Heart skips every 4th beat ?

[reconjj]

Hello All , Ive been on Eligard , Zytiga , prednisone since Feb. 1 , 2022 ( 1yr. ) . Yesterday at a visit with our family primary care Dr. just to keep all in the loop he listened to my heart and noticed my heart had a skip every 4 beats . Can this be caused by my cancer Drugs ? I will be talking to my MO soon about this . Would the problem be Zytiga , or prednisone ? What other second tier drug would be a replacement recommended ? Thank You

[Todd1963]

Zytiga can cause an irregular heartbeat. It is listed as one of the side effects. You might want to see how your blood potassium level is right now. Potassium is kind of like go-go juice for your muscles and your heart is a muscle. Another side effect of Zytiga is low potassium levels. I’m sure you are getting a CBC and a. Metabolic panel drawn every three or four months to monitor kidney and liver function so you should already have your potassium levels available. I have been on Zytiga since October 2013.

[reconjj in reply to Todd1963]

Hey Todd , have ever had an irregular heart beat ? if that is my problem with Zytiga what would be a replacement for Zytiga and prednisone ? Thank You

[Todd1963 in reply to reconjj]

Well I am not saying it is the problem and that would be between you and your doctor to discuss but the first thing that comes to mind is xtandi. As a bonus you no longer have to take prednisone with it.

.

[garyjp9 in reply to Todd1963]

Wow! Going on 10 years and still working for you---that's great!

[Todd1963 in reply to garyjp9]

yeah I am a miracle boy. 17 years stage 4

[tango65]

It could be related to zytiga if you have low potassium (hypokalemia).

ECG could give a diagnosis of the arrhythmia (premature atrial contraction or premature ventricular contractions ). If you potassium is OK, then you should consider to consult with a cardiologist to see what type of arrhythmia you have.

[reconjj]

Thank You Tango for that info . My primary at V.A. today gave me a baseline with machine and sticky tabs on my chest . She said it looked good . So she is sending me for more tests at V.A. My potassium levels are good . Lots of Guys been on Zytiga long time . I gotta see how long term Xtandi guys are doing . Anyhow Im gonna send a note to my MO at V.A. and she might want me to stop and see ? Thanks Again , JJ

[Tall_Allen]

I get that too (I'm not on ADT). My cardiologist said it's not harmful and to ignore it. He said it seems to increase with age.

[reconjj in reply to Tall_Allen]

Thanks tall one . I needed that . I just messaged my MO at HinesV.A. Dr. Elizabeth Henry , she is a Dr. at Loyola Univ. as well. Maybe stop Zytiga until heart test are completed ? Your thoughts , Thank You , JJ

[Tall_Allen in reply to reconjj]

No need to stop Zytiga, IMO. Talk to a cardiologist, not a PCP.

[Shamrock46 in reply to Tall_Allen]

I also have developed that and made an appt. w/cardiologist in office where my husband is treated. After ECHO and ECG he diagnosed Premature Atrial Contractions due to aging and stress. It acts up every time we're awaiting tests/results and less than good news. Best to have yours checked out to find cause.

[London441]

What is your resting heart rate?

[Fred312]

Beta blockers are the main treatment for PVC/PAC. They work pretty well and are not pro-rythmic, they won't cause new, possibly bad, rhythms. Many drugs can cause, high blood pressure can also increase likely hood of getting them. I get them from stomach acid reducers, PPI's and some H2 blockers.

[Benkaymel]

I've been experiencing sporadic skipped beats for several years - way before my PCa diagnosis. Sometimes they were very occasional, other times every few beats. Excess of stimulants like caffeine and alcohol makes them worse, but I have greatly reduced my intake of both and rarely get skipped beats now. I've been on Xtandi for 4 months and have been very rarely getting the odd skipped beat if that helps.

[Derf4223 in reply to Benkaymel]

Cutting caffeine an alcohol should also help with hot flashes.

[Benkaymel in reply to Derf4223]

I agree, but of course I never had any hot flushes until I started ADT and I virtually cut out both caffeine and alcohol at diagnosis. I'm currently trying apple cider vinegar and acupuncture for the hot flushes - it's too early to tell if either are helping.

[Hidden in reply to Benkaymel]

The hormone treatments are causing the hot flashes. Vinegar and acupuncture will not help.

[Derf4223 in reply to Benkaymel]

I forgot to mention my MO put me on Venlafaxin for hot flashes. 37.5 mg works well enough for me but don't be surprised if they want to start with 75 mg.

Another SE I and many other men on ADT get is sleepy-tiredness. Ginseng (Nature's Bounty Ginseng Complex) 2 capsules with breakfast is getting me through the day. I take weekends off from it to lower SE odds further. PS 2 capsules/day is 1/2 of what the bottle's directions state.

Accupuncture might help with hot flashes and there is a wrist worn device that is said to help also -- EmbrWave (sic). The EmbrWave requires one to push a button when having a hot flash which obviously would not help with night time HF's. Accupuncture is from what I gather something that needs to be repeated and as far as I know you don't want to do it to yourself (I could be wrong, but I wouldn't want to).

[garyjp9 in reply to Derf4223]

Embr Wave has a nighttime setting enabling it to function during sleep. I don't have one but know men who do.

[lookout4 in reply to Derf4223]

Hey Derf,

Just an interesting observation about cutting out caffeine; since my DX and subsequent meds, I found that caffeine counters the SE of the meds. BUT the hot, and cold, flashes are there, before my increased Caffeine consumption. Just sayin'

steve

(edit), about arrhythmia's... The correct balance of fluids and minerals is SO important!! I can't say enough about that. While it's true aging has an effect on arrhythmia too, there are lots that contribute to arrhythmia.

[winkoliu]

Drink too much coffee, tea, and chocolate will get arrhythmias. Many arrhythmias are harmless. It's common to have an occasional extra heartbeat and not even be aware of it, or to only have mild palpitations. People with harmless arrhythmias can live healthy lives and usually don't need treatment for their arrhythmias.

The following supplements might be good for treating arrhythmias : Fish oils, Flaxseed, Magnesium, CoQ10, Resveratrol, Potassium, Berberine, Garlic.

[Grandpa4]

My guess is that you are getting a PVC every fourth beat and the compensatory pause is the missing beat. I am surprised he did not do an EKG to confirm this. In general they are harmless unless in the setting of a heart attack. I agree with checking potassium.

[alperk]

30 years ago, prior to PC, I had several episodes of irregular heart rate. Cardiologist had me wear a Holter monitor for 24 hours and made a diagnosis of benign premature ventricular contractions (PVC). 10 years ago on a golf trip with 8 guys, one introduced us to a heart monitoring ap. Those who tried it immediately had concerns. One went to Mass General Emergency at the end of the trip. All benign. I still get them, especially if I think about it a lot. Relax. You should get cardiologist confirmation but it most probably is nothing to worry about. You've got enough on your plate. Good luck.

[dadzone43]

Might just be your age. I do not know how many heart specialists are on this forum.

[Hidden in reply to dadzone43]

Bingo

[leo2634]

I'm on the same medication five years this week. I'm sure you know all the side effects by now, but I think talking to a cardiologist best doesn't sound like one of the many side effects of ADT. Never give up. Never surrender. Leo

[Currumpaw]

Hey reconjj!

A few days ago, TMagee had a question similar to your question. The heading was "Gatorade, water ? I replied. My answer that day is below.

"Are you taking statins? Age and statins are two factors that could be causing your erratic cardio numbers.

I have written about this before. An aunt was placed on palliative care. She had been in the hospital and back and forth to a nursing home for a broken hip and shoulder. I was called. She wanted to see me. I asked my cousin for details. I brought a shaker cup, whole organic milk, chocolate whey, chocolate syrup. soft boiled eggs and buttered wheat toast. She was 89 years old. She was hooked up and her vital signs were being monitored at the nurse's station. Her heart was bouncing between 115 and 155 bpm! She had a, I believe, triple bypass years before. She had afib several years before. I brought her a bottle of LE CoQ10. Her afib disappeared. In the hospital, I asked my cousin if she was still taking CoQ10 when I saw her hear wildly fluctuating. Ohh! Not since she fell and her hip and shoulder were broken. I asked him to talk with her doctor about CoQ10. Surprisingly her doctor was very receptive especially after hearing that CoQ10 had helped stabilize her heart before her fall. Even more surprisingly the hospital's pharmacy had CoQ10. My aunt's doctor immediately prescribed CoQ10 capsules a day. This was just before noon. My aunt was given one then, in the evening and the next morning. Her heart had stabilized in 24 hours to mid 80's bpm. That afternoon after my aunt had three CoQ10 capsules, a nurse assisted my aunt with a walker for a little exercise down the hallway.

I read MyLittlePeeps suggestion. I have a story about that. I had sinus problems for at times in the past. For a quick fix I went to a medical walk in in which a really cool, sharp old doctor with decades of experience worked. My friend Dr. Gordon. He was in his mid-eighties. He smiled and said hello saying he hadn't seen me for a while. I replied I had been lucky with my sinuses. He informed me that he'd had a heart attack despite watching his diet and exercising. This--was his story, which he told me in 2014.

He had a cardiac catheterization and some angioplasty by one of the top cardio docs--he was a cool old doctor himself and well liked and respected among his peers. Despite the treatment he had afib so badly that he wasn't hardly able to do his daily activities or return to what he loved, treating and helping others. It became sort of like Humpty Dumpty nursery rhyme now with the top cardio guys doing tests, prescribing meds -- YEP! Just like the nursery rhyme goes--they all failed. Doctor Gordon began reading and came across info about CoQ10. He began taking CoQ10. His heart stabilized. He returned to work and he began playing handball again with his friend who was of the same age!

I would suggest the supps, PQQ and N-Acetyl-L-Cysteine along with CoQ10. I am "suggesting" not prescribing. Do your own research. Confer with your doctor(s) and then make your decision. As we age our bodies no longer make the same amount of CoQ10 as they did when we were younger.

Your Gatorade? Have you ever heard about "The Pickle Juice Game"?

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My best to you,

Currumpaw

[reconjj in reply to Currumpaw]

Thank You Currumpaw that is very interesting . I will look into those supps .

[MiaAmia]

Hi! Female partner of PC patient here. Several years ago I was referred to a cardiologist for an irregular pulse where it appeared my heart was skipping beats. The conclusion was that what I was experiencing about every four beats was a beat or what is called a "compensatory pause." Because my heart function otherwise was fine, the cardiologist suggested I try reducing caffeine and my calcium supplements (I was taking 1400mg per day for osteopenia as recommended by my gp) rather than going on beta blockers which I would have to take for the rest of my life (I'm 64). Since taking that action, my pulse has returned to normal. I have not taken calcium since then and bone density tests indicate no significant change.

I know that ADT and other treatments can contribute to bone loss and other mineral imbalances, and many men, including my partner, are advised to take calcium supplements. Certainly mineral imbalances (calcium, potassium, and magnesium particularly) can occur. My thought is that a cardiologist should be consulted and bloodwork to review mineral uptake would be helpful as adjustments might be needed. The good news for me was that the "compensatory pause" was not serious and was rectified with the change made (with a doctor's input).

[Qrak]

I do get that from time to time. Different possibilities what could be the cause. Besides having good potassium levels, regular walks definitely help. They force the heart to beat regularly. See what kind of pace does the trick. In any case it is good for you. My heart likes a regular workout and if it doesn't get one it starts skipping. Good luck.

[binati]

My mother had an irregular heartbeat for many years - like 20 or so. Doctor said it would not be a problem. I too have the same now - called ectopic heartbeat. It seems to run in the family. However, my cardiologist said that it should not worry me. So keeping a watch. I am very active and work out regularly plus lots of golf (all walking) and no problem so far.