Be still my beating heart...AC-TH and arrhythmia

Pinay88 · 01-06-2012, 06:55 PM

Hello everyone,

Firstly, continued blessings to all in the new year!

It has been a while since my last log in...quite preoccupied with the TH part of my treatment. My 3rd cycle with TH though did not happen january 6. Early on even with AC, I had infrequent and fleeting palpitations. My cardiac dopplers have always been normal. However, prior to Jan 6, I had more insistent palpitations which prompted an EKG that showed Premature Ventricular Contractions in bigeminy. I am on bed rest now and prescribed diltiazem to still my erratically beating heart. I have no other systemic symptoms..thank you God for that =) Best part, though I am on bed rest, I still have toilet privileges...woo-hoo!! I am due to see my cardiologist again on the 9th and praying for sinus rhythm so I can get going with TH again (just two more to go before it is just vitamin H solo).

Just a shout out please, does this cardiac side effect happen often? Anyone else with experiences to share? I just feel kind of singled out...I asked my onc and the cardiologist if they've seen other patients like me on the same chemo cocktail (with herceptin) to have had this, and I've been told that I am the first....granted that in my neck of the woods (I am in the Philippines) not a lot of patients can afford the cost of treatment. So, I also need to pacify my erstwhile troubled mind. Thanks much in advance for all your input and words of experience...

Becky · 01-06-2012, 08:58 PM

Heart problems can occur with adriamycin - less than 10% of those receiving it can get heart pumping problems up to 8 years afterwards although most occur straight upfront.

With Herceptin, about 4% of women can experience problems and for the most part, it is reversible after Herceptin is stopped. Then you can go back on (and perhaps have to stop again). So it really depends on what really caused this to happen to you, adriamycin or Herceptin or a combo of both perhaps.

Although I finished my Herceptin, I did have reduced function by the end but not drastically so. I started at 65% and ended at 51% - still above the desired 50% and not quite a 15% reduction which is a criteria for "giving Herceptin a break for awhile".

From my cancer center I did meet a woman who had problems from adriamycin (she was not Her2 so they know it wasn't from Herceptin) but she was in a trial that combined Avastin with the Taxol so they will never know 100% that it was adriamycin.

Hang in there. Rest up and see what happens. We are here for you.

Ellie F · 01-07-2012, 04:46 AM

Hi
Just wanted to chime in to say a colleague of mine ended up in intensive care with cardiac problems post adriamycin. it took a bit of time but she recovered well and 9 years later is still around and very well.
Ellie

Pinay88 · 01-07-2012, 03:16 PM

Hi Becky,
Thanks for your reply.
I knew of the potential cardiotoxicity and just digesting the fact that I am now part of that percentage to experience this side effect. Another hiccup in this journey but I do believe that I'll get through this one yet.
Hi Ellie,
It definitely encourages and boosts morale to hear positive stories...endorphins abound =) thank you for that.

Will definitely keep you all updated on this.

NEDenise · 01-09-2012, 06:56 AM

Donna,
I'm on a herceptin holiday right now as well. I'm sorry you're having trouble too, but I have to admit...it helps to know I'm not alone.

My ejection fraction has gone from 65% to 45% since starting this adventure.
I had adriamycin too...but I'm hoping my reduced function is the temporary kind from the Herceptin...and NOT the more permanent kind from Adriamycin.

I haven't had palpitations (which is weird because I DID have them pre-BC!?!!) but I am soooooo tired. Not sleepy...just worn out...all the time. My cardiologist prescribed an ACE inhibitor, and I see her again on Thursday for tests.

I'll say special prayers for both our hearts! Rest up! I hope you're feeling better soon!
Denise

Pinay88 · 01-21-2012, 12:09 AM

Hi Denise,

I take solace in the fact too that I am not alone in this 'cardiac' experience.

My Ejection Fraction on the echo was 60% from a baseline 65% but I do have arrhythmia documented by a 24 hour holter study so I am maintained right now on a drug called bisoprolol which is doing pretty good work of containing my palpitations. I am currently on herceptin holiday but just had taxotere number 3 and that leaves one more dose and then, that is done! I am smiling as I type this tidbit...have to celebrate our victories =)

I pray too that it is a reversible herceptin effect rather than that of adriamycin. I have to say though that since the 'holiday' , I haven't felt as winded as I did before with my two prior sessions of T and H combined.

I hope you are doing well and the tiredness easing off. I'll definitely keep you in my thoughts and prayers. We'll both see the end of this through.

JennyB · 01-21-2012, 02:35 AM

Donna,

I too am on a Herceptin holiday due to low EF so you really are not alone at all. I posted the other day on the Herceptin/Tykerb page under decreased heart function title and plenty of ladies responded with good ideas to help me strengthen my heart.

I wish you well

Jenny xx

02-27-2012, 02:34 AM

Hi Hanna,You are going tgoruhh the normal anxieties and fear associated with a medical diagnosis. You have a little information. You know what they say, Having a little information can be more harmful than having no information. I have been a nurse since 1972, Registered since 1975 and never had a anyone under 35 years die with this condition. Your concerns are legitimate. Fear of the unknown is real fear.These are facts to me. I am still a Registered Nurse. Remember, you are not even diagnosed yet. Do you think your doctor would put your life at risk. If something happens to you he/she will lose the right to practise. He/she would not take such a risk.I your doctor felt that you were high risk he/she would have called the ambulance and sent you to the doctor there and then.Finally, many people live with heart arrhythmias all their lives and eventually die of old age.I hope I have answered your question? You are not at high risk.

sarah · 02-27-2012, 05:57 AM

well you're not alone, I have a "blocked" artery due to radiation. I have to have angioplasty and a stent put in. My brother has been told he has aryhymic heart (never had cancer) and was told it could be adjusted with electric shocks!!! sounds radical to me but...
side effects can be tough, hang in there, there are solutions
health and happiness
sarah

rhondalea · 02-27-2012, 06:30 AM

I also had AC->TH. What I experienced is that chemo does some really whacky things to my thyroid hormone levels.

I have always been a big fan of blaming the thyroid for everything that goes wrong (and indeed, I blame it for my cancer), but even if that's a little over the top, the thyroid does affect every single system in the body.

I remember having some intermittent heart blips during chemo--a few episodes of racing and palpitations--but I paid little attention to them, because I've had them before when my thyroid levels have been either too high or too low. My LVEF remained stable and my EKG and every other test I was given (except the thyroid) were normal.

It seems that even those without preexisting thyroid problems often go on to have them during/after a major illness, so you might want to consider asking for a thyroid panel just to rule it out as a cause. If it turns out to be the cause, then you've saved yourself a whole lot of unnecessary treatment. (Just be sure that they check everything, because TSH (which is a pituitary hormone) can be within the normal range even if your actual thyroid hormones are out of line.)

I can only imagine that it must be crazy-making for you to be confined to bed, so I hope you have a resolution for this soon.