Hello Everyone,So I was diagnosed with P-Afib nearly 7 years ago. Beta blockers were a disaster and made me exceedingly ill.....Once on a calcium channel blocker, Verapamil, things however settled down. At the time I was told Ablation isn't an option for me as it could be my heart is misfiring due to other parts of the heart misfiring to the part that Ablation treats. This said because my Afib was induced by cancer treatment ie chemotherapy, Herceptin & radiotherapy (on the left side of chest). I have never seen my EP in person due to Covid but I have finally a face to face appointment in a weeks time. I'd like to know more about Afib due to cancer treatment. This is primarily because I have recently noticed a bit of a change & am getting little episodes of a racing heart rate.....only a few seconds...despite medication. I don't have a Kardia. Maybe I should buy one?
Anyway I'd appreciate any information on how my Afib might differ to 'standard' Afib (his words). My heart rate is these days much higher than it used to be pre Afib. Usually around 95. Used to be low 70s. Pre tablet treatment it had started running at 130 at rest. I was left like that for 8 months as my GP said he specialised in heart problems & he wasn't worried. It was another GP who said they were concerned & referred me to Cardiology. Glad that GP did as it scared the cardiologist silly when I finally had a 48hrs heart tracker. Lol...
I am worrying that I maybe missing an opportunity for a successful Ablation by not going down that pathway. Especially as I'm hearing its likely more successful to do earlier than later - well at least for "standard" Afib.
Can any one point me to any research on this non standard form of Afib please?
Many thanks.
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waveylines
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I think you need a long chat with your ectrophysiologist to be honest. None of what you write makes much sense to me. IF your arrhythmia really is atrial fibrillation and not flutter or another more complex one it is confusing to say that ablation is not an option "because a different area of tha heart is missbehaving." Although the majority of rogue impulses do come fron the four pulmonary veins they can come from other areas within the left atrium. This is why people who have a cryo-ablation using a freezing balloon to creat scar tissue in those four veins can need a second radio-frequency ablation to deal with areas not touched.
I have to confess also that whilst I have often come across people who develop AF following heart surgery I have never heard of it caused by cancer treatment.
I tend to agree. Halfway through radiation for cancer in my left breast, I developed A-fib.. With that being said, I had a cryoablation in May 2022, and haven't had a fib since, knock on wood!
Hi Bob am afraid cancer treatment does cause Afib as part of cardiotoxicity from chemotherapy & other specialist treatment. It wasnt recognised some years ago but research has established that various treatment do indeed cause it. If you Google it you will see it is well recognised. The bit I don't understand is why the Afib would be different. I think my EP was saying the heart can misfire elsewhere.....maybe this happens if you have cardiotoxicity......& therefore a standard Ablation may not work.
I stand corrected re cancer treatment though I never had any problems. Perhaps lady cancer treatment may be different. (local damage??) There are only so many places AF can come from so still unsure what he could mean. AF is AF is AF after all.
Im glad you were not affected Bob It's because cancer treatment can cause cardio toxicity and does do do for a significant percentage. And this has now been scientifically proven. It used to be ignored and I know when I had treatment it was still reguarded by some clinicians as unlikely. But research has moved on.
With breast cancer you may be told you need radiotherapy on the breast affected. For me that was my left side....over the heart. If you read the link CDreamer sent it lists the effects of different chemos and chemical interventions. Many are given in a combination. So out of 5 given to me 3 had a known effect on the heart. Two of them gave a known association with Afib. I was formerly diagnosed with Afib by my Cardiologist after a 48hr tracker. I dont know what the EP means either. Will update this post post appointment. 😊
No "lady cancer" is no different. Over here you are monitored before and during chemo for damage to your heart , as it is well known that some chemos can cause that. And not only to ladies🤣 The radiation to the left side is just an additional chance of getting your heart damaged.
I believe a Kardia may help your EP see what is going on but if it will increase your anxiety I think you should stay away so depends if you are a worrier? You have never struck me as such so I think it is a question for you to decide - would you be worse with or worse without?
Hope that may help in your quest and that others with more knowledge and direct experience may post for you. Best wishes 😘
Thank you CDreamer for your very kind words. I was lucky to survive & get a full remission. Despite the afib I feel Ive been given my life back. 7 extra years that I wouldn't have had without treatment. That paper is really interesting Thank you! yes I had several of those treatment linked to Afib. I will make my list of questions from it. Thank you. In truth they are still finding their way around how to treat/manage cardiotoxicity or even fully understand it. A friend of mine went through a simular treatment. She completed her Hecepeptin course. I did half of it & asked to stop because of my heart. I'm glad I did. My poor friend is far more poorly than me as she has HF as a consequence. I just want to make sure I've covered all the bases to reduce progression and to treat optimally.
I will talk to the EP about a Kardia. If it would help him to evaluate me further then yes I'd get one. Would it worry me? I dont know tbh.....I wouldn't have a clue what the read outs mean. I appreciate my EPs honesty. And of course I don't want to go through an Ablation if it wouldn't help me but if the Kardia would help him to evaluate this Id definately do it.
Hi Wavey, the Kardiamobile is very straightforward and user-friendly. It can easily be carried around with you during the day if you're out and about and interacts with an app on your phone. It gives you an analysis that is considered reliable by many EPs and it will track 'possible AF', AF, tachycardia, PVCs and SVCs as well as normal Sinus rhythm of course. You can get print outs, a set of readings by time etc and send or print up for your EP.
Thanks Singwell. That's helpful. I know there's two different ones with different number of leads. Which to get? Sort of hoping that my EP may have them in their arsenal to evaluate me again. So will wait till I've seen him.
Radiotherapy may generate conduction tissue fibrosis and sick sinus syndrome or AV block. These conditions may only become apparent after many years of latency. As many as 27% of patients require a PM implant [3].
hello. I find this very interesting. I had treatment for breast cancer 2020 which included radiotherapy at a high dose as it was during the worst of the virus and it was a choice of high dose over 5 days or no radiotherapy at all. I was originally booked for 4 weeks with one booster week. I was diagnosed with arrhythmia issues in June 2022. Prior to my BC treatment I had no issues with my heart. So the article mentioned by another member makes interesting reading. I am going thro a bit of a health scare at present so if I need any treatment I will certainly mention my concerns.
I had an Ablation Sept 2022 and felt it helped me with my arrhythmia issues.
All the best to you when you have your face to face appointment with EP.
Thankyou fairyfeathers. I'm sorry you had to go through that during the pandemic. What a nightmare for you. When I had my rads I was told by the consultant that they are very careful these days to miss the heart.....more modern technology means they can be far more focused. So whether it's the rads or your other treatment who knows. My suspicion is that a combination may actually add fuel to the fire. Yes that article from CDreamer is really informative. I'm defo taking it along to my EP.
I hope your health's scare settles. Have got my fingers and toes crossed for you. 💕
I was left as well because at hospitalisation Stroke with Af and 4 days there having a Neck Scan found to have Thyroid Cancer.
They still had to remove the cancer to stop hyperthyroid.
Arguments between my triage team. The Dr was a 'hormone' specialised and said
no operation until at least 6 months post stroke but against her was the surgeon and his anaesthetist who has thyroid cancer returned after 15 years.
2 onto one a.s.a.p operation prevailed.
Biopsy, check heart AF, and check voice box.
4 months I was ready. We flew through it all. Still had TSH relatively high so no toxicity which can happen. 2 unirs saline and 1 hour blue thick dye administered before the operation.
Success but the mono voice took 3-4 months to get back to soprano.
I refused RAI Radio Active Iodine and Suppression. Low risak. Surgeon took whole thyroid out a carcinoma right lobe and tiny bits left. He decided to take out 12 right lymph nodes right. 2 infected and caught in time. I was very lucky.
I did read that RAI messes up TSH and throxin regime.
I take 125 (88kg) daily Synthroid under tongue daily. TSH 0.9 - 2.5 OK.
We follow Gary Claymore USA top surgeon - keep TSH not too low and not too high of normal.
It took 2 years 3 months, a demanded DHB specialist by me and a change from metroprolol to bisoprolol 2 BB Beta Blockers. Then to a Private Spec who introme to CCB Channel Channel Blocker. Some twinking .... CONTROLLED
1 year 3 mths later
120mg Diltiazem CCB AM
2.5mg Bisoprolol BB. PM
BP 123/70. 69-88 H/R Day. Always 47 H/R Night
Metroprolol banned 2 x 2sec pauses night on 24-monitor. None with others.
On exertion short of breath on Metroprolol.
Exertion makes me stop until I regain energy. 0/2 getting around my body. Left
behind chamber enlarged so NO ABLATION.
So I'm told AF rapid and persistent has caused enlargement. Blame medical leaving a patient uncontrolled causes that. At 2 years 3 mths I had a resting heart of over 120 DAY. On Bisoprolol avg DAY RATE on 24 monitor was 156!
I asked why was I put on Metroprolol when I said that it would make me breathless,
told all Stroke victims are put on that a.s.a.p! Not good enough.
Sorry that everything took so long but just like me ... that's our lot. We can complain so that others do not go through it .. but we are guinea pigs on trial.
Since my complaint for AF patients they now use BISOPROLOL.
Hi Joy. So sorry you went through all of that. Poor you. I agree as a patient you have to be on the ball & an advocate for yourself. How are you now?I also have Hypothyroidism & on a full replacement dose of ndt , T4 & T3 included. Generally its best not to go on TSH alone but everyone is different. Certainly in the UK getting ft4 & ft3 blood tests can be getting blood out of the stone on the NHS. I have to say any beta blocker makes me exceedingly ill....causing my heart to race even faster!! I discovered this is because beta blocks slow the conversion of thyroid hormones from storage to useable form down, causing fatigue breathlessness, hypothyroid symptoms! I am amazed they persist with using beta blockers knowing this! The argument is that some beta blockers are worse than others.....not for me.....I tried 3.....same result, last time thought I was dying. Refused to take them anymore. Calcium channel blocker instead....Verapamil. Trade off is of course if it will damage my kidneys long term. I'd rather ablate & hopefully get rid.
I have to say any beta blocker makes me exceedingly ill....causing my heart to race even faster!! I discovered this is because beta blocks slow the conversion of thyroid hormones from storage to useable form down, causing fatigue breathlessness, hypothyroid symptoms! I am amazed they persist with using beta blockers knowing this!
How very interesting- I didn’t know that but makes perfect sense why I was so ill with Beta Blockers - thanks!
I think you will find they all do it some degree, but some are worse than others. Propranolol for example. Propanolol beta blocker is used in treatment for HyPERthyroidism (overactive). Bisprolol made me exceedingly ill & had the same effect on me as propranolol.
@ Waveylines: There is a difference between making you ill and having bad effects, which I fully believe you were. But the difference in conversion of T4 when on Propanolol can be measured. Did you have your FT3 and FT4 measured before Bisoprolol and when on it? Without thyroxine dose change? Please tell me, as I would be very interested.
And this:-Beta-blockade is mainstay of symptomatic therapy; antiadrenergic effects block effects of excess thyroid hormone. Beta-blockade also plays a role in the prevention of peripheral conversion of T4 to T3. Propranolol is the best studied in this class, but other beta-blockers have similar effects in hyperthyroidism.31 Mar 2022
So sorry you've had all of that thrown at you Jot2theworld. It's a lot to deal with. So good for you for getting out there & enjoying yourself, living life day by day. The very best way to be. Hugs
Sigh..... what the pharmacist said to you is very misleading. Armour, NDT has to meet set standards, there is a tolerance ratio they have to meet like other like synthetics of its contents. Armour is consistent. Synthetics have had more recalls than ndt. Ndt has been around far far longer than synthetic.......Been in use for well over a 100years & has a long history of sucess. Lastly everyone is different and as such we need diversity in medicines not streamlining. I tried the synthectics they helped but for me Armour gave me the same level feeling that I did not get with the synthetics no matter how hard I tried. I feel like my old self on Armour.
OK but here in NZ there is no MEDSAFE drug alterative.
When I changed to SYMTHYOID. I have never had to change my dose of 125mcg daily but I do dissolve the two tabs under the tongue. It goes straight into blood stream that way.
I can empathise with your concerns. Afib is in my family : mother and two brothers, but none of them suffered the dramatic changes in quality of life that I did.
The only difference is that I had 6 weeks of radiotherapy to my left shoulder back in Feb-March 1990. Only for the last few sessions did I have any protective layer for the rest of my body. My first ever episode of SVT was in April 1990 when I had an adrenaline surge during an appointment with the orthopaedic consultant who had performed the initial surgery on my shoulder. The events were rare until 2016 when things suddenly got dramatically worse and I ended up having 3 ablations, one for SVT and two for Afib. Not a single blip since, except for when I had Covid recently.
Yes, this is purely anecdotal and I am just one case. I hadn’t thought about any connection until I read your post.
Since there was a considerable time lag from 1990 till 2016 for me so don’t despair about missing the boat regarding ablations.
Thank you Maggiemunro. Am so glad you are doing well. My EP dismissed Ablation as a treatment. I feel reassured that you had a long time lag between so thank you!
Oh I feel for you. How is your thyroid. Didn't they cover you up?
I asked with 2 teeth xrays to cover me up and the breast xray with
unusual replies. I complained about the breast one "we usually don't use it".
The Dentist said using it doesn't prevent the rays but spreads it.
Nevertheless I demanded it.
How I got thyroid cancer in the first place is unknown.
I refused RAI Radio Active Iodine after thyroxidectomy . LOW RISK. But against the Stoke Dr who is a Endocrinologist. 3 years later ALL CLEAR. Just had a scan this week.
Yes, hyper and I think hypothyroid can give one AF. It gave me AF.
I think my thyroid is fine thanks, since my blood tests always come back in nornal range. Don’t forget this was 30 years ago and thinhs have moved on since then, I hope!
Hi Waveylines. Thank you for your very informative post. I had a stage 3 rectal cancer 9 years ago. I went into rapid afib and cardiac arrest 2 years ago. My EP told me, my heart problems might have been caused by my cancer treatment. When he fitted my pacemaker/ICD, he could not perform an ablation. My heart MRI showed fibrosis, scare tissues. Similar to you my pacemaker box shows a couple of spikes per month at around HR 180, since it is not sustaining, the pacemaker clinic did not worry about it. I have pretty much been afib free the last 2 years.
Am so sorry to hear what happened to you Sustainedvtach270. How incredibly scary. So glad you are doing much better now. I've not had a mri of my heart. But they did check the structure of my heart with an ultra scan. Told me I had left ventricular damage associated with Herceptin. Luckily for me though they told me it had healed on the repeat scan a year later....this was 5/6 years ago. Otherwise my heart was structural very sound. Whether a ultra scan would show fibrous tissue I don't know. They did pick up on the tachycardia at that point. Which eventually prompted the 48 hours tracker revealing Afib. Cardiologist at the time rang me and said you must've felt very poorly. I did! Bloody pressure & heart rate were all over the shop. 111 wanted me to go to a&e but I refused as I knew I'd be left in a sideroom for the night & then discharged with yet another email to GP.... Been there several times before. Probably shouldve gone though....lol.
a delight to reply to you. Like you I developed AF after breast cancer treatment, including herceptin, also greater incidence of AF on AIs. My oncologist said was chemo, my cardiologist said my age!! I had a cryoablation at St Thomas’ August 21 which improved things then radio ablation in November 22 and they blasted a different area and I am doing really well. Prof Gill at St Thomas’ told me 70% success first ablation, 90% with second. I am so pleased that I persevered. Good luck and feel free to ask any question. , this s a very knowledgeable and supportive group xx
Thankyou Linkj. So glad you've felt well since. Thats fantastic!!! Maybe I should get referred to your Proff. My EP seems to think I'm a lost cause. I dont know much if anything about the different ablations. I need to gen up so any info gratefully received.
Interesting post and replies. I hope you get some answers from your appointment this week. I haven’t had an ablation but take Diltiazen , Flecainide and Xarelto for the afib. Best to you.
bio:
My afib started 4 weeks after 33 radiation treatments to the left breast at 9:00 position in June 2015 along with being diagnosed with radiation pneumonitis and polyneuropathy. Two years later diagnosed with SSS now have a pacemaker.
Sunny-fi. So so sorry to hear this. Poor you. Must've been & is very tough. They seem to be finding out more about the effects of treatment on the heart, plus long term effects. The treatment saved our lives but it did so with consequences that no one really understood. Cancer treatment is tested to some degree but the long term side effects are not really known or underestimated. Never mind the consequence of combined protocols. The other month, I read a piece of research that only came out in May about Estrigen blocker that many womennget put on for often 10 years as preventituve measure against cancer retirning. The long term effects are much greater than they thought.......then they wonder why so many women stop taking them! In their eagerness to stop cancer progressing and reoccurring many patients have effectively been & are guinea pigs......there can't be many conditiond where this is allowed en mass. My oncologist told me that the arm of treatment I was put on turned out to be the most effective with dealing with cancer. Brilliant! But what if I'd been on a different arm????? Scary....
I read that you should not give an anti-coagulant when you have cancer. Extreme risk of bleeding.
But I can't see you on one?
Lots of pig's diss... (3 times). Research is that diss... organ bits like this isn't passed by our NZ Safe medication. It differs from one pig to another, dose cannot be kept the same etc.
What is your TSH, T3 and T4 total.
Mine is kept constant with Synthroid. 125mg daily. TSH 1.0-2.0. T3 4.0. T4. 21.0-22.0 All in normal range but because of papillary cancer I have no thyroid.
Thanks Joy. I had cancer quite a few years ago but was successfully treated for it. The P-Afib & heart damage are a consequence of necessary treatment. So my cancer was in remission when I was put onto anti-coag treatment.
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