I did wonder if it was working at all, but due to the unpleasant side effects I didn’t want to mention it to my Doctor in case he increases the dose. I don’t want any more of that..!
I’m happy to say that I had a successful cardioversion in November and I’m still in Sinus rhythm. I’m still on Bisoprolol at a very low 1.25mg dose. I tried coming off it & had a rebound whereby my heart felt like it was beating particularly hard. I’m told this is normal and goes away after a few days but it was pretty alarming so I decided to wait until my follow up appointment.
Fast forward to my appointment yesterday & I expressed the desire to come off the Bisoprolol. the cardio nurse discussed the risk of going back into fibrillation if I come off it but suggested a try a different drug. He’s prescribed Flecainide. He said this would effectively do the same as the beta blocker but without the associated side effects of no energy, no ability to lift my heart rate & reduced exercise capacity.
That all sounded good (though I’d rather not take anything…). I read the enclosed paperwork & I’m now concerned that I’ve been prescribed the wrong drug.
Flecainide seems to be for supraventricular arrhythmia, ventricular arrhythmia & paroxsymal atrial fibrillation. I was in permanent atrial fibrillation but now in normal sinus rhythm. The leaflet, nor a scan of the internet says anything about using it in these circumstances. In fact nearly everything I can find talks about it being for serious heart conditions, which I’ve been told I only had AF without any other complications.
Has anyone else been prescribed daily Flecainide whilst in normal rhythm, or following a successful cardioversion?
I was on it for 5 years with 1.25mg Bishop as well, as a preventative against atrial flutter (rather than aFib). Was ok until dose went up to 100mg from 50mg after a flutter recurrence. Then 2.5 years of feeling crap after exercise and increasingly frequent flutter episodes Then got stuck in flutter, had another ablation which seems to have fixed me. Came off all meds post ablation.
So it's definitely used as a arrhythmia preventative. Talk to your consultant if you can, or see how you get in with it.
Oh, and I first went on it after a successful cardioversion
Thanks Beej
This is interesting about the bisoprolol as I’m on 5mg a day.
I just have no energy to do anything.
I can manage a 20 ish miles ebike ride on a Saturday and then feel like a zombie the day after.
lack of motivation to even walk the dog.
That's happened to me as well.
Can't ride up hills, no energy, no motivation.
Had to be a nonstarter in the Strathpuffer because I doubted I would have managed to get up the first hill even walking.
I've stacked on 7kg and I'm starting to think the cure/treatment is worse than the problem.
Question re effects of Bisoprolol: What happens if I try to ignore the breathlessness and lack of power and push on climbing a hill?
I've been getting off because that feels like a warning, so is there a risk, eg fainting or worse, or will I just feel more crap?
i was on Bisoprolol early in my AF. it made me pass out a couple of times when riding. walking up stairs was almost impossible.left me worn out constantly.
cardiologist changed my meds to Tildiem, which works fine for me. riding 100 miles most weeks. walks of up to 10 miles no longer a problem. still in AF.
Bit of a thread resurrection, but looks like I am the latest STW victim of AF. Started about a month ago now where suddenly over night I noticed my RHR was about 20 bpm higher than what it normally was. Over the coming days it stayed like that and I had a general feeling not feeling quite myself. Saw a GP later that week, who was not overly concerned and put it down to a post viral reaction. Give it a couple of weeks and come back.
It stayed persistent so saw a GP again week before last who also took my BP, which was elevated. Well it was very high - as I have white coat syndrome - but even taking it at home it was higher than it should be. So went to see a cardiologist last week, to EKG which confirmed AF. ☹️ Blood test taken to try to figure out what may cause it and will also go in for an echocardiogram this week. I am on a diet of blood thinner, beta blocker and something for the rhythm. I am lucky in that I have private health insurance through work - so getting appointments is fairly quick.
I am not going to lie, it is a massive kick in the nuts as it has come out of the blue with no prior warning - and being on my own with own thoughts and access to google is not necessarily doing me well. Although it does run in the family. My mum was diagnosed almost same age as me (53). That said I am sure I am in good care - and reading this and other threads is comforting in that it is treatable and manageable and will hopefully mean that eventually i can carry on more or less as I have. I am determined to beat this so will make sure I make the life style changes which can help as well as losing some timber.
One question which occurred to me reading the BHF website is around driving. Has any of you fellow AF’ers been told anything about not being able to drive?
My BIL has AF, and he hasn't been told not to drive. He's not a particularly 'fit' person but hasn't been told not to drive - he's even got a new motorbike recently.
You only have to report the fitting of a mini defib, not AF itself.
https://www.gov.uk/driving-medical-conditions
I dug a little deeper into DVLA
https://www.gov.uk/arrhythmia-and-driving
You must tell DVLA about your arrhythmia if one of the following applies:
- you have distracting or disabling symptoms
- your arrhythmia means you might not be able to safely stop or control a vehicle
Thankfully neither apply.
I had a pulmonary vein catheter cryo ablation seven weeks ago to 'fix' my persistent atrial fibrillation. So far my heart is in a normal rhythm and I'm back on my bike and I've just started back at the gym. I'm still on beta blockers and blood thinners but my cardiologist thinks I should be able to drop these in early December.
Initially it happened to me in 2020 and I had a cardioversion done then which worked. I then had 5 years of no symptoms then it returned in February this year. This time the afib persisted. The key is to get a cardiologist that specialises in this. You want an electrophysiologist. My first cardiologist was decent but he preferred the drug solution but that didn't work for me. I got a second opinion with an electrophysiologist. He described my original cardiologist as an 'excellent plumber, but what you need is an excellent electrician'.
Thanks for that. Was that private or via NHS?
I have my follow up in a couple of weeks where the blood samples and echocardiogram will be discussed. I will then also discuss the next steps. I have a clear presence to get to a no or very minimal drugs position. From research, this seems to be the order of which things are done it - and that was also what the cardiologist said to me - seems in US they jump quicker to number 3.
- Drugs
- External DC Cardioversion
- Ablation catheter
There also seem to be a newer treatment called Pulse Field.
And if at some point my cardiologist “stops” I will definitely go for second opinion.
Right on the money. My local hospital cardiologist was, to be frank, pretty useless.
I resorted to a private consultation (because I could) and chose to see their best electrophysiologist based on his bio. The insight and advice he provided was like night and day compared to my local old boy.
FWIW I had a cryoablation followed a few years later by RF ablation. Mostly sorted now. Very occasional relapses (couple per year) due to various triggers.
“My” cardiologist specialise electrophysiology as well so hopefully I am in the right hands. Still early days - although I could be done with it already….
I went private for my treatment as I was insured through Aviva.
Good luck with everything, I hope you get sorted.
Thanks. I am lucky to have private health too.
Must say this is a bit of a rollercoaster emotionally. It is amazing how your mind can find the worst case scenarios in these situation - sometimes I wish I did not have access to google 😀 There are days where I am struggling and shitting myself. In some ways work is a relief - although in a paradox way I think the stress from there and the impact that has had on my me over a number of year is part of the reason for it all. But who knows?
Tomorrow is echocardiogram day and return of the 7 day Holter monitor - and then week or week after next back to see the cardiologist.
I am keeping a list of an ever increasing number of questions for when I see the cardiologist - particularly around the drugs I am getting and the next steps (I am not a very patient patient). This and some of the other threads has been a great help too. Although I would not wish this on anyone, it is nice to not be alone.
I can appreciate how difficult it is. I wasn't allowed to exercise while my AF persisted so no gym or cycling for me for six months. I got pretty grumpy. Bear in mind though one of the cardio nurses said to me if you are going to have a heart problem this is the least serious. This is the worst phase while they try and figure it out.
One of my friends is in permanent AF and she racks up about 10000 miles a year on her roadbike.
Try not to over think stuff. Let the cardiologist guide you but don't be afraid to get a second opinion if you feel you aren't getting anywhere.
Thanks. Much appreciated - and yeah, not being able to exercise and burn it off makes me grumpy. I even enjoyed cutting the lawn today 😀
And this “One of my friends is in permanent AF and she racks up about 10000 miles a year on her roadbike.” is encouraging.
'excellent plumber, but what you need is an excellent electrician'....almost the exact words mine used 9 years ago...wonder if it's the same bloke or if its a standard joke?
"From research, this seems to be the order of which things are done it - and that was also what the cardiologist said to me - seems in US they jump quicker to number 3.
Drugs
External DC Cardioversion
Ablation catheter"
I went straight to number 3
If you don’t mind me asking, what was the main reason to go straight to ablation? I assume it worked?
If you don’t mind me asking, what was the main reason to go straight to ablation? I assume it worked?
I seem to recall the docs thought drugs wouldn't work for me, not would cardioversion.
Yes it worked... 9 years and counting
That is great to hear. 👍
I've not had AF but I have suffered from other heart arrythmia. Anyone suffering has my complete sympathy as it is indeed a mindf*** of the highest order, particularly when it affects the things you love (i.e. mtbing)
In my case it was really strong premature ventricular contractions. They'd come on randomly and I would feel like I was going to drop dead on the spot with the really strong ones.
Fixed with ablation. I'm 100% fine now
Hope you get it sorted OP
Thought I should give a brief update.
I had a cardioversion back in October, which did not work. I then had a pulse field ablation in December. So far so good. Coming up to my 3 months check up soon. I was taken off the beta blockers after the ablation, as my RHR was down to 40, but I am still on blood thinners and the arrhythmia drugs. I expect to come off both those after the checkup.
I am back on Zwift, and putting in some hard sessions. The arrhythmia drugs are still curbing my HR a bit.
Fingers crossed this stick and I don’t need a second ablation.
