Atrial fibrillation and fast heart rate , side effects of bisoprolol and amioderone

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I am so pleased to have found this site and hope to get some useful advice from fellow sufferers of atrial fibrillation and fast heart rate. Last August I was so concerned about being breathless that I saw an out of hours GP who said it was asthma and gave me antibiotics and steroids . I finished the courses of both with no difference in how I felt so was given two more courses of steroids (done by my GP over the phone) . By November I was no better and saw my doctor who said my heart rate was 155 beats a minute and there was also an arrythmia .An ECG followed and I was sent at once to hospital where further tests were done over the next three days as an in patient. Atrial fib and fast heart rate were again diagnosed and I was started on Diltiazem and warfarin treatment. The swelling in my legs was a real problem in the weeks following so my GP cut the Diltiazem dose in half. The cardiologist said that in six weeks they would do a Cardioversion which happened in mid December so would continue on the Diltiazem and Warfarin . I was also taking Valsartan Hydrochlorothiaxide 160mg daily for my BP ( long term for years) . Unfortunately the Cardioversion failed so I have just seen the cardiologist who has changed my medication four days ago from Diltiazem to  beta blocker Bisoprolol ( 2.5mg twice  a day ) and amioderone , an anti arrhythmic drug , (200mg three times a day for one week, then two daily for a week, then one daily from then on). I also take Warfarin and Valsartan . He didn't talk about the impact or side effects of these new drugs, and was dismissive of my concerns about amioderone saying it took years for side effects to be a problem. He said they will not be doing another Cardioversion but will control my problems with the medication. However, my breathlessness is worse , I feel so tired, my chest and whole body feels heavy and weighed down and even a short walk or climbing up stairs is a major undertaking - not easy when I have dogs to walk . I already have a substantial weight problem and am seeing a kidney specialist next week since my GP is concerned about recent kidney function tests. Frankly , I am not surprised since all this medication must be affecting the kidneys. I desperately need some informed advice about how to get my life back. An added complication is that I am judging dogs at Crufts in March and can't see how I will manage that when I will need to be on my feet for hours going over dogs. I appreciate the fact that treatment can not be immediate and am very grateful that it's free here in the UK but need someone to take an overview and coordinate the effects of the medication and choices I may have . 

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  • Posted

    I went exactly what you went through, I was treated by a private specialist, like you the cardio version only lasted three days, so he decided  to put me a pacemaker in,

    it's three weeks on Monday since I had it done,  I now feel like a new man at 77 years old,  instead of messing about with waferin he has put me on a anticoagulant called rivaroxiban , a very tiny tablet once a day.  My pulse rate now is 80 before it was sometimes 166 btm  ans a good blood pressure tablet which keeps my BP aprox 125 over 82.

    hope you get on ok,but get taking Rivaroxaban  instead of going to have it checked quite often with warfarin .

     

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    • Posted

      Charles, this is interesting. My GP has told me that I would not be considered for a pacemaker because this is only used for slow heart rates and mine is fast with arrhythmia . Yet you have a pacemaker and had a fast heart rate . I am still struggling with slowing it down - the amioderone is not doing it . 
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  • Posted

    I can understand how bad you are feeling right now as I have been through it too.  I do not have an absolute answer for you (maybe someone else will have) but would suggest that bisoprolol may not be suiting you.  Or the dose may be too high.  I was put on that several weeks ago and ended up in a and e because of chest pains caused by the bisoprolol. I was taking half the dose you are taking.  Atenolol, the offered alternative, caused extreme tiredness and a very slow pulse rate.  I am now on a very low dose, one eighth of that originally offered, of propranolol.  This suits me better.  I reckon you need to ask your GP about this, as soon as you can.  There is no need to suffer..  Best of luck!
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  • Posted

    I know exactly what you're going through.... believe it or not I happened to mention I was having a few palpitations occasionally to my GP....and  he promptly changed my very effective long-term long-acting Inderal L A 80 mg to Bisopralol 10 mg would you believe -  I am only 10 stone and 5' tall - it nearly killed me.  

    Talk about a "sloth on tranquillisers"  - LOL -  I was reduced to a crawl to get around as my BP was SO low snd I was SO tired ALL the time.   It took me  many months to reduce the dose to 1.25 which controls my palpitations but still makes me feel lousy.  

    They also wanted to put me onto warfarin but I refused point blank.   Instead I take my enteric-coated aspirin daily instead and it works very well     They also insisted I took statins as well which I resisted for a month and then gave in....BIG MISTAKE and one I have regretted ever since but that is another story and you will find more on that subject on the STATIN SIDEFFECTS forum!! 

    Suffice it to say that I am currently in a wheelchair as a result of statins.

    As a Labrador owner myself  of some 50 years - I can understand your concerns about being on your feet for many hours in the show-ring particularly if your ankles/legs are swelling as mine

    have done on the Bisopralol even at my reduced dosage of 1.25 mg      I find that no amount of diuretic makes any difference.... so I would talk to your GP again about this.

    I am about to ask to be referred back to my cardiologist as I would prefer to be on my old Inderal LA with a touch of digoxin to control my occasional palpitations.... Which is the way we dealt with  patients with palpitations in the olden days and it worked well enough then.  Okay Bisopralol is a cardio specific drug but it is too specific  for me obviously as I was able to walk my labradors 3 miles before breakfast every morning, without fail for well over 30 years - and now I can't get  across the room without the help of  sticks or in a wheelchair....ever since I was changed to Bisopralol...

    So please get checked out again...nowadays doctors are purely signposts .. And do not treat patients "wholistically"  anymore  -they are all "specialists" and no longer join up the dots!!  My late husband was a GP for 40 years - one of the old school who took time .....so I do know what I'm talking about!!

    I Wish you all the luck in the world and will look forward to hearing how you get on..

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  • Posted

    Have you had your INR checked since staring Amiodarone. I was taking Warfarin for six weeks then anothr cardiologist said that I could not have another cardioversion unless taking it. Within ten days my INR had gone from 2.5 to 3.9 as if already on Warfarin  the dosage should be halved when starting Amiodarone.

    You certainly do not want to be on Amiodarone long term because of its side effects. Why can you not have another cardioversion? Have you asked about ablation?

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    • Posted

      Hi Derek, this is my third day on amioderone and I am having an INR check on Monday. So I don't know the impact yet of taking the amioderone with the warfarin. My INR have been up and down like a yo yo right from the start while I was in the six weeks run up to Cardioversion. So that is a concern . Odd that the cardiologist didn't give me any guidance or advice about blood test follow ups for these new drugs. I think he was against another Cardioversion because I am overweight which makes the procedure less likely to succeed . He didn't actually say that but reading about the procedure makes that point. Ablation has not been discussed yet so I assume he wishes to control my fib with medication .
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    • Posted

      I was first prescribed a low dose of Warfarin and the normal starting dose of Amiodarone when in hospital after going into AF after aortic valve replacement. Then the Warfarin was gradually increased over weeks to get my INR to the required level.

      When going into AF again after another procedure I was started on 10 mg Warfarin and it was gradually reduced when I reached my target INR. Then along came a stupid assistant registrar who did not know of the consequences of prescribing Amiodarone to a patient already on Warfarin.

      When I had my cardioversion there was a man of 22 stone with AF and sleep aponea having his 16th cardioversion. Weight would seem to be no barrier. Have you Googled ... the history of Amiodarone? An interesting read.

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  • Posted

    Hi, I was diagnosed with ectopic beats last June and spent 10 days in hospital having lots of tests. I was put on bisoprolol but felt breathless on them so stopped them. I then saw a private Dr and he put me on flecanaide but these caused more palpitations. Then I was  taken into hospital about 6 weeks ago and diagnosed with AFIB. I was given rivaroxiban but not keen on taking them.  I have an appointment next week at the arrythmia clinic to see a physiologist and hoping I will be offered the ablation. I have been suffering with palpitations and heavy chest pain for over a week which is really uncomfortable, although I have had this condition for over 30 years, but only recently diagnosed.  Sometimes I don't have any problems for weeks and then they come back with a vengeance. I feel very tired when I have the palps. Hope you get sorted with the right medication soon.    
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  • Posted

    Thank you everyone for such quick replies containing such interesting information. Well, I can already add an update. I went to my local GP surgery and spoke to the pharmacist - the doctors' and pharmacy are in the same place. She said my breathlessness and lethargy were definitely caused by the Bisoprolol and could not understand why the cardiologist had put me on it since I have a history of asthma . She then recommended that I see one of the doctors immediately. I explained to the receptionist the problem and within half an hour I was seen by one of the senior doctors who told me to stop taking the Bisoprolol at once since it blocks production of adrenaline hence the extreme lethargy. He was not happy that I had been put on two major different drugs at the same time since he said it would be impossible to monitor side effects . He said that the amiodorone  should continue and once in my system should control the arrhythmia and slow my heart rate but regular blood tests will be essential since it can affect thyroid production. So I am having a thyroid check next week . So I feel relieved that I can at least stop the Bisoprolol which I know did not suit me. I will be continuing with the Valsartan and Warfarin and of course the kidney consultant may have views when I see him next week. My GP stressed that it was a question of getting the balance and dosage of the right drugs to control my problem , so I can only hope for some positive improvement so that I can judge the dogs in March. 
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    • Posted

      Good that you have a doctor who acts quickly. I expect like me you got an Assistant Registrar in cardiology.  I had a lot of problems in that respect and wrote to the chief of cardiology and had a meeting with him when he put his hands up to all his departments failings.

      Give us your description and we will look out for you on TV when you are judging at Crufts.

       

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  • Posted

    It's very early days for you yet. Give the Amiodarone a chance as it takes about a month or longer for you to get the full benefits from it. When it does start working you may probably have to stop taking the bisoprolol as it seems this has been given to you as an immediate way to help get your heart rate under control. Bisoprolol gets into your system within hours - Amiodrone takes weeks. When the Amiodarone begins to work it should make you feel a lot, lot better and I am sure you will be able to get on with things like before. Best of health to you.
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    • Posted

      Thank you , this seems to be my GP's view . However, I know amiodarone   has major side effects if taken long term but hopefully it will help get the arrythmia   and rapid heart rate under better control. Interesting that today I had two blood tests done at the GP's . One was an INR update and my level had fallen to 1.8 since taking the amioderone when I expected it would have risen. The second test was for thyroid , iron etc so it will be a few days before those results. It is obviously a balancing act to get the drugs right .
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  • Posted

    It's good to hear other people's experience. I have just had my third admission to A&E in the last two weeks.they tried cardioversion and the effect only stopped the Atrial flutter/ fibrillation  for 24 hours then I was re admitted and they increased my bisoprolol and flecanide dose even though I was struggling to cope with th side effects.after my third admission they stopped both of these and prescribed a reducing dose of do a further Amiodrone 200 mg and said they would send for me to do another ablation. It would be good to hear from people who have been successful in their treatment. I hope you get your medication sorted and are soon feeling better
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    • Posted

      I was put on Amiodorone by my Cardio Consultant but he did say it was for a short time 6 months max as it had bad side effects. My GP said it was poisoning me! The Cardio nurse tried to keep me on it but my GP took me off it as Cardio Consultant was on a course. This after 3 months. Amiodorone achieved the control of the heart rate but not the af but the side effects were breatlessness, poor vision, itches on the skin , vivid dreams and an amazingly alert and analytical brain function.I had tests for kidney,liver and ? each month. The medication takes 6 to 12 months to be out of the system. I was then put on digoxin for heart rate (successful)
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