Atrial fibrillation flaring after virus and struggling with higher bisoprolol dose

[santamola]

Has anyone got this, or have experience of dealing with it?

I've had it for five years and never had an issue really as it was well controlled. I take bisoprolol. I don't have to take blood thinners as I was given a Watchman device (google it, too long to explain!) as I am prone to gastric bleeding. All good so far yes...

Then two weeks ago I got a nasty virus, the usual cold, cough and razor blade sore throat. First such thing in years, and it wiped me out, still have the residue. Out of the blue in the second week of being ill the AF went all over the place, heart rate up to 140, back to 60 - doing a complete dance! I didn't feel it much but my watch told me and gave me a bit of a fright!

I made appt with cardiology and consultant wasn't one bit worried, but doubled the bisoprolol dose to calm the heart rate. And that's where it all went south. I just was on the floor with weakness, dizzyness and a very low HR. Called them and am awaiting a return call - won't be over the weekend anyway. So I intend to reduce the bisop tomorrow back to what I was taking and hope for the best.

Has anyone had a bad reaction to increased dose of beta blockers like that. I'm falling asleep in my soup ha ha. I don't want to second guess the medics but I really can't tolerate the higher dose of bisop.

@Anjelika No I'm not using NHS and am very well looked after by the electrophysiology/cardiology team. I can get an appointment with consultant via his secretary within a week to ten days, or earlier if things are awful. The consultant does the usual consultant stuff which means looking at his computer screen (not at me ha ha) and checks the usual signs. He uses my iphone Afib/Heart Rate app a lot, and said it's a good indicator that saves me having to wear a 24 hour or more ECG lead thing. So that's how this saga started.

The arrythmia nurse will speak to me as needed and I have his mobile number. He then liaises with consultant and the next plan is put in place. So I am to have a cardioversion next.

The bisop at my usual dose of 3.75 never caused me an issue at all. It was when they just doubled it overnight that I nearly collapsed and felt awful. They acknowledged that and are titrating it up, so it's 5mg for a month and we'll see how that goes after the cardioversion.

I don't know how you can live with AF without rate control. Does your heart go fast or is it all over the place with palpitations. It's not very nice either way is it!

Have you spoken to your cariology team about having an ablation OP? I had one for my A Flutter & it's honestly changed my life.

I am still on bisoprolol but split the dose between morning & evening for rate control as I still need some help there but following ablation I don't notice any flutter at all

I asked about ablation at the most recent appointment when all this started up again. Doc said not at the moment, I don't have symptoms that cause discomfort i.e. chest pain, breathlessness, weakness, dizzyness etc. so it's rate control they are after now, and hopefully to get me back to sinus rhythm with the cardioversion.

I have a bleeding problem which is why I have a Watchman device, and afaik an ablation requires blood thinners for a period before and after which would be a bit dangerous for me. But there must be others with a similar issue, however as I don't have symptoms they are going for the least invasive option at the moment.

From what i know about AF some people barely know they have it and others have lots of symptoms. One symptom on the NHS website is finding it harder to exercise. If i have an episode I can barely walk across the room without feeling like I will faint never mind do any exercise. Luckily I havent had an episode since starting on Flecainide 18 months ago. Have been offered an ablation but at the moment I think I will stick to the medication.

I take bisoprolol 1.25 after having an ablation (privately) for AF which started during COVID. Forty eight hours post vaccine I was in resus with my heart racing all over the place. I still get palpitations three years on, almost every hour of the day on and off which I’ve been told are mostly atrial ectopics. I was tried on 2.5mg in hospital but couldn’t get off the bed. Even on 1.25mg my heart rate is regularly in the 40’s.

I am no longer aware of my AF. I know it is banging on in the background as I was in permanent AF, but pacemaker and AV node ablation mean I cannot feel it and my circulation is controlled by the pacemaker.

But when I was in AF all the time I felt so unwell. Breathless, giddy chest pain ... really dreadful. I find it amazing that anyone might not know it is happening!

My treatment has not solved everything as I am still getting some breathlessness, which is very frustrating indeed.

I am intrigued at the sort of service you can get by going privately. I am grateful to the NHS for the very expensive surgeries I have had, but frustrated by the fact that they make you run the gauntlet of cheaper options first and lose years of quality life. It is the same with lowering cholesterol ... mine is familial and my abstemious diet cannot help. I have been through so many statins which caused side effects, but am now to be given Inclisarin injections 6 monthly which are side effect free but very expensive. I qualify because I have also had a heart attack and stent. But I was forced to go through the mill for years first.

My experience of having AF and being treated under the NHS has really changed over the years. When I was first referred to Cardiology in 2013, it was relatively easy to see a specialist and get the ablation I needed. I had this ablation in 2015. It worked for about 8 years.

Having had no success being referred via my GP in 2023 when my AF returned, in 2025 I ended up in A&E as my heart rate was so high and I was given an "urgent" referral to Cardiology. This resulted in an appointment for a 24 hour heart monitor a few months later (my heart was in NSR during that 24 hour period so a waste of time) and a heart scan, after which I got a letter simply discharging me as an outpatient. No option to appeal this decision or explain that my AF had got a whole lot worse. In the end I paid out to see a Consultant a few months ago who I'd researched and knew headed up Cardiology at the local NHS hospital just so I could get him to refer me to an EP at his NHS clinic. Still waiting for the ECG, MRI and EP appointment he referred me for to come through but going via the GP and even via A&E resulted in nothing - not even the chance to speak to a Cardiologist.

It is so frustrating. You just feel you are totally lost to the system and left to soldier on. I am so tired of having to vociferously advocate for myself.
At the moment the wait time for follow up with the cardiologist after my procedure is 10 months and in the meantime my life is limited by breathlessness.
The only cardiologist round here who does private treatment is a most unpleasant person (or as the nurse described him: a nasty shouty little man) and I have been on the receiving end of this and have no wish to repeat it.
I live alone and am coping with all this by myself. Heart problems are a huge challenge for each individual and so fundamental... it is crazy tgst getting help is such a minefield.
I am so tired of having to push for help.

@MischanceI hear you! I have just been left to get on with it and get most of my information from Facebook groups and other AF support groups, self medicating as best I can.

@Anjelika that's interesting. I have SVT but have had paroxysmal AF before.
I had EP studies and was discharged from cardiology a few years ago as stable. I also had multiple fruitless holster monitors because they never coincided with symptoms.
I went to my GP because of worsening symptoms and they did an urgent chest pain referral. It was rejected because of my cardiac history and I am now on the list for routine cardio appointment. It could be six months. So I've booked a private appointment in the hope that I can at least get some advice in the short term.

@Mischance I am so tired of having to vociferously advocate for myself.
Sadly that's true in all areas of medicine. I've learned to be a bit more assertive but the stumbling block is often GPs who are too busy / jaded.

DH had a cardioversion last month. Sadly it only lasted 4 days, and he'd paid £1750 as a private patient to avoid the 6 month NHS list....I joked that it was a very expensive 4 days! The procedure itself was fine though, he had no recollection of it at all and his chest just felt a bit tender the next day. He said that he hadn't realised how unwell the AF was making him feel - being in sinus rhythm was such a relief.

He has been offered the chance of a private ablation as the cardiologist also works in a regional Spire hospital but at £26k and no intensive care unit on site, I've said to DH that I'm too frightened for him to attempt it. He only found he had AF when in theatre at a Winfield hospital for a hernia OP, and he reacted badly to the anaesthesia... he had to be moved by ambulance to the local NHS unit and it was terrifying.

It's terrible, I waited 18 months for my ablation & then waited 9 months for my 3 month follow up. Things are still not right but I am now under a different cardiologist for a different problem after telling my AFib team something was still wrong for the past 4 years. It was only when my rheumatologist got involved & starting sending me for tests & sending some very stern emails to cardiology that they did anything & other issues were found

Hello again to anyone interested 😊

Well I had the cardioversion yesterday. It was a doddle, needle in, lights out, wake up, all done.

The good news is, I converted back to sinus rhythm. How long that will last is anyone's guess, but honestly the difference I feel being in normal rhythm compared to the last few weeks of Afib is just immense.

Consultant feels that now I am back in rhythm and rate is steady that I am to stop beta blockers completely. That was a surprise. He only wants me to use one 5mg pill if my rate goes above 120bpm for an hour or two. Today is first day without beta blockers in five years. Wish me luck!

I feel great now, it's hard to describe how bad I felt when in Afib. I couldn't feel it in my heart, but I was not right in myself.

Onwards and upwards now, and let's hope the cardioversion holds until after my trip away in August at least!

Best wishes to you all, and thanks for following my saga.

Great news, you really do feel generally terrible when in AFib, I used to feel really really nauseous in a particularly bad episode & generally quite weak & exhausted.

I hope it holds for you & you can continue with pill in pocket as that sounds great

Are you having to wean off of Bisoprolol or have you just stopped completely?

That's great news OP.

That’s wonderful news!

No weaning off, a straight cold turkey OFF switch for the BBs. And yes I was surprised at that, but I put myself in the hands of my consultant EP, I figure he knows more than I do!

I am realistic though, and know that cardioversions don't always hold, but for now I'm happy to feel OK again.

I hope those of you with similar problems get some relief also.

It was great chatting about this. Fellow feeling makes us wondrous kind as they say.

@LostThestral got everything crossed for you. My GP and the private cardiologist said that sometimes they will cardiovert you if you rock up in A&E. It just depends if there’s a cardiologist on call with not too much going on. From my experience of our local hospital I can’t imagine that happening in a million years.

Great news! Just enjoy!

Morning folks,

Well that didn't last long! I went back into full blown Afib after 24 hours of bliss. Oh dear. And someone tried to break into my garage (it's at the bottom of the long garden). I live on my own so seeing the garage door swinging open didn't help the Afib one bit either! Thankfully nothing stolen, but now need a new garage door!!

I contacted the arrythmia nurse. Not too worried at all, I've to monitor things for another 24 hours and if it doesn't improve, I may need to come in. They will decide based on my apple watch readings.

It doesn't pay to be too complacent ha ha. I'll be ok, am just disappointed I suppose, but onwards and upwards. 😊

oh no, sorry to hear that OP, it's such a horrible feeling

Atrial Fibrillation Support on facebook is really helpful, people share tips on how to convert back to sinus rhythm. Sipping ice cold water seems to be a popular one

Oh no, that's so frustrating OP. I'm very suspicious of the use of cardioversion, it doesn't seem to last long for many.

So so frustrating - you have all my sympathy. I too am dealing with all this in my own.

I opted for pace and ablate in the end. I am now totally pacemaker dependent but no longer aware of the AF.

The treatments are all so hit and miss and often carry side effects that are worse than the disease!

I have my fingers crossed that a solution will be found for you.

Sorry to hear about your garage.

Thanks all, we are all in this together (unfortunately).

Some good news, my brother managed to contact someone he knows who came earlier to seal the door up. He will fit a new one at the weekend. That was great news and he is a lovely bloke. It's not the up and over door, it's a side door for walk in access. Still will cost a couple of hundred at least. I'm not claiming from insurance as the excess is nearly the same cost, and the premium will go up as my no claims will be gone.

Onwards we go. One thing goes wrong, then my guardian angel appears - to fix my door! I reported it to police but they weren't a bit interested, as I presumed, but I wanted it on record anyway.

I'm still Afibbing away!

Viruses are one of the major triggers for my SVT/atrial malfunctions, so I do hope yours settle soon.
The valsalva (sp?’) method works well for me as a rule - again, thanks to one of those self help pages.
I discarded all the electronic monitoring, as they just freak me out all the more..
Good luck..