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Reclast Risk of Atrial Fibrillation with Mitral Valve Regurgitation
I'm 64 and in good health except for mild (1+) mitral and (1 or 1-2+) tricuspid valve regurgitation last checked two years ago . I understand it's fairly common. After a successful year on Evenity my endocrinologist wants me to start on Reclast. He mentioned in general the Atrial Fibrillation risk and didn't encourage me to get a heart test when I brought it up.
And Dr. Google says "Mitral valve regurgitation significantly increases the risk of developing Atrial Fibrillation." I don't know what exactly is "significantly" nor what if mine is mild. It's been two months and am concerned about putting off treatment and losing my gains but I want to be sure I'm covering my bases. Doctors (real ones) seem to have such different takes on this.
Am curious if anyone has any thoughts or experience on this subject.
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Hi @spiderplant
For what it's worth, I'm 69 and have the same mild heart valve regurgitation as you. I've had at least 6 Reclast infusions, beginning around 2012, with the latest in 2024, and neither my rheumatologist nor my cardiologist has ever indicated that AF can be a problem with Reclast; they were more worried about the risk of spontaneous femur fractures due to the total number of infusions I've had.
My cardiologist, however, did clear me for the full 12-dose treatment of Evenity which reportedly carries a risk of cardiovascular issues. I have also done 9+ months on Tymlos. Based on my family's health history, I have an annual checkup and echocardiogram to keep an eye out for changes in cardio numbers. It might be a good idea to get a second opinion which may allay your fears.
Enjoy your day!
Cheers!
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3 ReactionsMuch appreciate hearing this, beanieone!
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1 ReactionI have had afib occasionally for 10 years. During my cancer treatment my doctor did not put ne on the usual Reclast that cancer patients go on to combat bone loss caused by the meds (and it also has some protective effect against recurrence). He specifically cited concerns about Reclast triggering afib.
However in more recent years he says that risk was disproven and any info on it online is outdated. I have not checked to see if that is true! I needed Reclast to avoid losing gains and have done two infusions so far, with a third this month. No afib!
However, although I have regurgitation in a few valves, I have not been diagnosed with mitral valve prolapse!
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3 ReactionsGlad to hear you had no issues and feeling much better about moving forwards with Reclast. Thank you!
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2 Reactionsspiderplant, the best answers come from the experienced members. From pubmed:
Contrastingly, some studies indicate that BPs are antiarrhythmic by inhibiting fibrotic myocardial remodeling.
[P]ossible mechanisms [for afib with bisphosphonates] include antiangionesis-related myocardial remodeling, calcium handling abnormalities, and inflammatory changes.
https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/nyas14332
https://pmc.ncbi.nlm.nih.gov/articles/PMC8820972/
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1 Reaction@genlty hmmmm that study on bisphosphonates and afib was January 2022. I was hoping it was older and outdated! My endo told me that that risk had been disproven so now I have to talk with him. So far I have had two 1mg doses of Reclast (20% dose) and I am going to talk to him about the third, especially since Ben Leder MD says a half dose may be enough. That said, in my case, more fractures could be life-threatening and I seem to be able to deal with afib when it happens by going to the ER. I haven't had any since I went on Reclast and had two whole years without afib while on Tymlos despite the fact that it sped up the heart briefly.