Atrial Fibrillation problem

[PatB1948]

I was first diagnosed with AF almost 20 years ago and am on medication since then. I am in AF all the time and on Bisoprolol 10mg and Edoxaban. In the last few weeks, I have felt my heart BPM have been faster and more erratic than usual. In the last few days it seems to have got worse, going up to 166 and down to 48 on some occasions. I have also been having right temple pain and blurred vision in right eye. I saw GP yesterday and had an ECG which was okay for someone with AF and also blood tests. He phoned me in the afternoon saying some of the blood test results were back and seem okay. He also phoned cardiology at Ninewells Hospital for advice and they said that they think it is the PMR having an effect on the AF. GP said to put Pred up to 10mg and he will phone me on Monday with rest of blood results and see how I am. I have been feeling light headed throughout and also very tired. Any advice would be appreciated. Pat

[herdysheep]

I don't have GCA, but that would be on my mind in your shoes. Have you had your eyes checked? How is your vision now? Some things mask others so could be worth a proper check.

[PatB1948 in reply to herdysheep]

I think doctor suspected GCA as well but the only symptoms I have are the temple pain and blurred vision but not all the time. I am going to optician this week to get eyes checked. Thanks for your input.

[PMRpro Ambassador]

There is no way on earth that just bisoprolol would manage my AF - and my AF is almost certainly due to the autoimmune part of PMR having damaged the sinus node and causing sick sinus syndrome, It started at the same the PMR symptoms started 18 years ago but was first identified 10 years ago and managed, So the PMR may well have worsened the AF.

After my bivalent Covid jab last November it suddenly and dramatically worsened - just a few hours after the jab. I was having up to 12 hours a day every day compared to short episodes every few wee, I ate a lot of salad!ks. The cardiologist won't have it is the jab, he says it is because the medication I had been on had stopped working which usually happens after 5 or 6 years, I'd been on it 10. I have always had problems when I was having a PMR flare and that was part of the reason I have been on so much pred, to help manage it.

Yes - I felt lightheaded, couldn't even stand to prepare a meal through the winter, and the fatigue was unreal! I was switched to a new medication and within 2 days I was back to how I had been before while I wait for a cryoablation in the next few months.

The alternating episodes of tachy and bradycardia (fast and slow heart rate) are also part of my AF, I have a pacemaker because the bradycardias got silly about 7 years ago with 7 second pauses, that is a long time without a heart beat, a pulse of under 10!!!! And ECG at the GP's is meaningless if you don't have an episode while it is being done so you need a proper long monitor, at least a 24 hour Holter but preferably longer - I was waiting for an external loop recorder when I collapsed and they were horrified to identify what was going on in the ED!!! I was lucky - I could have fallen down stairs or been driving when it happened and had a lot worse than a black eye.

You need to push to see a cardiologist who knows what they are doing.

[PatB1948 in reply to PMRpro]

Thank you PMRpro for your quick response. I am on the highest dose of Bisoprolol and it certainly doesn’t seem as effective as it was originally. When GP phones on Monday, I shall push to see a cardiologist as you suggest. Your AF seems much worse than mine which is debilitating nevertheless. Shal let you know how I get on. Pat

[PMRpro Ambassador in reply to PatB1948]

Mine was OK until the covid jab last November. Originally, they didn't do an ablation until they had to because 11 years ago they were risky and not very effective. Advances in techniques have changed all that and the electrophysiologist said that now a 60 year old would definitely be treated with ablation, an 80 year old wouldn't and in between it depended on the patient. I am adjudged suitable as reasonably fit and active.

[Sanekate in reply to PMRpro]

I had my first big afib episode after Covid moderna/spike vaccine & ended up in a&e. The same vaccine made me feel dreadful 6 months before, but my 3 previous vaccines were Oxford/AZ type and I was fine with them. I'm hoping I can choose the type next time

[PMRpro Ambassador in reply to Sanekate]

Mine was with Pfizer. No choice here - no AZ at any point but there have been issues with it too. I'd had no problem with the previous, just the bivalent one.

[PatB1948]

I had cardioversion a few years ago but it was unsuccessful. I am in AF all the time and although I asked about ablation, they said I wasn’t suitable for it. Perhaps I need a pacemaker, I shall ask if and when I see cardiologist. Here at Ninewells, they have a one stop department for heart and other problems and they check on most things on the same day and then you see a consultant. I’ll ask the GP to send me there and that usually happens quickly. Will let you know. Pat

[PMRpro Ambassador in reply to PatB1948]

The pacemaker is so they can medicate more heavily without the bradycardias happening. Doesn't stop the high end stuff.

[PatB1948 in reply to PMRpro]

Oh I didn’t know that. My AF is usually at the higher end so maybe won’t ask about pacemaker.