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AI and cardiac med interactions
Breast Cancer | Last Active: 6 hours ago | Replies (12)Comment receiving replies
@californiazebra I'm glad you no longer need the Kisqali and hope you'll avoid problems with the letrozole. My first afib episode was in August 2023 before my breast cancer diagnosis in the fall of 2024. Now I wonder if the afib was an indicator that I had cancer before the mammograms and other tests indicated it. The reason I say that is I had no risk factors for afib. My cardiologists (I saw a couple) asked if I had cancer since it was a risk factor for afib so perhaps the cancer triggered the afib. At the time when I saw these docs, I said no because I did not know I had cancer then. I had the impression it was the cancer itself, and not any medication treating it, that could be a cause. One of those mysteries of cause and effect we never answer.
My afib was episodic and I was prescribed Eliquis. I was on the fence about taking it but when I had a couple more afib episodes decided it was the safe thing to do. I also consulted with 2 electrophysiologists who both said I was a candidate for an ablation. I had planned to do the ablation in the fall of 2024 but when the breast cancer diagnosis was made late in 2024, the surgery was cancelled.
After completing a double mastectomy and chemotherapy in the spring of 2025, I asked my electrophysiologist if I was still a candidate for an ablation. He said yes. Although my cardiologist says I need to stay on the Eliquis regardless of an ablation (my age 76 and being female are risk factors), I elected to have the ablation. My electrophysiologist says I could go off the Eliquis with careful monitoring for afib. I feel the ablation is one potential thing to protect myself. Plus, research now indicators ablation should be considered a primary tool to treat afib rather than a backup if meds don't work.
I have had no afib episodes since my ablation in September 2025 but remain on the Eliquis too.
I'm happy that your afib episodes have decreased so much since dropping the Kisqali. I would encourage you to get at least 2 opinions about an ablation. It's also possible that your afib episodes will continue to decrease even more then longer you go without being on Kisqali. It's possible they may disappear completely! That is my sincere hope for you!
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@prarysky
Thanks for your nice reply. I sure hope Letrozole is not contributing to my afib since I'll be on it forever as far as I know. I have recurrent breast cancer, came back 7 years after my DMX. I'm doing well though. I started Letrozole 2 weeks after I started Kisqali, but the afib started the first week of Kisqali. I had one afib episode 5 years before Kisqali after losing 25 pounds in a month due to dysphagia and not eating at all so I may be predisposed to afib, but Kisqali definitely fleshed it out. I did not know cancer was an afib risk factor. I looked it up and it's generally the inflammation is causes and the cancer treatments that are the issues. Medical issues definitely have a domino effect, one leads to another.
That's fantastic that your first ablation worked! Also glad you do well with Eliquis. I've had so many issues with meds, I refused to take Eliquis until I landed in the hospital last September from a TIA with aphasia. That was scary. I thought it was that major stroke they'd been warning me about. I had several retinal TIAs and one other cognitive one before Eliquis. I'm doing fine on Eliquis and no TIAs in the past 9 months while on it.
I'm 67. I have my 2nd opinion consult with a different EP next week. The first EP was a definite no. He was flippant. I'm less worried about the standard ablation risks and more worried about my personal risks due to anesthesia issues and a hereditary nerve disorder that makes my nerves easily damaged. I also have 2 venous anomalies that will change the catheter plan and two arterial anomalies I'm worried may increase stroke risk, all picked up incidentally on scans. I especially worry if I have to have multiple ablations.
I was also hoping my afib would be better and better over time now that I'm off Kisqali, but I've been off 8 months and continue to have about 1 episode a month (better than the 5 per month on Kisqali). I just finished a 65 hour episode today, my longest yet so I guess improvement without ablation isn't in the cards. My heart has obviously remodeled after 5 years of frequent and long episodes. I'm interested in PFA for less nerve risk and shorter anesthesia time. Did you have PFA? We'll see what the EP has to say. Hopefully, he's more optimistic than the last one. Thanks again for your response. I truly hope your ablation success is permanent.