Any of you with PMR also have afib and on blood thinners?

Posted by vandyms1974 @vandyms1974, 2 days ago

I developed PMR and was prescribed Prednisone. That made a lot of difference. However, I later developed afib and was given Eliquis. Now it is harder to treat the PMR due to the bleeding potential while on Eliquis. I am currently on 1 to 1 &1/2 mg per day and it helps. However, we are considering the use of the Watchman heart implant to possibly get off the Eliquis after a few months. Anyone else been down this path? I am on the fence about the implant. Could it make the afib worse and an antiarrhythmic be needed? Lots of questions!

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

@navymom154

I developed A-Fib long before PMR/Pred. It was suggested I get a sleep study done. Turned out I had severe sleep apnea and since using a C-PAP I no longer have A-Fib and am off blood thinners! I'm so glad I took the sleep study advice!

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Interesting because I was diagnosed with sleep apnea after being diagnosed with PMR and being on Prednisone. I guess it is just a matter of prospective on cause and effect. Whatever precedes something gets blamed for being the cause.

As a statistician I know this isn't true. Correlation does NOT equate to causation.

I have a hard time not blaming Prednisone for many things so I apologize if I do. I'm currently off Prednisone and now I'm off 3 blood pressure medication, atorvastatin as well as my blood thinner. To me that is some supportive evidence that Prednisone was causing many things.

I got used to my CPAP machine but more and more -- I don't think I have sleep apnea anymore. At the time sleep apnea was diagnosed, it was said that Prednisone was causing changes to my face and neck area. Prednisone was said to be "exacerbating" if not causing obstructive sleep apnea.

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@dadcue

I didn't have a-fib but I had other cardiac arrhythmias while on Prednisone. I didn't get on blood thinners until I had multiple, bilateral and extensive pulmonary embolisms of "unknown etiology." After spending a a couple of days in intensive care, I eventually went home on "warfarin for life." My cardiac abnormalities probably stemmed from elevated blood pressure in excess of 200/100. I developed left ventricular hypertrophy (LVH) from high blood pressure.. A cardiologist started three blood pressure medications. I didn't have much hope that I would ever be able to stop the blood pressure medications and warfarin. Being short of breath with minimal exertion all the time was the worst of it.

Things started to improve after I was able to discontinue Prednisone. At first, I was dizzy all the time and I had to be careful so I wouldn't faint. My blood pressure was getting too low and I was diagnosed with orthostatic hypotension.
https://www.mayoclinic.org/diseases-conditions/orthostatic-hypotension/symptoms-causes/syc-20352548
My blood pressure medications were stopped one by one. Now my blood pressure is a healthy 110/70 with no blood pressure medications. I have bradycardia but that was normal for me when I didn't take prednisone.

After 10+ years on warfarin, the anticoagulation clinic offered Eliquis so I wouldn't need to have my INR checked so often. I was reevaluated for my heart health. When it was learned that I was no longer on Prednisone, it was decided that I no longer needed any blood thinner. Now I'm off warfarin and all my cardiac medications including Atorvastatin in addition to being off prednisone.

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Wow, that is progress! Thank you for sharing that. Thankful you were able to turn this all around. Blessings.

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Thanks for that. Is it the pred or the PMR that lead to afib? Somewhere I read that PMR can impact the sinus nodes. Who knows? I think PMR is a bear!!

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@tapamil65

I have AFIb and PMR. Trying to wean down the prednisone, currently at 9mg going to 8.5 today and reducing by 1/2 mg a month. It’s such a slow process. But have tried 1 mg a month and always flare at about 5. Trying a slower taper. My doc has never mentioned the danger of afib and taking Eliquis with prednisone. I learn more from all of you. Now I am worried!!!!!

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I am sorry, but don't worry. I have been on Pred for over two years and on Eliquis for over one year. I just wanted to pursue the Watchman to get off Eliquis, but am a little concerned about going into my heart, which as far as I know is physically sound, The electrical part is causing problems. My doctors are so concerned about the stroke potential without Eliquis. We will keep looking into it. It is harder to treat PMR while on Eliquis.

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@vandyms1974

Thanks for that. Is it the pred or the PMR that lead to afib? Somewhere I read that PMR can impact the sinus nodes. Who knows? I think PMR is a bear!!

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"Thanks for that. Is it the pred or the PMR that lead to afib? Somewhere I read that PMR can impact the sinus nodes. Who knows? I think PMR is a bear!!"
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PMR is a bear! Inflammation can cause a lot of things so PMR inflammtion can expose many things. However, prednisone has been researched thoroughly over the decades since it was first used for RA.
https://www.verywellhealth.com/prednisone-heart-rate-5113682
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I have learned to never underestimate what Prednisone does in the body. I believe it is all related to cortisol which Prednisone replaces. Look at some of the effects that cortisol has in the body.
https://my.clevelandclinic.org/health/articles/22187-cortisol

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