Afib and Prednisolone

[Attic]

Hi everyone, I have Atrial Fibrilation and have been started on 15mg of Pred. Yesterday I had quite a bad attack where my heartbeat reached 148bpm. When the attack was over my heartbeat dropped to 50bpm. It stayed there for sometime. It has now gone up to 57bpm which is still too low really. I just wondered if this has happened to anyone else and could it be the Pred.Thank you Jenny

[PMRpro Ambassador]

Your post seems a bit of a non-sequitor: "I have Atrial Fibrilation and have been started on 15mg of Pred"

Did you already have a/fib before developing PMR? Is the pred for PMR?

I have a/fib which was actually CAUSED by the autoimmune part of PMR having damaged the sinus node which governs heart rate. My a/fib was always worse during a flare - and more pred helped manage it.

Once you have a/fib it does progress over time. When you have an episode with a high heart rate, it is often followed by a period of a much slower rate as your system recovers, 50 bpm is fine - it is when it gets into the 40s you might need to consider seeking advice. I developed periods where I was having brady/tachy episodes where in the bradycardia my heart rate could be under 20, and I was given a pacemaker to prevent the slow periods.

Are you under a cardiologist?

[Attic in reply to PMRpro]

Sorry PMRpro didn't make myself very clear. This is my 3rd time with Pmr now. My 1st round was just over 10 years ago for which I was on Pred for 6 years, I developed Pmr in that time. I have never been referred to a Cardiologist. Thanks for putting my mind at rest about the low Heartbeat.

Jenny

[PMRpro Ambassador in reply to Attic]

If you have a/fib, what medication are you on? You need to be on at least an anticoagulant and preferably referred to a cardiologist. If you have longer periods where the heart rate stays at IRO 140 or above, then you should really call 999 to get an ECG done while it is happening and in case you need medical attention.

[Attic in reply to PMRpro]

Hi PMRpro, I am on Bisoprolol 5mg daily and Apixaban which is a Blood Thinner. I have been Hospitalised a couple of times, once my Heart Rate was 170bpm and the other time it was 158.

The Dr told me if I have an attack to take an extra 5mg of Bisoprolol which seems to do the trick, but no mention of a Cardiologist.

Jenny

[PMRpro Ambassador in reply to Attic]

You're lucky - pill in the pocket bisoprolol doesn't help me! There is likely to come a point where it affects your QOL and then you will need a cardiologist because an ablation these days is often a first line approach and works better sooner than later when previous options haven't worked. And there is a question of age and fitness. The waits now in the UK are lengthy I gather. I would want to be in that queue earlier rather than discovering I'm going to have to wait years ...

[Attic in reply to PMRpro]

Years being the operative word I think. I think I had better make an appointment at the Doctors.While I am on, can I ask you if you think Pred can make you light headed, because even though my Pulse Rate has settled, I feel terribly light headed.

Jenny

[PMRpro Ambassador in reply to Attic]

All the time or now and again? I find the effects of a longish episode of arrythmia can leave me feeling very dodgy for a day or two.

Pred can make you a bit light headed but it is usually worse at high and very low doses - maybe others can answer that better than me.

[Attic in reply to PMRpro]

I feel really peculiar and am considering stopping the Pred. This is my 11th day though so I don't think I canJenny

[PMRpro Ambassador in reply to Attic]

Have you ONLY been on pred for 11 days? Then you COULD stop. But I think you need more discussion with your doctors.

[Attic in reply to PMRpro]

Thank you PMRpro, how long can you be on them before you stop. I won't do anything until I have spoken to the Dr on Monday. It might not even be the Pred, as you said it could be the tail end of that horrible afib attack. It was my worst attack ever and I was ok on Pred the last twice.Jenny

[PMRpro Ambassador in reply to Attic]

When I first started pred, I was put on a 6 week course - 2 weeks at 15, 2 weeks at 10, 2 weeks at 5mg and stop. so you could try that - gives you plenty of time to discuss it. I was fine until 6 hours after missing the first 5mg dose. Never got to 5mg again for years though!!

[Attic in reply to PMRpro]

Thank you PMRpro, it is lovely to know there is someone to listen who understandsJenny