalking also, I don't tire out easily, no naps in the afternoon etc. My cardiologist told me it was a win win situation, my natural heartbeat kept me safe and aided recovery without the need for beta blockers. You can function extremely well with a low heart rate, yours is not so low. I would be more worried if it was the other end of the scale. Trust your cardiologist, they're the expert.

[Trixie66740 in reply to Sanmo]

Thank- you - with my AF the heart rate jumps around alot so at times it can be very high so I assume this is why the cardiologist recommended a betablocker. I will trust the expert, give it a try and monitor heart rate carefully - Thanks for taking the time to reply

[Sanmo in reply to Trixie66740]

You're welcome. Remember there is often more than one solution, your cardiologist and in fact all medical staff, rely on your feedback so they can be satisfied or adjust your treatment.

[45sue]

A lot may depend on the dose & what other meds you are on . If you are going to give the beta blocker a try ideally it should be titrated/increased gradually. Problems seem to arise when the highest dose ( 80mg) is prescribed to begin with.

[Tonypredarmy]

Hi,

I suffer from Bradycardia (slow heart rate) and in 2023 had AF for around 3 months. my normal resting heart rate is around 52 and at night averages around 48.

I was instructed to take Bisoprolol which completely wiped me out as it dropped my heart rate even lower. I had no energy, couldn't walk any sort of distance and struggled even getting out of bed. After a month I went back to my cardiologist and he arranged for my heart rate to be monitored over a week. I also logged my blood oxygen level which was registering between 88% and 90%. Following the monitoring he agreed for me to stop taking the Bisoprolol but told me to take them as and when needed as a 'pill in the pocket' should my heart rate go too high.

After 7 days without taking them, I felt a hundred times better and 6 weeks later woke up and my AF had gone.

I still occasionally get palpitations but it only lasts around 30 minutes or so. Since 2023, I have only taken Bisoprolol once and that was when I had a Urinary Tract Infection which my body naturally reacted to by elevating my heart rate.

Nobody knows your body better than you, so if you feel that it is having an adverse affect on your health (as it was with me), I would seek a second opinion, speak to your GP or contact PALS at your hospital for advice.