Irregular heartbeat issues

Posted by caroljeand @caroljeand, Feb 12 11:40am

I am tapering off prednisone and currently at 1 mg. I have been monitoring my blood pressure since I was on blood pressure medication prior to PMR diagnosis. PMR (or more likely prednisone) has created more blood pressure issues for me so I check it daily.
I have noticed more notifications of irregular heartbeat on my monitor since tapering. Has anyone else been aware of this issue?
I just turned in a 48 hour heart monitor so I’m anxious to know the results and conclusion.

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Profile picture for pmrsuzie @pmrsuzie

I have been taking BP med for many years. Have had two stress tests and monitor studies. First study was probably before pmr started. I was diagnosed with an arrythmia and prescribed metoprolol. The second study was more recent, revealed PSVT and was prescribed flecainide. Both these meds are low doses.
I monitor my BP daily, before dinner, and occasionally get that irregular heartbeat symbol. I saw my cardiologist this week and asked about it. He immediately asked what was my heart rate. It's been normal. He said not to worry unless my heart rate is also elevated.
Best to keep track of these things in a planner book. If I get that irregular heartbeat symbol I would write 135/70 ❤ 67.
My EKG was normal.

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@pmrsuzie
I guess we all have an irregular heartbeat at times but it concerned me when I was seeing it more often. Just received my report and apparently there is nothing significant to address at this time. Hoping things straighten out once off prednisone this week. I’m sure it will still take time for my body to acclimate for the positive.

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Profile picture for caroljeand @caroljeand

@dadcue
Thanks for checking in… I turned in my monitor on Thursday and had a message yesterday to check my chart. There was no report so I put in a call to the doctor and haven’t heard anything back yet. It could take 5 to 7 days for a reading but why the my chart message?!🤷🏻‍♀️
I have a feeling my issues are all due to the prednisone and have two more days of one mg. I will be so glad to be off to see how my body reacts.
I have cataract surgery scheduled for March and April. Just have a concern about being on Kevzara that I need to sort out. Someone on here posted about needing to be off Actemra for knee surgery so I wonder if cataract surgery would have the same need to be off kevzara.
Did you not feel different when your BP rose over 200? I do know checking it so often can cause anxiety for higher readings. I just check it in the morning before breakfast unless I feel odd. Last few days I haven’t gotten the irregular heartbeat notification so very anxious to hear my results.
Assume I’ll get a call today.

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@caroljeand

I thought my little home blood pressure machine malfunctioned when it said my BP was 210/110. I was getting ready for work and since I worked at a hospital I decided to have a nurse recheck my blood pressure at work. I didn't have any symptoms but the nurse took me to the emergency room when she got the same 210/110 reading. I wasn't anxious about anything because that isn't my nature. I think the nurse panicked more than me because I didn't want to go to the emergency room.

When the emergency room checked me in my blood pressure was still 200/100. Nothing was done in the emergency room to decrease my blood pressure. It was strange how it slowly returned to normal about 2 hours later.

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Profile picture for Mike @dadcue

@caroljeand

I thought my little home blood pressure machine malfunctioned when it said my BP was 210/110. I was getting ready for work and since I worked at a hospital I decided to have a nurse recheck my blood pressure at work. I didn't have any symptoms but the nurse took me to the emergency room when she got the same 210/110 reading. I wasn't anxious about anything because that isn't my nature. I think the nurse panicked more than me because I didn't want to go to the emergency room.

When the emergency room checked me in my blood pressure was still 200/100. Nothing was done in the emergency room to decrease my blood pressure. It was strange how it slowly returned to normal about 2 hours later.

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@dadcue
Wow… what a story! I would have been freaking out.
I did call my rheumatologist and was told to stop kevzara 2 weeks before the surgery and continue two weeks after the completion of both. That leaves me with no kevzara for six weeks. Not sure how that’s going to affect me. I have no other choice except to delay surgery. I would prefer to get it over with.
They don’t seem too alarmed about discontinuing for that time so we’ll see.

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Profile picture for pmrsuzie @pmrsuzie

I have been taking BP med for many years. Have had two stress tests and monitor studies. First study was probably before pmr started. I was diagnosed with an arrythmia and prescribed metoprolol. The second study was more recent, revealed PSVT and was prescribed flecainide. Both these meds are low doses.
I monitor my BP daily, before dinner, and occasionally get that irregular heartbeat symbol. I saw my cardiologist this week and asked about it. He immediately asked what was my heart rate. It's been normal. He said not to worry unless my heart rate is also elevated.
Best to keep track of these things in a planner book. If I get that irregular heartbeat symbol I would write 135/70 ❤ 67.
My EKG was normal.

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@pmrsuzie
My cardiologist has recently suggested combining a low dose of both metoprolol and flecainide taken together after I had a CT Scan. I had a 2-week bout of irregular heartbeats (with a pacemaker) that warranted the test. At first she said that I would need to be hospitalized for 3 days during the process of combining the 2 drugs. After the test, she said that I could start taking a low dose (50 mg twice a day) of the flecainide together with my regular dose of metoprolog (also 50 mg twice a day). ( I have asked for an explanation of why the hospitalization is no long required and am waiting to hear back.) Any comments on this combination of drugs at this dosage? Worrisome symptoms to contact the doctor about? Other advice? Thank you.

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Profile picture for finnegan @finnegan

@pmrsuzie
My cardiologist has recently suggested combining a low dose of both metoprolol and flecainide taken together after I had a CT Scan. I had a 2-week bout of irregular heartbeats (with a pacemaker) that warranted the test. At first she said that I would need to be hospitalized for 3 days during the process of combining the 2 drugs. After the test, she said that I could start taking a low dose (50 mg twice a day) of the flecainide together with my regular dose of metoprolog (also 50 mg twice a day). ( I have asked for an explanation of why the hospitalization is no long required and am waiting to hear back.) Any comments on this combination of drugs at this dosage? Worrisome symptoms to contact the doctor about? Other advice? Thank you.

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@finnegan
I'm not an expert so what I tell you is not really 'advice', it's what is working for 'me'. I am taking 50mg Flecainide Acetate twice a day, morning and evening. The 50mg Metoprolol Succinate ER I take once a day in the morning. Both meds with breakfast. I think the metoprolol is also helping with my Meniere's symptoms because it's a beta blocker sometimes prescribed for Meniere's patients.
I had the monitor and stress tests because I was having noticeable palpitations/arrythmia. This combo of meds is working for me, I only occasionally now get that irregular heartbeat symbol when I take my bp. If I get that irregular symbol, I'll wait a bit and retake my bp. I have never gotten that symbol the second time. I only see the cardiologist once a year.

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Profile picture for finnegan @finnegan

@pmrsuzie
My cardiologist has recently suggested combining a low dose of both metoprolol and flecainide taken together after I had a CT Scan. I had a 2-week bout of irregular heartbeats (with a pacemaker) that warranted the test. At first she said that I would need to be hospitalized for 3 days during the process of combining the 2 drugs. After the test, she said that I could start taking a low dose (50 mg twice a day) of the flecainide together with my regular dose of metoprolog (also 50 mg twice a day). ( I have asked for an explanation of why the hospitalization is no long required and am waiting to hear back.) Any comments on this combination of drugs at this dosage? Worrisome symptoms to contact the doctor about? Other advice? Thank you.

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@finnegan What PMR meds or other meds are you on. I was on Tyenne (Actemra bio-similar drug) for PMR and had PVC's (Premature Ventricular Contractions). When I stopped the Tyenne due to diverticulitis the PVC's went away. If you have started a new drug recently I would talk with an AI agent to see if your new drug has a known cardiac risk. If it does then you could bounce the problem back to your doctor who Rx-ed the new drug. I do not want to get into a loop of taking one drug to offset the side effects of another drug if I can possibly avoid it.

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Profile picture for finnegan @finnegan

@pmrsuzie
My cardiologist has recently suggested combining a low dose of both metoprolol and flecainide taken together after I had a CT Scan. I had a 2-week bout of irregular heartbeats (with a pacemaker) that warranted the test. At first she said that I would need to be hospitalized for 3 days during the process of combining the 2 drugs. After the test, she said that I could start taking a low dose (50 mg twice a day) of the flecainide together with my regular dose of metoprolog (also 50 mg twice a day). ( I have asked for an explanation of why the hospitalization is no long required and am waiting to hear back.) Any comments on this combination of drugs at this dosage? Worrisome symptoms to contact the doctor about? Other advice? Thank you.

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@finnegan
I don't know what kind of irregular heartbeats you're experiencing. I am on 40mg sotalol twice a day for PVCs that started about 7 years ago. About 3 years ago I started having PACs too, so they added 40mg verapamil twice a day. Each has the added effect of slightly lowering BP. I have not had any issues since, other than the first week I was on prednisone for PMR. Choice of Rx and dosage varies by doctor, symptoms and potential interaction from other meds.

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I don't know about your case, but I was on verapamil for hypertension because my white coat anxiety causes me to have panic attacks when my BP is measured, and my PCP couldn't get a good read. After almost passing out a couple of times when I was relaxed, I was able to get her to lower my dose. BUT -- when this prednisone withdrawal hit me, I was still on verapamil and unable to get off because she had retired and I had not been able to establish a relationship with a new one. I was dropping, lightheaded and off balance and cut back at my pharmacist's recommendation but not off. In my case, I think the verapamil was working against me -- my BP was dropping and the verapamil was making it drop even more. To make matters worse, it says in my records from my PCP that I am hypertensive. My rheumatologist told me to discontinue the verapamil. He recognizes what is going on but nobody else in the medical world seems to.

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Profile picture for caroljeand @caroljeand

@dadcue
Wow… what a story! I would have been freaking out.
I did call my rheumatologist and was told to stop kevzara 2 weeks before the surgery and continue two weeks after the completion of both. That leaves me with no kevzara for six weeks. Not sure how that’s going to affect me. I have no other choice except to delay surgery. I would prefer to get it over with.
They don’t seem too alarmed about discontinuing for that time so we’ll see.

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@caroljeand The half-life of Kevzara is approximately 10 days and it takes 5 half-lives before a drug is considered completely out of your system. That would be 50 days. You will only be without some Kevzara in your system for a very short time. True, the last 10-20 days the amount would be very low.
Not sure how delaying surgery would help since the timeframe would be the same, unless you believe you will be coming off Kevzara completely in the near future.

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Profile picture for potterywoman @potterywoman

I don't know about your case, but I was on verapamil for hypertension because my white coat anxiety causes me to have panic attacks when my BP is measured, and my PCP couldn't get a good read. After almost passing out a couple of times when I was relaxed, I was able to get her to lower my dose. BUT -- when this prednisone withdrawal hit me, I was still on verapamil and unable to get off because she had retired and I had not been able to establish a relationship with a new one. I was dropping, lightheaded and off balance and cut back at my pharmacist's recommendation but not off. In my case, I think the verapamil was working against me -- my BP was dropping and the verapamil was making it drop even more. To make matters worse, it says in my records from my PCP that I am hypertensive. My rheumatologist told me to discontinue the verapamil. He recognizes what is going on but nobody else in the medical world seems to.

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@potterywoman
Even though I have a medical related background, my knowledge on some areas is limited but verapimil seems like a cardiology opinion might be warranted.

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