Imbruvica and A Fib

[BobTerry62]

I started Imbruvica 420mg on Feb 1 2019 which was reduced to 280mg mid July. Recently I have been diagnosed with A-Fib. We knew when we started with Imbruvica that one side effect was A fib. Of course, we do not know that Imbruvica caused me to get A Fib. Any comments?

[mjcll41]

I am not a doctor, but I work with them. I know a few other things that could cause it. Do you have sleep apnea?

[BobTerry62 in reply to mjcll41]

No, I do not.

[mjcll41 in reply to BobTerry62]

High blood pressure

Heart attack

Coronary artery disease

Abnormal heart valves

Heart defects you're born with (congenital)

An overactive thyroid gland or other metabolic imbalance

Exposure to stimulants, such as medications, caffeine, tobacco or alcohol

Sick sinus syndrome — improper functioning of the heart's natural pacemaker

Lung diseases

Previous heart surgery

Viral infections

Stress due to surgery, pneumonia or other illnesses?

taken from mayoclinic.org/diseases-con...

[Hidden]

acalabrutinib

[cllady01 Former Volunteer]

imbruvica.com/cll/side-effects

Atrial Fibrillation is in the first list of the above linked information sheet.

I hope you are doing okay. It has happened to a good many CLL patients on Imbruvica/Ibrutinib. It would be best, if you haven't done so, to be under the care of a cardiologist who will work with your hematology/oncologist to assure things go well for you.

[BobTerry62]

Thank you, cllady. It is a quick and big change in one's life when all of a sudden you can't walk 50 yards without stopping for a rest/breath. Oh well, I have lots of paperwork to do and hope to get some reading done. Take care.

[Hidden in reply to BobTerry62]

I call it the "new me"

[TimHB]

In my 7th month on ibrutinib I developed AFib. I was predisposed because of a history of hypertension but it was widely accepted that it was a side effect of the ibrutinib. I was hospitalized for 4 days while the ibrutinib cleared my system because AFib meds are contraindicated with ibrutinib (went "code blue" 3 times), then I was treated with a huge push of amiodarone which brought my heart rate from 180 to 40 within seconds. Once stabilized, I was discharged with a prescription of metoprolole. Over the next 10 days I slowly ramped back up to full dose of ibrutinib. My CLL team coordinated closely with my cardiologist throughout the entire ordeal and they continue to share notes after each checkup. It's been a year since then and I'm doing fine on a full dose of ibrutinib and a low dose of metoprolole. And I wear a Fitbit to keep an eye on my heart rate.

[Bugsy2]

It gave me atrial fibrillation after 17 1/2 months and I had to stop the drug entirely and switch to Venclexta. The problem resolved within 24 hours of stopping Imbruvica. See CLL Society article on heart problems and even death from Imbruvica. Do not ignore this.

Study identifies cardiovascular toxicities associated with ibrutinib

September 23, 2019 , Vanderbilt University Medical Center

[Bugsy2]

medicalxpress.com/news/2019...

[bhayes84]

As Ivotedfornixon mentioned many Afib patients switch to Acalabrutinib / Calquence.

[Hevs333]

I suffered from a atrial fibrillation but not due to any treatment it is just something that happened I didn’t tolerate medication very well and was offered a operation called an ablation I am now AF free and on no medication so a good result for me

[Bill1288]

I was on Imbruvica 8 months when I got AFIB. I had no symptoms. Was found by primary Dr. Doing routine EKG. Worked with cardiologist and put on eliquis. Was being monitored every six months. After 20 months of being on Imbruvica I went to a CLL specialist . He put me on Acalabrutinib. I still have AFIB but other side effects are minimal. I don’t have any symptoms and am still being checked by heart dr every six months.

Bill1288

[kgrant1741]

My husband was on ibrutinib and also developed some afib after about 3 months. Continued full dose for an additional 4 months. He was on a trial which used ibrutinib as first line treatment until NED, then 4 months of chemo consolidation. Remission lasted 2 years, now on acalibrutinib (calquence) for 4.5 months with no side effects so far. (mcl patient)

[Berrytog]

Interesting stories, yes, I think AF may have a lot to do with Ibrutinib .

When I first started eight years ago I did not have it then a year later it started intermittently, then stopped until my second hip operation last year when they changed my blood pressure pills as mine was too low. Then it started again, I went back to my old regime then the AF stopped but I started again on my new pill and back it came, so I was sent to see a specialist and they felt no treatment was necessary other than a blood thinning pill.this, so I believe is because my normal pulse is around fifty five and now it is between eighty five and ninety.

There are no symptoms and I continue with my three pills.

[barger1951]

Yes, it is definitely a side effect if Ibr. I could not sleep on my left side at all. Hopefully, you will be able to get to an even lesser dose and it will not be so bad.

Good Luck,

barger1951

[tryandtry]

I too developed Afib after some 18 months on Imb.). No PROOF of the cause, but Imb. is reported to cause Afib in some 15+% of patients). I had no symptoms, so it went 2+ months untreated. That damaged my mitral valve, so I needed it repaired. That was done via TMVR (trans-catheter), which went fine. I'm now on Tikosyn to regulate my heart - a fairly expensive, and hi-risk drug.

My point is, "Get a Cardiologist involved ASAP, before any damage is caused". There are ways they can treat Afib without surgery - don't wait!

Good luck.

Gary

[LovecuresCLL]

My Mum (no CLL) has A-fib and she is on Coumadin to prevent blood clots from forming.

I heard of this relationship of IB and A-fib on this forum before ...that it can be a side effect of the medication. It seems highly suspicious that IB is the cause. How old are you?

Your cardiologist and your oncologist should be working together to resolve/treat this.

I know with my mom they mentioned “converting” her back to normal sinus rhythm . But she opted not to do that as there were risks involved.

The question I have is: do they stop the med IB when someone develops Atrial fibrillation? Maybe you can go to Venetoclax. I would ask questions like that. Or acalabrutinib?

Maybe someone out there knows because I have no idea.