Atrial Fibrillation and Bradycardia What CLL Treatment might I get

[Strech51]

Hi. I am just wondering if anyone has had any treatment whilst having Atrial Fibrillation and Bradycardia. I have AF and B which I believe I may have had for all my life (69) certainly for a long time. I think I may be heading toward treatment as my bloods aren't very good although I am due a repeat blood test and Clinic visit again soon. I am looking for any advice as I believe that Ibrutinib may have caused AF but what if you already have AF and B. Physically I feel fine and keep myself fit and I haven't had any problems with either heart conditions. Any info would be great.

[lankisterguy Volunteer]

Hi Strech51,

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I have seen several presentations from CLL experts that diagram the decision trees for how they choose / suggest treatments for patients. I believe all of them would suggest Venetoclax & Obinutuzumab (aka Venclexta & Gazyva) for anyone with existing heart complications, AFIB, hypertension, etc.

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That combination would likely be offered for a fixed duration of 12 months, with the Obin/Gazyva outpatient infusions started first for several weeks and then the Venetoclax ramped up over 5 weeks with frequent testing on the days of dose increases. See this webpage: venclextahcp.com/cll/dosing...

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The first two months will involve lots of visits to the infusion clinic and for blood testing, but after that it becomes routine with perhaps clinic visits every three months.

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Len

[Strech51 in reply to lankisterguy]

Thanks Len. It’s given me something to consider when I go to the clinic next week. All the best Steve

[carolly in reply to lankisterguy]

I am in cycle 2 of O+V and have Fast AF on and off. I’ve had it for at least 7-8 years, 1 ablation a few years ago but need another. My AF set off just as I started treatment, but before a single drug hit my system (probably the stress of it all). Whilst a total pain, it hasn’t stopped my treatment.

[Strech51 in reply to carolly]

Thank you for sharing this. It’s very similar to what Len said . My AF has been with me for a long time perhaps always. My pulse is slow but I don’t have any problems with either. Just hoping the Dr has a plan for my treatment when needed. All the best Steve.

[Mkhait]

Hi Strech51,My wife was on Imbruvica for almost 5 years ( CLL 17 del ). At some point she developed AF.

Her doctor recommended Brukinsa, one of the latest kinase inhibitors. Apparently it has much less cardio effect compare to Imbruvica.

After switching to Brukinsa for about 3 months and cardioversion procedure her AF is gone as of today for almost 6 months.

Mark

[Strech51 in reply to Mkhait]

Hi Mark. That’s great news thanks for letting me know. Steve

[Shedman]

A friend your age, also has these issues.Recently he found that his caffeine intake was exacerbating the arrhythmia/AF; he switched from coke with rum to gin and tonic - one issue resolved. [yes, he’d be better with less alcohol]

The bradycardia is a different matter.

[Strech51 in reply to Shedman]

Thanks for the info. I have stopped nearly all alcohol and caffeine except for a few cups in the morning. Hope he is still enjoying his G&TAll the best Steve

[Hiker13]

Age 83 with high blood pressure and afib; in June I completed the one year treatment plan with obinutuzumab and venetoclax. I had not major problems. Was able to continue my normal active lifestyle.

[Strech51 in reply to Hiker13]

Thanks for letting me know about your treatment. I don't have a problem with blood pressure but I do have a low pulse rate with AF. I am having bloods done this week with a visit to the clinic so I will be looking for the best treatments for me. Its bad enough getting CLL but then having to cope with the heart issue as well is a worrying thought. Is the treatment you had completed after the year and you go back to W&W.

All the best Steve

[Hiker13 in reply to Strech51]

Yes, it was a one year treatment. Blood flow cytometry test showed no cancer in my blood. So I guess you would say it us back to wait and watch. I pray for a long remission. I have blood work done every three months.

[Strech51 in reply to Hiker13]

That's good news. I am rooting for and the longest remission.Steve