UKC

Hi,

I appreciate this is a medical case and everybody is different but looking for advice.

I have now been suffering from atrial fibulation for about 4 years now. I have had 1*cardioversion and 2*ablations which fixed the problems for a while (the CV for about 3months, the ablations 1 year and 17months).

Due to the current situation I am not seeing my consultant for 4 months, but he has suggested that it may now be time to manage the AF with beta blockers (bisoprolol). I am 45. Whilst I feel better, I feel between 50 to 95% on these.

Anybody doing this and how does it impact your life ( specifically to this group, any hill walking/ mountaineering activities.

Thanks

My old boss ended up with this condition and he chewed it over for a good while. He was offered Beta blockers and a mechanism implanted into his chest to start his heart again if it stopped.

He decided after talking to the consultant to drop both options as he didn't like the idea of the side effects of beta blockers and the heart starter can kick in when it shouldn't. He does take some pills but keeps them to a minimum.

His background is a retired racing cyclist in the 60's/70's and club rider up till a few years ago. He has altered his riding habits by using an electric bike to help him on a bad day. The docs told him to de-stress his life so he packed up the business and I took it over.

Like you say, all cases and severity have to be judged on an individual merit but that's what I know second hand for what it's worth. Good luck with finding a safe balance that works for you.

It depends on the dose, of course, but Bisoprolol can leave you unable to climb up a flight of stairs, let alone a hill. What dose was suggested?

While I was going through AF treatments,  I was on a cocktail of Statins, Beta Blockers and anti coagulants.

Beta blockers definitely helped reduce the AF occurrences but definitely impacted capability.  I just got into a routine of wearing a heart rate strap and resetting my expectations accordingly.   So cycling I tried to stay up to 115bm as opposed to 130bpm most of the time. I didn't run but I carried on climbing OK at my particular limited level. 

Fingers crossed my last ablation in May was OK and since February I've been taken off beta blockers and anti coagulants but still on statins.

Long and short of it was that I could adjust to being on Beta blockers (2 years in total, managed to cycle 12000km last year but slowly), and it was definitely better than AF occurrences - but I'm glad to be off them.

Good luck.  I think you have to go with consultant's advice

I have an implanted defibrillator fitted. It is monitored continually from a device at home which enables the hospital to  check on my condition, and alter the settings if required..

It has only fired off once and according to the hospital probably saved my life. The shock was quite violent. It was in a busy area where there were people about who could call an ambulance, in a remote area, on my own, the outcome could have been different.

I have heard of one case when a similar device fired off whilst the wearer was having sex with his wife, threw him across the bedroom onto the floor. 

I wont comment about medication as most folks problems are different, some slightly, some in a big way and have to be treated accordingly.

John

try and speak to your Arrhythmia Nurse about this, they should be contactable by phone or ask advice from the Arrhythmia Alliance: https://www.heartrhythmalliance.org/aa/uk. 

Its really not a good idea to ask on here for advice because although well meaning everyone's response to beta blockers and other medication will be slightly different. Their experiences whether positive or negative may not relate directly to your condition and procedures that you have experienced.

Atrial Fibrillation is a common arrhythmia but symptoms vary so much that there is no "one size fits all approach" talk it over with the professionals, it may be that you try a selection of different medications over a period of time to see what suits you. There are many different beta blockers for instance, some of which are tolerated well by individuals, sometimes not.

Dave (Arrhythmia Nurse as a day job)

Cut out or reduce caffeine and alcohol and reduce stress as much as you can (easier said than done) as all are triggers for af.

Hi Rob,

As Dave said below (and maybe my post was not that clear). I actually seem to be 'OK' on the bisoprolol (I am taking 2.5mg), although haven't tried too much on them at th moment. It's the actual thought of being on them for the rest of my life, and how that may affect such activities as running, squash, mountaineering etc.

I've had 2 ablations, and after a few hiccups I feel 100% (back in rhythm) - that is where I want to be, but I realise that the number of ablations are limited....

Thanks

OK, thanks for the info. Glad the ablation worked, and fingers crossed you stall in rhythm!

that options has never been mentioned - is it for AF?

Hi Dave,

Yes, I did caveat that in my OP and apologies if I wasn't clear. Not so much about the dose - it seems that doses can vary...it was really about the concept of being on bisoprolol (and the effects - actually not just about exercise but in general - I normally feel pretty louse in the morning - I have 2 young kids - I don't want to struggle to get out of bed for the red of my life) vs the benefits of ablations (i.e after I have healed, I feel 100%. But as above, i realise that there are only a certain amount of these you can have, and after being in AF for a while, your heart get's used to be in AF, making it harder for ablations to be effective (which they are generally not).

Thanks for the advice about the nurses - I will give them a call. My consultant advised to go back in 4 months. I know it is tricky at the moment, but do you think it is reasonable to try and arrange a phone consultation with him in the mantime to discuss?

Hi, Yes, I am pretty sure it was booze that triggered the 2 episodes of AF. That is something I can definitely control. Stress not so, and I try and drink decaf tea. My cardiologist didn't seem to think caffeine or stress were too bad, but always advised against booze! cheers

to be honest from what you've said the nurses will be able to advise you just as well as the consultant re: your bisoprolol dose. The only sure way you will find out if you feel better off the beta blocker is to stop it and run the risk of the AF coming back. Not a great option.

I wouldn't be too worried about the thought of being on a beta blocker for the rest of your life. Many outdoorsy people are, I see a lot of fell runners and long distance cyclists who manage very well on low dose beta blockers. Think of the medication as your friend, not the enemy, easy to say I know. With 2 young kids, are you getting enough good quality sleep, if not thats where I would start.

Hi..OK, will defo follow up with the nurses in the meantime.

A few days ago I was feeling so good, I considered coming off the bisoprolol just to check if I was back in rhythm on the off chance, but my wife convinced me otherwise. I think I am in persistent AF otherwise.

That is good to know about the fell runners/ cyclists. Do they all have AF? Yes, that is what I need to get accustomed to..at the moment it is quite a big thing to do (probably more mental than anything else). I was trying to get reassurance on this through my OP.

Yes, I generally sleep quite well...I have always been an early to bed, sleep well/ OK kind of person, and the kids generally sleep through now...

Anyway, thanks for the info - I am sure you don't want this to turn into an online consulatation... I have to say that I have always been very appreciative of the cardio teams who have always looked after me very well!

Ah righto - so you are back in rhythm? Good news.

There is good advice above, and my suggestion is to listen to your consultant; if the Bisoprolol can successfully keep the AF in check, then that would be a great result.

Just as further anecdotes: my friend was on 10mg, and that left her pretty whacked. At 5mg she was able to get out in the hills, but everything had to be taken at a much slower pace than before.

Good luck!

An earlier responder referred to an implanted defib device, I thought I would add my experience of having one fitted.

My heart condition is quite complex, and as such I am not going to discuss it here. Sufficient to say that my GP commented that he had never heard of it, but it didn't sound good.

John

Hi Rob,

No... Two ablations and have recently slipped back in AF. I haven't really tested my new 'mountain fitness' levels under the bisoprolol (5mg) for obvious reasons. Walking seems to be OK - I may be a little tired the next day. Maybe I will go for a gentle jog soon. Maybe I need to give the hils a go when restrictions are lifted! I seem to remember I was in AF when I had a w'end in Glencoe walking the usual suspects (and I felk OK). Yes, trying to speak to the cardiologist, but had a very good talk with Arrhythmia Alliance as per Dave Ferguson's advice above...

Thanks!