Heart irregularity

[Hannah183]

Had PMR nearly 2 yrs flare up in July possible GCA. Neck pain and vision loss (only few seconds). Upped pred and now lowering gradually again. But now have about every two weeks and always starts when asleep or resting heart goes irregular and starts racing. Had all checks for heart attack. Echocardiogram monitor etc. Blood tests. All ok. Has anyone else had anything similar.

[Rose54]

Hi Yes May2015 racing heart was HA

Last week heart beat of 103 called ambulance but apparently no HA ECG was fine showed the same as 24 hour Holter monitor in June.

Had another ECG yesterday at GP that was OK as well.

Have had Bisoprolol increased and back to GP in 3 weeks to see how I feel .

I feel very anxious at present as no knowing if it will happen again.

I was told to just phone ambulance if it does

[Hannah183 in reply to Rose54]

Thanks for the reply on low dose bisoprolol. Also told phone 999. But done that 3 days in hospital but fine all that time so sent home. Interested that other people have had similar. Trying to be relaxed about it

[Carriemetz]

Yes, in process of checks now. Only at night when I lie down, or when resting in evening. Had low dose beta blockers prescribed while waiting for checks and not had episode since I began taking them three weeks ago. It’ll probably turn out to be stress or something! It usually is. I do get anxious when it starts, which naturally makes things worse! Am trying to keep a sense of proportion abt it. However, think u shd keep an eye on the neck pain and vision lapses though.Get them checked asap? Best wishes, Carrie

[Hannah183 in reply to Carriemetz]

Thanks Carrie. So reassuring to know others have something similar. Upped pred by hospital for possible gca.and all symptoms gone

[PMRpro Ambassador]

I have atrial fibrillation which started about the same time as my PMR symptoms and the cardiologist here said he was pretty sure it was caused by the autoimmune part of PMR damaging the sinus node, the electrical cells that govern heart rate. I too tend to have episodes at night or mid-late afternoon when sitting. They don't last very long - and on the couple of times I have been to the ED since diagnosis they had stopped by the time I got there! I was diagnosed by accident when I was in hospital for severe back problems and had been given i.v. diazepam as a muscle relaxant - one of the rare adverse effects is arrythmia! Once it was managed I realised what the episodes of palpitations I'd had for years were!

A one-off ECG is useless, often even a 24 hour Holter ECG finds nothing because it is only if it happens at the time that it will show up. My GP in the UK, to whom I'd complained about the palpitations, told me to dial 999 - a paramedic with a 12-lead ECG device may get there before it stops and catch the evidence. It's a waste of time trying to get there yourself and a GP rarely has an ECG device in the practice.

It MAY be the higher dose of pred - but equally, if you haven't had it before, the damage may have happened during the flare and as you reduce the pred the inflammation is making it happen which is what happens to me. I wasn't on pred when it started originally and it is worse during a flare - and part of the reason I'm on the dose I am is to help control the episodes.

[Hannah183 in reply to PMRpro]

Thanks have made a copy of your reply. Answered a lot.

[Pangolin43]

Hi Hannah183,I am currently taking 9 and half mg of Pred daily having reduced from 15 mg, diagnosed April 2021. Like you I recently noticed my heart beating very fast (103 bpm) often when resting. I’ve also experienced regular what I can only describe as small vibrations in the chest area too. My Dr sent me for ECG which showed nothing worrying and I am waiting for the result of a 24hr holter heart monitor. (This could take 6 weeks and I’m now in week 3!!!). My GP said it was unlikely to be Pred causing this. I’m not so sure as I’m sure I have read that it is a very uncommon side effect of taking steroids. It is very scary. I try deep breathing to try and bring my heart rate down. What is bisoprolol?

[PMRpro Ambassador in reply to Pangolin43]

A BP medication that also slows heart rate

nhs.uk/medicines/bisoprolol/

Don't know what world your GP lives in ...

[cycli in reply to PMRpro]

gaga land like quite a few

[Nextoneplease]

Just to add….I was diagnosed with atrial fibrillation about six years ago, while I was in hospital following a knee replacement. My heart rate was around 170 for hours and nothing seemed to slow it until bisoprolol, which felt miraculous. However, a few weeks later I had an adverse reaction and the AF got worse again. My medication was changed and worked well - there are lots of alternatives.Nothing to do with PMR I think, but I just wanted to reassure you that there are lots of good treatments.

All the best

Nextoneplease x

[Mack100]

I mentioned on here a few weeks ago about my recent episode of atrial fibrillation which resulted in a 5 hour stay in my local ED. I was given bisoprolol by mouth and magnesium by infusion which reduced the HR from 135 to 100 which was judged to be acceptable for AF.I didn't take the the bisoprolol any more as my BP and resting HR are already low and my GP agrees with this.

The only medication I have now added is apixaban which is an anticoagulant which is vital in constant or paroxysmal AF as adverse clotting must be prevented.

Although low dose steroids have been linked to AF:

tctmd.com/news/even-low-dos...

I feel this is more related to generalised cardio vascular disease than specifically AF but the link between inflammation and AF which PMRpro alludes to is documented:

frontiersin.org/articles/10...

I have also moved to decaffeinated tea and coffee and completely avoided alcohol which resulted in me being free from AF and also quite interestingly ectopic heart beats which I have had most of my life. I will certainly challenge this elimination in the future which I will do sensibly as I would like to enjoy the occasional tipple.

The documented link between caffeine and AF is poor with conflicting research results although this study:

ahajournals.org/doi/10.1161....

suggests:

"Our data suggest a lower risk of AF among men who reported coffee consumption of 1 to 3 cups/day."

which is probably enough for me to resume caffeinated coffee in a few weeks.

However when it comes to alcohol the picture is a bit different:

acc.org/about-acc/press-rel...

Note that this is specific to AF and not general CVD for which red wine is often recommended in small amounts. It's interesting that the authors refer to "quality of life" being reduced in complete alcohol abstinence which suggests that doctors are human too, well at least some of them.

😀

[Nextoneplease in reply to Mack100]

Yes, I remember now, Apixaban was one of the drugs I moved on to, and I have also much reduced my caffeine intake (I only drink alcohol on high days and holidays anyway).

[Sharitone]

I always get palpitations when I sit down. ECG was fine. More worried about my brain though, since I recently referred to 'tachycardia' as 'pachydermia'🐘

[Carriemetz in reply to Sharitone]

Oh me too. I referred to beta blockers as direct debits!

[cycli]

My heartrate is now irregular when it was always steady. This can only be down to PMR/GCA. I have a naturally ectopic beat as my heart fires from a different location to the normal so there is o occasion a double tap when it resets. Heart stops for a fraction and whumps back in.Quite a boost . However, recently it has been doing this far more regularly and the pulse goes from 68-76 to 103/4. When cycling fit it was 51 resting and 67 end of day. For my age max is supposed to be 128 but because of my fitness and years of building good cardio-vascular my max was 180-90. Now I have no idea, but I know the irregular regularity and increased rate when tired is a bit concerning. It is controllable with proper rest and breathing.

[PMRpro Ambassador in reply to cycli]

Um - then do as it is telling you!!!!

[cycli in reply to PMRpro]

Believe me I am.

[Karenjaninaz]

Hello Hannah, I am 79 and I’ve had something similar. I was checked out by my cardiologist and they couldn’t find anything organic. Prednisone lowers our magnesium as well as other drugs we might be taking such as as acid blockers. I’m a retired anesthetist and I figured out it might be magnesium.So I started taking 50 mg of magnesium glycinate even up to 150 mg a day. That has abolished any irregularity that pops up. There are many forms of magnesium but the others give me the trots.

[Hannah183]

Thanks everyone for replying. I now know not alone. Have things to try, and more importantly not to worry so much