Bradychardia: Can anyone reassure... - Atrial Fibrillati...

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Bradychardia

Tellingfibs profile image
27 Replies

Can anyone reassure please ? I have been taking Bisoprolol for about 7 years now, and am on the high dose of 5 mgs twice daily now. This keeps my heart rate around 60 when I am sitting. Sometimes, if I am being lazy, the rate can be as low as 55, but perks up once I start doing things. However, this afternoon I had a post lunch nap, loaded the dishwasher and made a cup of tea, only to find ( with my Kardia ) that my heart rate was 47. Now, it has never been this low and I am a bit anxious about it. I do feel ok - not faint, dizzy or breathless so I am thinking it can’t be too important. What do you think ? I feel if I ask someone medical they will say not to worry if I feel ok. Normally, Kardia tells me I have a mostly ‘normal rythm with supraventricular ectopics’. Quite rare that I get an NSR reading, but certainly a few intermittent Afibs. However, I took a Kardia reading last night and it was NSR, and today two out of three have been NSR, so that’s good. I wondered if that had anything to do with the slower heart rate. I’d very grateful for any thoughts.

Annie.

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27 Replies
Buzby62 profile image
Buzby62

Check with your medics in case your condition has changed (maybe for the better) and medication may need adjusting. 10mg per day is a not a small dose.

I was on 1.25mg twice daily for paroxysmal AF and when in NSR (most of the time) my resting HR was always in the mid 40s.

It doesn’t take much bisoprolol to lower you in to bradycardia in my experience when NSR.

Best wishes

Tellingfibs profile image
Tellingfibs in reply to Buzby62

Thank you Buzby62. I am surprised because my heart rate has been so steady for years. My Bisoprolol dose was increased over time because I had some breakthrough Tachycardia spells. I have actually asked my GP if I could possibly reduce the Bisoprolol a little, but he advised against as I have a lot of SVEs - although never fast heart rate. I will contact him.

Annie.

Buzby62 profile image
Buzby62 in reply to Tellingfibs

Maybe time for a cardiology/electrophysiology review ? Things change over time.

I believe reducing it does not always make the difference you might expect as it’s not a linear dosing drug and we all react differently.

I was initially on just the 1.25 once daily and doubling the dose did not make that much difference to my rate but kept me topped up 12 hourly I feel.

Ppiman profile image
Ppiman in reply to Tellingfibs

I would trust your GP on this. I was told that a slow rate is of no concern, if it is not symptomatic. My SVEs (and AF) have become much more frequent and my bisoprolol was increased to help. So far that hasn't improved the frequency of ectopics or AF but it has improved the NSR readings a great deal.

I have my own theory, such as it is, that these SV "ectopic" beats are a kind of "micro-AF" since the shape of the beats look identical on the home ECG machine I use and they sometimes come in groups of 2,3 and more.. My cardiologist (who did my ablation aflutter and is expecting to have to do one for AF / SVE in the future) looked over some ECGs which marked th beats as ventricular tachycardia in error, worrying me, but he assured me they were atrial but difficult for the machine to determine by AI owing to my left bundle branch block (phew).

I get mine mostly after waking (like now, as I type) and in the evenings, with AF occasionally joining in the fun!

Steve

Tellingfibs profile image
Tellingfibs in reply to Ppiman

Hi Steve. am feeling reassured about the slow heart rate because I do feel ok with it, and anyway, it’s not all the time. I have said before on this forum though, I worry about the SVEs. When I use my Kardia with my fingers, I have more Afib readings, but when I use my right hand and left knee, the readings are usually SVEs. My GP said the latter was likely to be more accurate and he suggested the Kardia algorithm shouldn’t be taken as gospel as it is JUST an algorithm and Afib is such a mongrel condition, the algorithm couldn’t possibly get everyone’s rhythm correctly determined.

Annie.

Ppiman profile image
Ppiman in reply to Tellingfibs

I think you have a good GP there. I am lucky, too, but when my Wellue showed "VT" recently, he packed me straight off to see a specialist. It was the EP who did my ablation for flutter who I saw and when he looked at the Wellue and Apple Watch ECGs he immediately said that they were not VT and were all atrial in origin. Apparently, my on-off LBBB produces ECG traces that make it hard for AI to determine. To be sure of things, he did order a 48-hour monitor for me (which I did over the weekend) as well a future echo and MRI scan to check my heart function. This was so he could prescribe flecainide if needed but he said an ablation would be the best way forwards eventually.

Steve

KiwiBlake profile image
KiwiBlake

Hello. I was put on Bisoprolol 2.5mg once per day about 2 years ago for rate control. I am also on Flecainide for rhythm control. Prior to going on the Bisoprolol my resting heart was about 65 bpm. Since going on the Bisoprolol it has dropped to about 55. Sometimes, if I'm feeling really relaxed it will drop as low as 48 while seated watching TV or just relaxing. When I glance down at my wearable and see it as low as 48 I think to myself that's a bit low, but I don't have any negative side effects, no dizzy sensations, no lack of energy. So in my situation I'm quite happy, as the meds are keeping me in NSR. Regards Blake

Tellingfibs profile image
Tellingfibs in reply to KiwiBlake

Thanks for responding KiwiBlake. I am probably fussing. Maybe it was just a matter of me being very relaxed ! Good to be in NSR a bit more the last couple of days ! Glad you are in an even keel.

Annie.

bean_counter27 profile image
bean_counter27

There's no problem asking for thoughts and ideas from forum members but you should discuss changes to dosages and medications with your relevant medical professional. We're all different so what works or is okay for a forum member doesn't necessarily mean it works or is okay for you.

Your medical professional also has your full medical background.

I also expect a medical professional will say your lower HR is fine so long as you feel okay. However, they are the person you should ultimately consult about changes in your vital signs.

Tellingfibs profile image
Tellingfibs in reply to bean_counter27

I agree absolutely. The beauty of this forum is that it can so often bring a person down from high anxiety at times when they are not thinking as calmly as they might otherwise. If medical advice is needed, the people here often give reassurance between the time someone posts here, and such time they are able to get to see a medic.

bean_counter27 profile image
bean_counter27 in reply to Tellingfibs

Yes, reassurance and advice from people who have gone or are going through the same as you is invaluable and can very comforting, especially given the lead times associated with consulting with medical professional these days.

Vonnegut profile image
Vonnegut

The lowest dose of Bisoprolol (1.25) was too much for me to take daily and it only reduces the heart rate and not the irregularity which is part of our problem. Flecainide does that for me.

Ewloe profile image
Ewloe

I’m often in the upper 40’s at rest. And it’s been recorded on a 5day ecg at 38 on occasions at night. Cardiologist and EP are okay with that as I’ve not been symptomatic and the 38 is only occurring when I’m sleeping.

Tellingfibs profile image
Tellingfibs in reply to Ewloe

Yes, I think the bottom line always seems to depend on how we are actually feeling and what other symptoms are new. I think there is a lot the experts don’t know for sure !

Blimeyohriley profile image
Blimeyohriley

I have bradycardia. Bisoprolol took my rate to around 41bpm (from around 48 without meds). I didn’t notice any symptoms so cardiologist(s) and EP weren’t concerned. I then started to have many more AF episodes so my med was changed to soltalol. Around the same time I started an unrelated medication which increased my heart rate as a side effect to around 58. I feel I have slightly more energy since then so I guess I did have a side effect I hadn’t noticed. My AF has decreased greatly now (who knows for how long), My EP suspects this is because the faster heart rate gives the rouge AF beats less opportunity to take over. Overall, I’m answering your question longwindedly, I was told by many that if I had no symptoms with my low heart rate then not to worry.

Tellingfibs profile image
Tellingfibs in reply to Blimeyohriley

Thanks for that very interesting post. It shows just how differently Afib and the drugs affect us all differently.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Are you genuine today 'tellingfibs"! ???

IAfter sleeping or during my night avge is 47! Normal for me and I have always have had rrouble with COLD SHOULDERS!

Now with AF I had H.Rate Day on monitor after the stroke and on Metoprolol which I said no to and had it prescribed of avge Day with little or no exertion 186bpm.

Finally changed when I demanded a follow up referred to by a Public Heart Soecialist and the 24-hr Heart Monitor showed 186avg.

At 1 year 5 months changed to Bisoprolol and she said a BB better for AFers. But it did not control my Day H/rate. A Monitor recorded 156bpm still not controlled.

Frustrated I talked to a newly arrived Locum. She had experienced AF. Had an ablation in Aussie. She referred me to a private Heart Specialist who had proved himself.

He was interested in my history.

I was introduced to CCB Diltiazem. 180mg 1/2 dose proved too much so it was lowered.

For 2 years 4 months now. I take CCB for control of H/Rate AM and it in moderating form now is in 60s and doesn't interfere with the 47avg Night.

Serately I take 2.5mg (10 is max) Bisoprolol separated take PM. Drs will simply put you up instead of advising H/Specialist that it is not controlling Bo or H/Rate or both. Then H/Specialist needs to rethink!

Don't forget that you are CEO of your Health. Drs, Specialists and Surgeons are working for you.

You also have the right to decline having appointments who who have looked after you. I did just that.

I had to go Private and pay $s for satisfection but sometimes you need to. He transferred me back and demanded a 24-hr monitor to get a picture of how good the new med is working and controlling (or not) .

A perfect way of monitoring your med.

Ask for one.

cheri JOY. 75. (NZ)

PS To get to the correct med for me I had 3 x 24hr H/Rate Monitor in 1 x 12mth period. Accurate and I then got satisfaction.

Tellingfibs profile image
Tellingfibs in reply to JOY2THEWORLD49

Thanks for all this, Joy. You have had a tougher time getting satisfaction than me. My GP is good and I am looked after by a decent cardiologist. I would just like to have both of them living in an annex and on call 24/7 ! 😄

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Tellingfibs

Hi

Yeah!

I actually received a Christmas Card from my private H/Specialist.

Lovely.

Thoughtful and kind. I reckon he saved my heart and me.

Drs dont change a orescribed meds. They just put up the dose.

Ask yourself is this med helping me or should I take it.

When my h/raye down to 60s I tried not taking the CCB or Bisoprolol separately and as my clinic I asked for one for each monitoring.

It turned out I still needed both.

Satisfied I knew the answer.

Its up to you.

cheri Joy

Richie33 profile image
Richie33

Read your profile and offering my comments only to reinforce that we are all so different as individuals - I am a 79 year old life long athlete who still lifts weights, jogs, walks, bikes and has a sleeping heart rate that stays in the 32-40 range - during the day my resting heart rate stays in the 40's while my exercise rate builds up to 140 at timesMany would say I need a pacemaker but my cardiologist simply has monitored me for 5 years and says this is my profile that fits me as an individual

Guidelines says average heart rates are between 60-90

Not for me

Tellingfibs profile image
Tellingfibs in reply to Richie33

You are so right. My normal resting heart ( with Bisoprolol of course ) is around 60, so I was worried about it suddenly popping up in the 40s. However, I feel the same so will try and get an appointment with my GP, but I am not going to panic - we’ll, not yet anyway….

Eater profile image
Eater

Things can change,I think it depends how active u are e.g more. Basic than you……..I had anaemia i felt lousy for months and now i have no over 100 and was told I will be taking 5 one day now my 2=meds are low,!

Onthebeat profile image
Onthebeat

I have been on 1,25 mg once a day for about five years. Used to be on 2.5mg before that. Maybe your condition is improving and you need to check with your medic in case he wants to suggest a slight reduction?

Ersilia2 profile image
Ersilia2

I’m on Nebivolol and my resting heart rate is in the low 40’s Cardiologist said if I’m feeling ok with no dizziness, no shortness of breath not to worry.They all have different opinions so check with your Doctor.

kocoach profile image
kocoach

Hello, I have had a resting heart rate of 46 for a couple of years and I was always told by my EP that if I'm not having symptoms ( light headedness, passing out, chest pain, breathlessness) not to worry about it. Well, this past Monday I had an anxiety attack because my HR sitting at computer chair was 46 bpm, which prompted me to go to the Emergency Room to get checked out. After EKG, blood tests and walking with a heart monitor attached I was told all tests looked Normal and not to worry as long as I had no symptoms. Tuesday morning while at home cardiology called me and said they spoke to my EP and he said if no symptoms don't worry and this morning my GP called me and asked how I felt which I told the nurse fine, so I was told again "no symptoms" don't worry. Sometimes I wonder, "if my tests show a healthy body why do I feel so bad? At any rate I hope this helps to make you feel more at ease. Have a Blessed Day. PS; I was given that night at the ER Prednisone 20mg for hives and was told they talked to the Pharmacist to see if it was safe for me to take, which was told it was. Well guess what, checking side effects on Drugs.com one of the side effects was a slow heart rate of which I already have.

Tellingfibs profile image
Tellingfibs in reply to kocoach

Thank you Kocoach. Your post is very reassuring. You must havd been very anxious to go to Emergency. I hope things are more settled for you now.

kocoach profile image
kocoach in reply to Tellingfibs

Yes, it is, Thank You. We just have to live the life that's been given to us regardless of what the circumstance's are, it's beyond our control anyway. I hope you're a bit more at ease also. Have a Wonderful Day!

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