palpitations

[withington1961]

Hi has anyone noticed an increase in palpitations with pred?

[piglette]

On of the side effects sadly.

[withington1961]

Ahh ok i did wonder . I also have atrial fibrillation - not present before PMR either. What joy. !!

[PMRpro Ambassador in reply to withington1961]

Ah ha - then look at my post which I wrote while you were writing yours!

What management are you on for the a/f?

[withington1961 in reply to PMRpro]

Hi I am on Flecainide and Bisoprolol . Every time I have a bout of palpitations I worry that I will have an attack of AF .Or worse still a stroke !! I am also on soluble Asprin . I too told my doctor and she said go to A & E if it happens again so there could be a tracing. I did so when it went on for 3 hours, and my heart was racing at 220 bpm !! they were thinking of shocking me after 5 hours then it suddenly flipped back to normal. I am down to 6 mgs of pred now and wondering if any of these heart problems will subside?

[PMRpro Ambassador in reply to withington1961]

Hmm - I'm far from sure that aspirin is enough! I've been on warfarin until recently when I have had an awful problem getting the INR sorted so have just been put onto one of the new anticoagulants. The UK is very dilatory about that I find - here you wouldn't be let out of hospital until the INR was stable between 2 and 3. I was about to go home and was grabbed and told no way Jose!

Are you sure you palpitations aren't short a/f episodes? I was started on the antiarrythmic at 1 tablet morning and night but I was getting minimal ones late evening it turned out. So it was upped to 1-1/2-1 and that seemed to sort it. I briefly started having late evening episodes last summer, especially if I was late with the 1/2 tablet - 1-1-1 is too much and brings my pulse too far down so I changed it to 1-1- 1/2 and that is working really well so far.

Honestly though - the little dosette box is getting over-stretched. And I'm off to Canada on Thursday and we're away for a month - you should see the medication bag! The new anticoagulants are in a metal foil blister pack as they are very sensitive to damp - the pack is ENORMOUS! But it means I don't need any blood tests...

[PMRpro Ambassador]

Whilst it can be a side effect of pred as piglette says - it is also something that CAN be due to the PMR, or rather, to the autoimmune part of PMR.

I had palpitations occasionally during the 5 years i had PMR before I was ever put on pred. I didn't really notice them much, the episodes weren't long most of the time or longer but not severe enough to worry me. My GP wasn't concerned enough to send me for any tests but said to call 999 if i was worried if it happened at night - which seemed a bit OTT but makes sense, paramedics have ECG machines and will be there quickly enough to probably catch some evidence.

Eventually I had some back problems and was admitted to hospital - and part of the medical treatment involved an infusion of diazepam. Which triggered a massive episode of the palpitations. It turned out it was atrial fibrillation and the cardiologist decided it was due to damage to the electrical cells in the heart caused by the autoimmune part of PMR. With medication it is well managed - and I realise that those episodes of "palpitations" were episodes of atrial fibrillation because they have gone.

A long reply to explain that, while it MAY be "just" the pred, it may not be. And they should really be checked out. Just in case.

[SusanEleven]

I seem to have the same level of palpitations on the pred as without it. I have had premature ventricular and premature atrial contractions for years. Have done several Holter Monitor tests though none recently and per the docs they were not any real problem. I find the longer runs of rapid beats scary versus a few isolated ones here and there or the sensation of skipped beats. At some point when I have energy again (ha!) I hope to get re-checked.

[Rjw2014]

The fact that it suddenly reverted to normal sounds like supraventricukar tachycardia. Can you ask to be referred to an electrophysiologist? I did not know that I had this until it was exacerbated by the pred, and I finished up being ambulances to hospital. I have since had an ablation, which I'm told has been successful, though I am now being investigated for possible angina! The cardiologist did say that heart problems are sadly "normal" for anyone with a rheumatic condition. And I used to be so healthy too!

[withington1961 in reply to Rjw2014]

Hi I was referred to a cardiologist after an echo cardiogram which was normal. He said that as I only get the AF at night to take an a flecainide tablet after dinner and a beta blocker in the morning. He said it was to do with the natural pacemaker throwing an electrical "wobbler" He also said that ablation would poss be an option if it gets worse or more often but that it carries a risk of stroke during the procedure and that if was needed in say 5 years or so procedures may have advanced and there may be less risk. The fast AF attacks are not too frequent but the palpitations are fairly scary and can last for an hour or so. Ps I was also very healthy too !!