Atrial Fibrillation After BC Radiation?
Hi, ladies. While I am generally doing well after completion of breast cancer treatment (lumpectomy, lymph node biopsy, radiation, anastrozole), this week I unexpectedly developed heart palpitations that turned out to be -- I was told after ER visit, and being observed overnight -- atrial fibrillation. I am 54, healthy, fit....have no other cardiac problems, diabetes, high blood pressure or high cholesterol. I was sent home with two prescriptions: a beta blocker to slow the heart rate, and a blood thinner to help minimize risk of clots/stroke. My understanding is that AI will probably be sporadic...on and off (I hope mostly off). I hope not to be on the drugs permanently.
Because I have virtually no risk factors for AI, multiple doctors told me the problem is very likely due to the chest radiation I had for BC....that while my heart remains structurally healthy, the radiation can cause changes at the cellular level that can alter the muscle's electrical patterns/conduction, causing AI. Clot/stroke risk aside (meds control this), the condition is more irritating than dangerous, they said, and I don't have to restrict regular activities, but be more aware of my body, lower caffeine and alcohol, and not be surprised if I'm a little more fatigued, winded, etc.
I had read that cardiac effects of radiation would probably only occur in women treated on the left side of the chest (my right side was radiated).
This came completely out of the blue. Anyone else have this, or heard of this? Hoping it's helpful to mention here, so others won't be as surprised if it happens to them.
Am trying to take this in stride, along with all other changes that have come with BC. It just takes a while getting used to new normal, and I had thought I was over the hump. One upside: another good reason to take super-good care of self physically.
Wishing everyone well on this lovely summer day. With hugs.
Comments
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Girl53: I too have atrial fibrillation but it occurred years after my radiation treatment. I am older than you 67, and didn't get it until I was over 60, so I'm thinking it's not related especially since my younger sister has it and has never had cancer. It is not uncommon in older people. I actually take a calcium channel blocker instead of a beta blocker because it causes less shortness of breath but still reduces the heart rate, as well as a "blood thinner". That said pretty much I can expect to be on them for the remainder of my life.
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Hi! I had an afib episode (my first) when I was 40 years old...for no apparent reason. I was hospitalized for 5 days, went home on all the ugly afib drugs, felt awful, and suffered greatly. I then found a naturopathic cardiologist who agreed that I shouldn't be treated the same at the 70 year old men who most commonly get afib. He believed mine at least to be a disease of deficiency, as opposed to excess (a lot of people who get afib are either heavy drinkers, extreme exercisers, excess weight, older in age, etc.). As expected, ALL of my hormones were out of whack. Once my thyroid problems, adrenal problems, etc. were under control, the afib disappeared.
I had a partial hysterectomy in March, and I've had some brief afib runs since then. I was estrogen dominant with an enormous fibroid - even though they left my ovaries, I still had tons of hot flashes just from the estrogen depletion. That settled down, and then in July I was dx with breast cancer! I will be doing tamoxifen, and given how much that messes with hormones, I expect I'll be experiencing afib once again. Actually, I haven't even started tamoxifen yet, but had my first real episode of afib in 7 years this week - I think with the "reset" from my hyster, my thyroid hormone doses are probably too high and I'm all out of whack again.
Some traditional cardiologists recognize that hormone imbalances can contribute to afib, so it might be worth asking to be tested! I hope it settles - afib is no fun - especially if you are symptomatic, as I am. I can hardly breathe, get weak and dizzy, my legs go numb, etc. It's incapacitating. Other people don't even know they have it, which is scarier as the risk of blood clots goes up significantly if you're out of rhythm for a long time.
Good luck!
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When I met my Medical Oncologist, he listened to my heart and insisted I have an EKG that day. I ended up in the emergency room where I learned that I was going in and out of afib with rapid ventricular rate all day long. I had no symptoms at all. Just a couple of months ago, I was a perfectly normal, 57 year old with a healthy lifestyle. Then I found a lump and it's been downhill ever since. Now I have IDC and afib with rvr. Very frustrating. I joined a Stress Reduction class where it was stated that 70-90% of doctor's visits are caused by stress. That's what I think caused the afib for me. I felt like I was having a panic attack when the MO gave me one piece of bad news after another and it just kept piling up. I'm trying to look at the afib discovery as a blessing in disguise. At least now I know about it and I'm taking a beta blocker for it. Today I went to the planning session for radiation. I'm surprised by how demoralized I feel right now with tattoos and black marks all over my body.
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I was diagnosed with paroxysmal afib right after I was told I had breast cancer at the age of 48. This was before I had surgery or radiation, so it was not caused by radiation in my case. My triggers seem to be stress and not enough sleep. My afib is highly symptomatic so I know exactly when it starts and ends. Because of my young age and the fact that my episodes are fairly infrequent, I only take aspirin to thin my blood. And I take a beta blocker for heart rate control. Over the last two years, I've had more frequent episodes, so I take my beta blocker morning and night and my aspirin dose has been increased from a baby aspirin to a regular aspirin daily. Now I also carry propafenone tablets with me to take when the afib starts; it's called "pill-in-the-pocket."
jlbestmcg - I've been told that those of us who have symptomatic afib are the lucky ones, because we're aware of it and can be treated. Maybe it was a blessing in disguise.
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I developed A fib during AC chemo. So I immediately dropped all caffeine, added OTC potassium and magnesium to my Mediterranean diet. Now I am doing very well. I only have A fib once in a while and a nap will take care of it so far. I am facing radiation next after 4 ACs and 6 Taxols. I hope to continue what I am doing and it will keep my heart steady.
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All: I can't thank you enough for your kind, informative replies and for sharing how you handle....they really help keep things in perspective. It seems that peoples' experiences of afib, and treatments, can vary widely.
Am doing okay since paroxysmal afib episode two weeks ago...taking the beta blocker and Eliquis, having only a little very-low-caffeine coffee, no alcohol, staying hydrated, getting enough rest, and doing a 4-7-8 relaxing breathing exercise. Am going to see the cardiologist a week from today. Not sure if she will keep me on one or both meds, since I am otherwise very healthy/have no cardiac problems.
If I had to bet, I think intense anxiety and dehydration probably brought this on (they also said my potassium was low). And maybe the estrogen depletion from anastrozole? Should I ask my oncologist about this when I see her? Does the body normally adjust in time to the much lower estrogen level?
I can see that, after BC dx and treatment, and an otherwise very stressful last winter, I have just been emotionally overheated and wound up. Unexpectedly, though I'd read that many of us struggle with anxiety after treatment ends, it has hit me super hard...I am afraid of EVERYTHING and am catastrophizing! LOL. Am hoping that the intensity of the anxiety and fear will naturally subside.
Am consciously slowing down (I eat, talk, walk, and do almost everything too fast and hard) and reminding myself that almost nothing is really urgent.
And as you say, maybe knowing about afib is a blessing in disguise, and real impetus for good self-care and calming down.
Will post again after seeing doctor. Thanks again so much to all for insight and tips....have a relaxing day.
jlbestmcg -- I think you are right about stress. I know that different phases of this are discouraging, including the tatoos. I so get it and am with you.
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"I felt like I was having a panic attack when the MO gave me one piece of bad news after another and it just kept piling up"
This happened to me as well. I've had anxiety issues and been taking Atavin for a while due to lots of stress in my life even before BC. And then BC, and the emotional roller coaster of tests and waiting for those results I went thru before surgery, I started having actual panic attacks.
My treatment has involved the machine doing a sideways dance. I lie on my back with my left arm over my head, and it radiates my left breast from the left side. Then rotates over me and radiates the breast from my right side. The Dr told me this reduces the chance of side effects on my heart or lungs. Hope he's right.
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sorry to hear this & hoping all goes well for you with your cardio appointment. I developed afib 6 years after left sided radiation. The cause of mine is from a damaged mitral valve, likely caused by radiation. I need to have the valve repaired or replaced soon- I have what is called severe mitral regurgitation, untreated it can cause heart failure. Like you I don't fit the typical pattern for Afib- I am in good physical condition, fit, low blood pressure- it's a long term side effect from my treatment. Hoping the best for you:)
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This August I had 20 rads (the shorter version nowadays) in the Prone position to my left breast. You basically lie on your stomach and only the breast gets the rads.They say the prone position reduces the chances or rads going near the heart. Radiation onco told me there is VERY little chance of heart damage. I hope he is right, who knows.I also hope that every year the medical field of radiation oncology improves and keeps us living BC free.
Did you have rads in the prone position?
Wish you the best!
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Welcome to you TimeForCure, We are glad that you shared your story and hope you will stay connected here. Keep posting and let us know how you are. The MOds
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I had 35-40 radiation sessions, lying on my back. I have read that they have improved the methods of delivering radiation, a good thing. Heart damage is not a common side effect, but it can happen
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you betcha. one of my favorite fb friends after. soon after such a session his heart failed and he was just able to pull over to the side of the road before he died. miss you john.
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I developed AFib after treatment but was thinking it might have been caused by herceptin. None of the heart tests I had during or after chemo showed a problem. Maybe it was the radiation or just an age thing.
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Time: Thanks for your reply...I was face up. And radiation was on the right. Maybe will never know what has caused it? Will just take the best care of myself possible and do my best to adjust and not ruminate. Will post again after doc appointment.
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All: Saw cardiologist today...she was wonderful. She took me off the prescription anticoagulant and advised low-dose aspirin once daily; my stroke risk is apparently very low. I will continue taking the beta blocker for now, as I am very anxious.
She said another episode could happen, or it might not...that my heart is otherwise healthy, I am young, and they'd rather go with the "pill in the pocket" approach rather than maintain on meds. They said if episodes become more frequent, I could carry a rhythm control drug and prescription anticoagulant and take as needed. Hope to not need.
She also said that treating the anxiety with a medicine might not be a bad idea. Will think this over. Would rather not go down that road if I can avoid.
Did lots of chores today and will now sit down with a good book while my hubby visits his father. Wishing everyone a relaxing evening.
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jenn32214,
That is how the radiation machine does mine -the nurse and Dr. told me that it by-passes my heart this way but a very tiny part of my lung will be scarred. If I ever need a lung x-ray, I need to tell them that I had left side radiation. I, too, hope that what I am being told is correct because I am anxious about my heart getting damage.
Celand
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