AF and steroids

[Luludean]

just a question , can steroids make an existing persistent AF worse?

Have just started 20 m a day prednisilone.

on apixaban, digixin and Losartan .

Bit wobbly not panicking . L

[doodle68]

Hi Lulu , I was experiencing approximately 5 day episodes of Paroxysmal AF in August with 2-3 days of normal SR and heart rate of between 120-140 when in AF ( I took an extra BB Nebivolol as a PIP which could reduce that slightly) .

Then I was diagnosed with temporal arteritis and put on 40mg prednisolone daily with a gradual decreasing dose.

The side effects of the steroids have been dreadful , I also went into constant AF no days free with a HR of 140 /160 and feeling awful.

I had ablation on Thursday and mentioned my change in AF patern to the Consultant Electrophysiologist who carried out the procedure, he confirmed steroids can have an effect on AF and cause arrhythmia.

[Luludean in reply to doodle68]

Omg !! Thank you there is no hope!!

I will keep trying for a few days . They don’t like it if you come up with questions .

You had an ablation without stopping the steroids???? And you were still on Apixaban or similar? Thank you for your reply.

[doodle68 in reply to Luludean]

...yes I had an ablation while on steroids (the dose is now down to 17.5 mg) it made no difference apparently and yes I am also also on Apixaban. I had no choice but to take the high dose of steroids in spite of side effects, failure to do so could have risked my sight within days of diagnosis and coming off steroids too quickly could result in a return of the TA.

.

.

[Luludean in reply to doodle68]

Well you were very brave !!

Is the arteritis caused by arthritis / RA?

I hope you are pleased with the outcome and treatment!

Did the ablation work ?

All the best , I’m in Cambridge .

Dark already !! L

[doodle68 in reply to Luludean]

Hi Lulu TA is and autoimmune disease no one is sure of the cause . Mine began with a lump on my temple,tender scalp and a headache. I also had polymyalgia rheumatica which is related. I was lucky, my stepmother had it so I was aware of the symptoms and fast tracked Steroids and a rheumatologist before damage to my eyes might be caused.

Too soon to say for sure if the ablation worked, I am taking a day at a a time and my heart is feeling better after being in persistent AF also I am not so exhausted all the time but the awful symptoms from the high dose of steroids including muscle weakness and extreme fatigue , severe osteoarthritis in my hips and spine and heavy bleeding from the ablation groin wound which I am having to treat with extreme care mean the benefits of ablation are not so obvious as yet .

My AF had become intolerable and I am sorry I had to wait so long partly due to covid for the procedure once I found Flecainide did not work

I foolishly believed those who said 'your heart can get used to AF as it progresses' well mine didn't. I have always been highly symptomatic and to have those additional symptoms none stop on top of everything was too much. The arrhythmia care I had locally was practically none existent, I had to pay for a Consultant and an ECHO in order to give Flecainide a try.

I was eventually offered the option of an ablation at Coventry after an 8 months wait a long drive away but I am so glad I did rather than staying locally. They were fantastic .

Looking back I would have ablation at the first opportunity (and preferably a cryoablation after reading lots of data) , any small risk is worth it to avoid none stop symptomatic AF and no quality of life .

[Luludean in reply to doodle68]

Good grief you have been through it!!!I hope you are well supported!! You have obviously done a lot of research . I now know what TA is. There are so many different forms of arthritis and all seemed to be being linked to other conditions . It is a minefield and so often conflicting diagnoses are given which adds to anxiety. I am always now surprised how many people are told they have fibro or poly mialgia. Not long ago it was not known . I hope your ablation has worked , mine did not . I live with persistent AF following valve repair . Flecanide and Amioderone did not suit , had terrible effect on me. Any way , I wish you all the best and hope to hear that the ablation has worked!

[doodle68 in reply to Luludean]

Thank you Lulu, as of this morning I am back in AF 149 bpm, I suspect steroids may be involved in my regression after the EP said he thought the ablation went well .

Too early to tell if the ablation is a total failure have to allow for the blanking period and it was worth a try even if back to square one.

I am on a reducing dose of steroids at least till December . I am 74 and live alone with a very hyper 1 year old Cockapoo and just taking a day at a time and using calm measured breathing to make me feel I have a degree of control.

Wishing you well ..🙂

[Luludean in reply to doodle68]

I am same age. I paint ( sometimes) I live alone too , with a cat . It isn’t much fun going to hospital alone and, now it is dark !! Don’t watch the news!!

Lot of people SO much worse off !!!

[CDreamer]

I was given steroid sparing drugs because of my history of AF. For what are you taking them for? My understanding is that short term, in low dose they should not have a detrimental affect. For how long do you have to take them? Is there no alternative treatment?

Often Pred is used because it’s very inexpensive, my creed is question, question, question! Could be one specialist is not talking to the other?

Good luck.

[Snowgirl65]

I've discovered through experience (!) that steroids do indeed trigger my a-fib. I was given a course of Prednisone (similar to your Prednisolone) last year in October for allergies, just after receiving an allergy shot of another form of steroid, and I ended up in the ER. It took a half-day to get my 188 bpm heart rate back to my "normal" a-fib rate of around 120, and then finally NSR. A quicky appointment after with my EP, and I had an ablation (my third) two months later in December, which (knock on wood) seems to be holding.

[Luludean in reply to Snowgirl65]

Thank you snow girl . I seem to be ok , bit more AF but dealing with that. Learnt not to wash the pills down with coffee though. Will hope to see some improvement during the month. L

[M987]

In my case, a 6 day prednisone pack took me from controlling my afib with flecanide to full on afib and needing an ablation. That was 2 years ago and I just had a second ablation this past Friday. Hopefully you are not as sensitive as I was. Best wishes

[Luludean in reply to M987]

O lordy M987!!!!!

I hope I don’t do the same!! I have a month of it . Wish cardiolgy and rheumatology were in dialogue .

Hope your anlation goes well !!!!