A success story, perhaps.

Posted , 8 users are following.


I was diagnosed with atrial fibrillation in January, and was put on 2.5mg Bisprolol a day. I started reading as much as I could about the condition, including this forum.

The effects of the medicine were breathlessness, sometimes bad, including a couple of funny turns while I was out and about, weird flutterings in my abdomen just below my ribcage, chronic sleeplessness: I was ticking over on about an hour of catnaps a day. I dreaded going to bed because I knew what a performance it would be. Worst of all was the overall complete and utter lack of interest in everything: I spent my time in front of the television in some kind of suspended animation.

After three weeks I went back to the doctor and said that I was not having this, that I would rather take my chances with no beta blockers than carry on as I was. He said that for the symptoms I described people were usually on 8-10mg a day. So, to make sure there was no misunderstanding, I told him that I would not, under any circumstances, take that high a dose. So he reconsidered, and thought of taking me off beta blockers, which sounded good to me, but then decided to try a lower dose, 1.25mg a day.

This took a couple of days to work, then I couldn't beieve the difference. I felt like I'd woken up from hibernation; all the things I'd moaned about to the doctor had gone, except for the breathlessness, and that was a lot easier. I felt good, about the same as I'd felt in my pre-atrial fibrillation days.

I've since been told by another doctor at the same practise that it is now accepted that lower doses can be more effective than higher ones. At one time everyone had high doses, but now it's accepted that smaller ones can be better. It certainly seems to be the case with me.

Could be worth a try.

Don't lose heart (please excuse the pun).

1 like, 29 replies

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29 Replies

  • Posted

    Hi Jim,

    Glad to hear your feeling much better. If you read my past posts on Bisoprol you will find it help full, as my wife also only takes 1.25 mg instead of 2.5 mg, but I decided she should take it at night time as opposed to in the morning, so that any effects can be slept through.

    Try this if you are not already doing it.

    Regards Ken.

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  • Posted

    Hi Jim

    "At one time everyone had high doses, but now it's accepted that smaller ones can be better."

    Although I'm not on Bisoprolol for AF, but two other medications for BP, my consultant recently told me that it is now believed that prescribing two or three medications at low doses is preferable to one medication at high dose.

    Glad you stuck to your guns for the lower dose, and feel better.

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  • Posted

    I have been on several beta blockers since 2000 for hypertension all had nasty side effects. The sleeplessness and disturbed sleep being very draining and light headeness becoming a problem.

    After getting AF following heart valve surgery in 2012 I was put on 1.25mg and I did not get as many side effects as with the original Atenolol but had disturbed sleep. It was stopped in September 2012 after cardioversion.

    For some reason I suddenly had a very rapid heart rate (150's) last September. ECG showed that I was in sinus rhythm and I was told to take 2.5mg twice on the first day and 2.5 after that. After two days my heart rate was down to 36bpm so I stopped taking it.

    After a colonoscopy last November I went back into AF. The theory was that the probe had stimulated my vagus nerve. Again told to take 2.5 mg Bisprolol. Apart from sleep problems it was slowing my heart down so much that I felt that I had as much power in me as a run down battery. By now I was also back on warfarin and amiodarone so had side effects in plenty.

    After cardioversion in March they wanted me to stay on the beta blocker as well as the other drugs. I pointed out how much it had lowered my heart rate and that being back in sinus rhythm it should not be necessary and the consultant agreed.

    The amiodarone on its own kept my heart rate to low between 36 and 44bpm. I stopped it on Sunday to see what would happen and it is now staying in the mid to high 40's

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  • Posted

    Response to Derek76

    As other posters have pointed out amiodorone is not good news at all and should be taken for a minimum amount of time ( my cardiac consultant told me that) But after stopping it

    I also had a high heart rate 140-150+ for 3 months before it came down after taking digoxin

    now with a PM at 60-66 whilst resting. Before PM heart rate would be 48-55 and it caused high AF but since having PM (set at 60) AF much reduced and actually in sinus for some periods.

    Interesting to hear the stories on the low dosage of bisop. As I said before I spread my dosage of 3.75 into 3 * 4.5hour intervals. It seems to work for me.

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  • Posted

    Billhopefull, I have never understood why some people have cardioversion or catheter ablation while others are on rate or rhythm drugs for life.

    Do you also take Warfarin?

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  • Posted


    Procedures followed depend on consultant, latest recommendations of various bodies, age

    of patient, length of time since start of AF, type of AF intermittent or permanent.

    Lastly, patient request.

    Yes I do take warfarin, very essential to take a blood thinner.

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  • Posted

    Do you have problems with warfarin? I developed pain in all my weight bearing joints when taking it from June 2012 until August 2013. The surgeon who did my aortic valve replacement said that I could stop warfarin after being back in sinus rhythm for six months. Naturally the cardiologist disagreed. When I told my GP that I was going back to aspirin (as recommended by the surgeon) my GP said that I was his fourth patient that week to stop warfarin. Unfortunately the new types of anti coagulants are contra indicated after heart valve surgery.

    After stopping Warfarin my joint pains disappeared. Since having to back on it in December the joint pains have returned. Some papers say that warfarin causes bleeding in the joints and is the cause of this pain. My GP has only heard of it causing major bleeding in the joints with massive swelling.

    Others I know on it feel cold all the time. Several have joint pain, one says that he aches all over and one lady neighbour is now wearing a wig as it thinned her hair so much.

    What other meds are you on?

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  • Posted

    Hi Jim - I am taking 5mg Bisoprolol, varying doses of Warfarin and 40mg Simvastatin and reading about your experiences with Bisoprolol might give it a try to cure my sleep problems, although other AF sufferers have different side effects with their medications. In my case I often wonder if my medications are fighting one another or hiding the real side effects I am experiencing particularly my sleep problems. My GP does not hold this view and insists I stay as I am. Maybe I should be a bit more forceful with him or get a second opinion.
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  • Posted

    Since finding this forum, I have insisted that my 7.5 Bisoprolol dose be decreased to 5 mg and have also started taking this in mid evening instead of morning. I also take Flecainide 100 mg twice daily. I am an AFib sufferer who didn't respond to two ablations and now have a pacemaker and soon to have an AV node ablation.

    These past two months I would not like to live through again. The fatigue was overwhelming and I could hardly show interest in anything, let alone walk for any distance without sitting down. The effect of the above changes to a lower dose and taking at night was immediate and dramatic and I almost feel my old self again within a few days. I have come to accept that sleeping will never be as good as it once was, whether due to Bisoprolol, Flecainide, Pradaxa or just getting older - there is worse than that, so I get what sleep I can and take a pill if I have a demanding day the next day.

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  • Posted

    My diagnosis is SVT (30 incidents over last 3 years). I started 1.25mg of Bisoprolol in November but had numbness in hands, bowel disturbance and tiredness. And still had 3 more incidents. After consulting with the Cardiologist my GP has switched me to Verapamil. Been on low dose for a week. Side effects have gone ( I think, tiredness is quite an issue for me as I work at night often), so difficult to say if that is less. But I had an incident this morning. Pulse at 155. Tried various vagal manoevours which didn't work but it reverted spontaneously after 3/4 hour. What I hate about this whole thing is not being able to say what brings it on or what stops it!
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  • Posted

    I was on slow release verapamil from 2000 until 2012 for hypertension after complaining about the side effects of beta blockers.. When I bought a BP monitor I found that my heart rate was in the 40's but I have no idea what it was prior to then.Verapamil initially made me sensitive to heat and sunlight but that eventually normalised. The main problem was constipation particularly particularly initially when I was on 2 X 240mg a day.

    After having aortic valve replacement in 2012 and going into AF for the first time I protested in vain when prescribed Bisoprolol. I was told it was much more effective that verapamil. After successful cardioversion I was very glad to be allowed to stop the beta blocker.

    With regard to vagal maneuvers to stimulate the vagal nerve. I had a colonoscopy in November during which my BP and heart rate dropped alarmingly and I went back into AF. This was evidently caused by the probe stimulating my vagal nerve. That put me back on to beta blockers until my next cardioversion in March.

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  • Posted

    On and on it goes for many of us and sometimes we can only console each other and say that there is worse out there than heart problems, though often it doesn't feel like it. So much juggling with drugs and side effects with different reactions to this and that, but now and then we can see a pattern from the postings of others, and Bisoprolol and fatigue are conditions I would not have linked without this forum - certainly not from any medical people who seem to be unaware or unwilling to tell us.

    Good luck to all who are soldiering on (and on). I have another ablation on 24th of this month to cut off some of the electrics from the atria. Just as I was beginning to feel better ......

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  • Posted

    Doctors usually direct that meds be taken in the morning. I believe that this is to relieve your symptoms during the day when you are active and most need the help.

    I have at times had suggestions to split dosage to morning and night. With regard to BP it didn't help and my highest readings were still highest in the morning. First thing today my readings were 199/94 and 40 bpm before taking 100mg of Losartan. Three hours later after being active around the house they were 147/71 56.

    When taking Bisoprolol in the evening it felt wrong that I should be slowing my then high heart rate down at a time of day when much less active.

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