Question: My mother is 83 years old with history of Atrial tribulation, high blood pressure, high cholesterol, diabetes. She had ablation treatment 10 years ago and AF has been in control until a few months ago when she started to have some episodes occasionally but not as high and as frequent as 10 years ago. A 2-week Holter tests a couple of months ago have not yet caught any. Her blood pressure fluctuates a bit and sometime gets quite low. She has trouble with sleeping from time time. Her cholesterol level is very low, no concerns there.

For the past 3-4 days, her heart rate in the morning stays high at around 80-85 even with very little activities. it stays at that level for several hours and sometime for most of the day. She also has been feeling chest pain, short of breath and tiredness which could very much related to prolonged high heart rate. I wonder if it is safe for her to increase her dosage of Bisoprolol 5mg from 0.5tablet/day to 1 tablet/day? Also in what situation, at what level of high heart rate, I should consider sending her to emergency of the hospital?

She has an appointment with her cardiologist in two weeks. We just hope to consult you in advance to get a better sense sooner.

Thanks!
Helen