Does anyone have AFIB which makes steroid therapy an issue?

I never had a problem with a-fib but Prednisone can certainly cause a-fib or make it worse.

Actemra might be an ideal medication for you. I was unable to taper off prednisone for more than 12 years after PMR was diagnosed. I had cardiovascular side effects from Prednisone. Actemra got me off Prednisone but it took time. It took me about a year to go from 10 mg to zero after Actemra was started. I noticed an improvement in my PMR symptoms in about 3 months. My rheumatologist says any biologic should be given at least 3 months to see if it will work for you or not.

I have been off Prednisone for almost 4 years. I still need a monthly infusions to Actemra to control my PMR symptoms. I don't have any concerning side effects from Actemra. Not only was I able to stop Prednisone, I was also able to discontinue five of my cardiovascular medications that were treating Prednisone side effects.

I sincerely hope Actemra will work for you as well as it does for me. You need to give Actemra some time to work because it doesn't work immediately like Prednisone does.

What dose of Prednisone are you on?
Anxiety pushes AFib for sure. Do you take anything for that?

I seem to be one of the few ones that ACTEMRA did not work. I developed severe itching and my joint pains actually increased. My Dr recommended that I stop it and I am back on 5mg prednisone. Doing great but puzzled as to why ACTEMRA did not work for me.

Actually Dr switched me to methylprednisolone. It is 20% stronger per mg so 16 = 20 prednisone. I took 16 for 2 days, which caused Afib, went to 8 for 2 days, now at 6mg. Anything more helps PMR symptoms, but pushes toward Afib. The anxiety is usually a precursor to an Afib occurrence.

This may not be a healthy response, but my cardiologist told me to take an extra dose of flecainide when this occurs.
Might be worth asking about.

Slightly off topic but, I had AFIB for 5-6 years (way before I developed PMR). I was on flecanide and other drugs and had 3 ablations. At one point a nurse practictioner suggested I have a sleep study done. I discovered I had severe sleep apnea was fitted with a CPAP and have not had an episode of AFIB since, (it's been seven years!) I've had PMR for three years and continue the seesaw-ing of taking pred after 2 flares.........but, at least no AFIB! I wish you well!

@dadcue I wander where and how Acterma is given and taking, and if it is prescribed by rheumatologist ? Or need to be bought?
I am having paroxysmal Afib for about 10 years. Older- no ablation !
Mostly always recuperate AFIB with Bisoprolol and Flecainide. This year I was diagnosed with PMR and looks like have no choise as started prednisone.
I did cortisone injection that helped for about 3 weeks but than all PMR symptoms (stiffness and pain)returned
My big concern to what degree prednisone triggered or making worse Afib ,that I experienced an onset periodically.
Plus having more concomitant health problems I am very hesitant to start prednisone, that have numbers of related side effects.
Therefore, looking for any alternative, perhaps Acterma is the one ? is it taking with prednisone or instead of ? Thank you

@monigue - steroid to treat PMR caused repeated Afib episodes, started Actemra weekly home injections and after 3 months it took effect and I know longer take steroids, 18 months in.

@monigue
I was diagnosed with AFib about 8 years ago, and subsequently with PVCs and PACs. I'm on eliquis to reduce my stroke risk, as well as sotalol and verapamil for the PVCs and PACs. I stay hydrated. That was working great. I was actually able to reduce some meds over time. I was diagnosed with PMR two weeks ago. 25mg prednisone increased my heart rate, PVCs and BP. I asked my cardiologist if I could increase my sotalol and BP meds to my prior dosage and I'm good again.

@monigue

My rheumatologist prescribed Actemra to me and still monitors me for everything related to Actemra. One time I asked my PCP a question about Actemra. He said Actemra was "out of his league" and I needed to ask my rheumatologist.

I think Prednisone can cause or exacerbate atrial fibrillation. Fortunately, I have never had a-fib as a problem. I needed to see a cardiologist for hypertension and frequent PVC's caused by left ventricular hypertrophy (LVH). My cardiologist said my heart was "irritable" from being "stretched" from intermittent high blood pressure. My blood pressure was very labile because of prednisone.

According to artificial intelligence:
"Atrial Fibrillation (A-fib): High-dose steroid therapy is strongly associated with new-onset atrial fibrillation. It causes direct electrical remodeling of the heart and mechanical strain, creating a high-risk environment for this arrhythmia."
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I had multiple blood clots in both lungs which caused a massive pulmonary embolism (PE). The PE put back pressure on my heart and caused some problems until the blood clots cleared. The PE made my lungs stiff afterwards. There were many blood clots in my lungs and doctors weren't sure how blood was getting through my lungs to be oxygenated. It was believed that Prednisone caused all of my cardiovascular problems but systemic inflammation wasn't helpful. Patients who survive a massive PE sometimes experience long-term symptoms like shortness of breath and decreased stamina, which may take months or even years to resolve completely. My symptoms didn't resolve until I was able to discontinue prednisone.