Not sure what to do for the best ! ...... BISOPROLOL !!!

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Following AVR surgery & a pacemaker fitted in 2011 I've been in paroxymal AF & have had 4 cardioversions. The last DCCV lasted 11 months but I went back into AF 2 weeks ago. i've now arranged for a 5th cardioversion in 2 weeks time. However since going back into AF my symptoms have worsened & I'm convinced in my own mind that the 1.25mg of bisoprolol i take daily is at least partly to blame for my dizziness, breathlessness, tiredness & general feeling of being unwell. My BP is OK & my heart rate is around 80bpm [I am of course on a beta blocker !] My cardiologist would like me to stay on the bisoprolol up to the time of the DCCV & for about 6 weeks after at which time we would review the situation. However as I'm primarily taking the beta blocker to try & maintain my sinus rhythm [now gone] I'm thinking of stopping taking the bisoprolol to see if I feel any better PRIOR to the DCCV [2 weeks away]. On the basis I can always go back on if i need to. Has anybody else on the forum been through a similar experience or has any thoughts. ........thanks in anticipation

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  • Posted

    I too have had a pacemaker following a few years of paroxysmal AFib and a couple of failed ablations, but have also now had an AV node ablation which is supposed to not cure the AF but mitigate the symptoms.  Following the pacemaker implant in February, I refused to take Bisoprolol any more as I know it made me feel terrible, too tired to function.  My cardiologist permitted this and to this day I have not taken it again.  Although my pacemaker needs further adjustment as and when the AFib attacks occur (last time they tuned it up to cope with 115 beats per minute) inbetween I feel fine - I get attacks perhaps every couple of months now, so am not sure how often yours occur.  Personally, I think that as long as you keep up your anti coagulation (Warfarin or Pradaxa) then you are safe and it is the symptoms of AF which bother you most.  So it depends on how often you get AF, how bad you feel during attacks and whether you have a sympathetic cardiologist.  I don't think Bisoprolol makes you feel ill and tired, most of us on these sites know it does!
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    • Posted

      Just a comment Josephine on your PM setting.

      Yesterday evening I asked my cardiac consultant how the setting of the PM was decided and he said it was a compromise between the "most suitable" rate and the life of the battery so if it is set to a higher rate it will be in use more of the time and the battery will need changing more often. Hopefully this is no a "minimum cost" issue.

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    • Posted

      Hi many thanks for this. As this will be my 5th DCCV it has been strongly recommended that I opt for a catheter ablation sometime in the New Year .....I'm told it has a higher success rate if the procedure is carried out whilst I'm [hopefully] in sinus ratehr than AF. I went into AF the first time immediately following my aortic valve replacement surgery in September 2011 & because of long pauses in my heart beat 4 days after the AVR surgery I was fitted with a pacemaker. After a few months [still in AF] they discovered that the new valve [mechanical] was leaking & I was offered & accepted a percutaneous paravalvular leak closure [in through a femoral vein & basically plugged] this closed the leak 95%. I was then given my first DCCV which lasted a few days, several months later I was given my 2nd DCCV which lasted 7 months, a few more months in AF then a 3rd DCCV again lasted 7 months, then back in AF, 6 months later my 4th DCCV lasted 11 months & I went back into AF on the 18th October. I've now booked my 5th DCCV [cardioversion] for the 25th November. It seems that apart from short episodes I'm either in or out of sinus & up until this time around i've not really felt much different in sinus or AF. However since going back into AF this time i've been much more symptomatic. Before when I've been in AF I've not been on medication [apart from my warfarin & statins], this time i've been on bisoprolol 1.25mg for about 18 months & I feel it's the combination of AF AND bisoprolol that is causing me the magnification of my symptoms this time around. It's really a question of whether or not I try to come off the bisoprolol for a few days prior to my next DCCV to see if I feel any better or try & 'limp' through to the DCCV & see how I am after the procedure ?? I also get the feeling that my tolerance for bisoprolol has lessened in the 18 months I've been taking it [in my head I though my tolerance would improve ??]
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  • Posted

    Have had PM set at 60 for 12 months and it has improved the AF  a lot as my pulse when resting was 55-59 much of the time. In fact 25% taking the amount they said my PM is being used. Also before I started on all the meds. and had cardioversions (2) I felt tired and dizzy just from the AF.  The half life of bisop. is 2 hours so the effects of the bisop. should only be 4 hours. If you are not already why not take it at night? and if you still suffer from the feelings during the day it is unlikely to be the bisop. but of course you could stop taking it for a couple of days to see how you feel. Surprised by the number of cardioversions you have had as thought that NHS/NICE had stopped them after 3.

    I would ask if there could be any bad effects from having multiple cardioversions.

    Everone is different of course and how you react to bisop. and cardiov. may be different from my experiences.

     

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    • Posted

      I think for me the difference is that my implant was followed six weeks later by the AV node ablation, which means that the top and bottom chambers of my heart have been permanently disconnected - also meaning that the pacemaker does all the work all the time, pacing only the ventricles and leaving the upper atria to do what they will.  Out of AF my rate is between 70-80 but obviously, during an attack, the rate is around 115 for the pacing to still be in step with my heart.  Last time it was 'out of synch' as they put it.   I suppose that if I progress to permanent AF then they would have to slow the pulse with drugs, but I will ask to try Dilitiazem (I think that is the name( as others on these sites have suggested it as an alternative to Bisoprolol which I cannot tolerate.

      I have not heard battery life mentioned as an issue but in any case, would prefer a changeover more frequently if it meant a better quality of life.

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    • Posted

      Hi ...many thanks for this. I have just started taking the bisoprolol at night [just a few days ago ....] no change yet. I am serioulsy thinking about stopping taking it for a few days prior to my next DCCV just to see what it does .... I suppose i've just been a bit concerned about what this will do to my BP & heartrate ! I have my cardioversions done privately through my PMI provider, who are aware that this is my 5th go around. My PM is set at 70 bpm lower end with the rate response on
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  • Posted

    Haven't had the problems that you have had but have been on Bisoprolol 2.5 for 2 years now for AF and it still makes me feel dizzy/light headed etc, my heartrate is kept at a steady 52 since being put on it though sometimes it has gone down as low as 48! on those days I can hardly get out of bed I am so tired, all this before I became severely anaemic but that is a whole different exciting tale. neutral
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    • Posted

      I'm not sure what my 'natural' heart rate is just now as my pacemaker is set at 70bpm at the lower level. What I do know is that my BP is presently at around 115/75 7 my heart rate at 93bpm ...... which I think is quite common with AF [mind you it can fluctuate considerably during the day/ ...... first thing this morning my BP was 138/85 & my bpm at 70 !!

      I've just had an email exchange with my cardiologist who has said it would probably be OK to stop taking my bisoprolol for a few days just to see if this helps my symptoms. He says there is a short 'half life' in bisoprolol but i should know after a couple of days if bisoprolol is contributing to my symptoms ....... i'll report back on Monday/Tuesday

       

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    • Posted

      OK change of plan ! stopped taking bisoprolol Saturday evening & all seemed OK [no better but OK] until this morning ...... I'd been up for about an hour, then wave of dizziness/weakness overwhelmed me . I could hardly put one foot in front of the other. Managed to use my BP machine ..... reading was 132/108 & heartrate of 113bpm !. Because I was feeling so unwell I went to bed & took a 1.25mg bisoprolol tablet ...... 2 hours later my BP was 127/78 & heartrate 71 !. I did feel a little better but really not great & I've spent from then until now in bed. I'm now not sure what to do ? I have my 5th cardioversion a week tomorrow & my cardiologist would like me to stay on the bisoprolol following a hopefully successful DCCV & then review. Has anybody on the forum ever changed their beta blocker with any degree of success OR tried a different type of drug to achieve their objective, which for me is twofold 1] To try & help maintain sinus rhythm following the cardioversion & 2] To keep me blood pressure at a reasonable level. My cardiologist has also recommended that I strongly consider a catheter ablation as I keep going back into AF following cardioversions ... has anybody out there taken this route/any thoughts [I know i'm not alone !!]. Going back to bisoprolol I was recently told pretty much out of the blue that I have pre-diabetes ..... never had any issue before I then read somewhere that bisoprolol can lead to type 2 diabetes [I'm 61, I don't smoke, drink too much, nor am I overweight & I use a treadmill [when i'm not in AF !] every day for 30 minutes [fast walking] + I usually go for a walk on the seafront daily for at least 2 miles [but not just at the moment !!]. Again has anybody come across this type 2 diabetes finding ?
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  • Posted

    Hi exhogg I would just like to tell you that I do think Bisropolol gives you all the symptoms you are experiencing ie: dizziness,breathlessness and feelings of lethargy as well as anxiety. I took my last one beginning of September and from that first day all my symptoms of the above disappeared and I have felt back to my normal self apart from the af which does'nt seem to bother me as I am on Dabigatran and Digoxin. Hope this helps.
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  • Posted

    Really agree with your conclusions.  Since stopping the Bisoprolol all those symptoms have disappeared and I feel more like my old self than for a long while now.  Give yourself a chance to adjust to either situation before making a judgment is the best advice, ie you are unlikely to die from stopping it according to my cardiologist and it was my own choice.  However, as stated, if my pulse continued in the 115 mark because the AF had become permanent, then I will look for a lowering drug, but NOT Bisoprolol!
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    • Posted

      Can I ask did you also have any immediate [in my case 2 days] "backlash" when you stopped taking the bisoprolol & if so do you know what happened to your BP & heartrate. also how long was it before the symptoms subsided & you began to feel as you say like your old self ? I have to admit I probably panicked this morning & this + the distress it was clearly causing my wife [always difficult for the partner] meant I quickly grabbed for the bisoprolol pack !!
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  • Posted

    I noticed nothing different for the first couple of days but after that an enormous improvement in how I felt, energy returning daily.  I had been on 2.5, then 5 and then eventually 7.5 which was the killer dose for making me feel like a zombie.  If you decide to try say one week, then be sensible and take your own blood pressure twice daily to note any concerning changes (I have a wrist cuff which also records pulse and is easy to use - relatively cheap to buy in Boots or similar).  I still monitor my blood pressure and heartbeat rate about every few days.  It is usually quite reassuring.

    It is easy to panic with anything to do with the heart.  I was a bit scared last week when the monitor read 115 beat, but the Pacing Clinic casually turned up the rate on their little machine and all is well.  You get these upsets from time time and they are rarely life threatening, just seek help and advice as you go.

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    • Posted

      Thanks. I think I'm going to 'limp' through until next Tuesday [cardioversion] staying on the bisoprolol for now [fortunately I've been retired since 2006 !!] See how I feel after the DCCV & then look to come off the bisoprolol ....... I know my cardiologist will want to put me on something to replace the beta blocker to help maintain sinus rhythm also to keep BP down. Has anybody else had positive experiences with alternatives to bisoprolol/beta blockers ?
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