Faster heartbeat with acalabrutinib?

[albie58]

Hi Everyone! I started taking Acalabrutinib about 6 weeks ago. The last few days my heartbeat has kicked up a bit. Nothing extremely high just on the high end of resting, around 70 to 90 beats a minute. I used to be around 60. I was planning on calling my doc tomorrow about this, but I thought I'd see if any of you have gone through the same thing.Thanks a bunch!

[cajunjeff]

Hello Albie. Acalabrutinib is a second generation btk inhibitor drug. The original btk drug is ibrutinib. While ibrutinib was a game changer in terms of its ability to control cll, its major drawback was/is an increased risk of atrial fibrillation (afib). Afib is often accompanied by an increased heart rate. Ibrutinib is also known to cause high blood pressure (hbp) in some people.

Acalabrutinib is considered by many to be a drug that works as well on cll as ibrutinib, but with less risk of afib and hbp. That said, I think all btk drugs are thought to carry some risk of cardio-toxicity.

Your heart rate between 70-90 seems in normal range, but evidently not your normal range. It seems certainly possible this could be an acalabrutinib side effect. It’s also quite possible it has nothing to do with acalabrutinib. Ibrutinib raised my blood pressure, but not my heart rate. I switched to acalabrutinib, but I still need blood pressure meds. My heart rate is relatively low though, usually around 50.

It’s definitely a symptom you should report to your doctors. I suspect the best anyone on here could tell you is that a btk drug like acalabrutinib could possibly raise your heart rate, but that there are many possible other causes as well.

I would think it’s good that even though your heart rate is up, it’s still in a normal range (or at least I think it is, I’m not a doctor). I think your plan to call your doctor tomorrow is a good plan. He/she will have more experience to give you a better answer and a plan if needed.

[albie58 in reply to cajunjeff]

Thanks Cajunjeff!My resting heart rate was always 50 to 55 before starting the med. I'm also on a beta blocker which at this point is having no effect. All the other side effects like headaches etc, have disappeared. I also wonder if this could be anemia as well. I did call and am waiting to hear back from them. Thanks for your help!!

[Newdawn Administrator]

Albie, you've done the right thing in notifying your doctor about this increase in your heart rate. I had well controlled high b/p and heart rate before I started Ibrutinib but after a couple of years I developed severe and intermittent tachycardia. At one point I had to be hospitalised as my rate was 169 +. However, I didn’t develop AF or any other cardiac issues and the introduction of a higher dose beta blocker has sorted the problem.

Your level is still within normal limits but obviously not normal for you. Hope you manage to resolve it soon.

Regards,

Newdawn

[albie58]

Thanks Newdawn!Can I ask what betablocker you are on and dose? I'm on 60 mg a day of inderal and there some beta blockers that are more potent. I'd hate to get off the drug as it's doing a great job and almost all side effects have subsided.

[kitchengardener2]

I have been taking Acalabrutinib for almost two years now. My heart was fine (to my knowledge) until last June when,following an accident at home I was rushed to hospital. Once there the young doctor who examined me said,that I had AFIB and would need medication for the rest of my life. Eventually I saw a cardiologist who said that I was not in any danger, my heart rhythm was fine but whilst I stopped the Bisoprolol because it sent my pulse crazy, I was told that continuing with Apixaban wouldn't hurt due to my age.

[albie58 in reply to kitchengardener2]

Thank you si much for sharing your experience! I'm off to the doctors today to see what's going on. An EKG is scheduled. I hope I don't have to go off the med as it has cleared things quickly and the headaches are gone finally!!

[Gampo]

Hi, I've been on Acalabrutinib for 7 months. In the first two months or so my resting heart rate increased from 50 to 60 and I noted a raised HR was listed as a side effect. It also seemed louder to me - I know that's a strange thing to say! I was more aware of my heartbeat when going to sleep. I mentioned it to my doctor who was completely unconcerned. Somewhere around 3 to 4 months it settled back down again and I've had no problems since.

[albie58 in reply to Gampo]

That's wonderful to hear! I am hoping that will be my situation. And what you described is exactly how I feel! Thank you for your response! Made me feel much better!

[Gampo in reply to albie58]

I clearly remember being freaked out about it! There are so many strange little side effects in the first few months but now I can barely remember any of them.

[kitchengardener2 in reply to Gampo]

Mine was exactly the same, when I was settling down to sleep, I was aware of my heart beat. My consultant and my GP weren't concerned.

[200185]

I had heart palpitations when I started acalabrutinib 2 years ago. Went to cardiologist. He started me on metoprolol 12.5 mg twice a day. No problems since. Best of luck!!!

[dave20]

My heartbeat dropped from 70 to 60 when i was on Ibrutinib. I changed to Acalabrutinib due side effect from Ibrutinib and my heartbeat went back to 70. I also notice my blood pressure is lower now.

Dave

[albie58]

So an update from yesterday. I went to see my doc and had labs. Hemaglobin is 9.1, platelets at 80, and neuts at 1.6. ALC went from 106 to 26.7 in two weeks. Doc told me faster heartbeat rate and loud beating of heart was due to lower hemaglobin. He wasn't concerned at this point about any of the numbers as he said this was expected as my bone marrow cleared. My reticulocytes are high and that indicated to him that marrow was functioning and trying to keep up with the anemia. I see him again in two weeks for another follow up. Thank you to everyone who answered me. I'm glad I'm not alone with these feelings!!