In 2015 I was diagnosed with atrial fibrillation. It was completely unexpected because I considered myself to be in good health and presumed I was "protecting" my heart with thirty years of running marathons and other cardio workouts.

Without boring you with the details I've received superb care from one of the best cardiologists in the area. Between changes in my diet, lifestyle, medication and a procedure called catheter ablation my heart has been in normal sinus rhythm since the procedure and my prognosis is excellent.

I would very much like to commence hormone replacement therapy under the care of an endocrinologist and my primary care physician if my cardiologist believes that I can do this with minimal risk of the AF to reoccurring because of changes in my body chemistry. I'm well aware of the risks already associated with HRT without cardiac history but have been unable to find any studies correlating HRT usage and the reoccurrence of AF in either genetic or transgendered women. Aside from the history of AF my heart is otherwise heathy. My ecocardiogram and stress tests were well within normal limits and without signs of blockage or coronary artery disease.

For someone that was quite healthy for my first 57 years the past 2 years have been quite a wake up call. Each morning I stand out on my back deck with my coffee and thank the gods for each moment and all that I have been given. I've listened to my physicians and indebted to them for their efforts and will continue to heed their instructions. All that said, has anyone else travelled down this path before me? Surely someone else with a history of AF or other heart arrhythmia has commenced HRT with the approval of their physicians. I'd greatly appreciated any positive feedback or links to the results of clinical studies on this topic. I'd like to be as well informed as possible when I discuss this with my physicians. Thanks!

Melissa

I have a type of atrial fibrillation called PSVT (paroxysmal supra-ventricular tachycardia).  It doesn't sound like what you have, so perhaps my comments are not relevant, but perhaps they might be useful.

Occasionally, for no apparent reason, my heart will go do some extra beats.  It doesn't usually last for more than a few seconds.  If it does, I can usually reset it with a bit of light pressure on a carotid artery.  And a couple of times, it has gone into tachycardia lasting 15-20 minutes.  It hasn't become annoying enough to require treatment yet.

My HRT doctor knows about it and is not concerned.  My lower blood pressure due to spiro does not seem to affect it, and the few times it has happened since starting HRT have not been any worse than before.

I keep in good shape and have lost about ten pounds since I started this journey.  I walk the dog for about an hour every day (every @#$% day!!) at a brisk pace, which helps with my overall cardio health.

I a 55 and have been on HRT for about 10 months. I had AF secondary to a PE, (blood clot in lung), and nearly died in 2013. My doctor was concerned, of course, and started HRT slowly. I have had no issues whatsoever and am much happier today. I did resolve the AF and was off blood thinners and heart medication for a couple of years prior to starting HRT though. My understanding is that HRT should not affect the AF itself, but if AF is uncontrolled can make the clotting issue worse. I am taking some risk though because my mother and grandmother both had breast cancer. I discussed the risks with my doctor and she agreed it was better than living miserable as I was. For me the health risks were worth the payoff.

A few things:

First, atrial fibrillation and PSVT are different pathologies, carry different risks, and are treated in different matters.

Second, since you (Melissa) have clearly done your homework, you know that HRT is not known to cause recurrent Afib.  Of course recurrence is possible after ablation, but you have had an excellent result so far, remaining in an normal sinus rhythm.  There is every reason to hope that the treatment was curative in your case.

If AF recurs, HRT may complicate the situation by slightly increasing the risk of thrombosis (clot) to the legs or the lungs.  Nevertheless, you would almost certainly be anti coagulated for the AF at that point, so I don't tend to think this would disqualify you for HRT.

Quote from: rmaddy on November 12, 2017, 12:12:05 PM
A few things:

First, atrial fibrillation and PSVT are different pathologies, carry different risks, and are treated in different matters.

Second, since you (Melissa) have clearly done your homework, you know that HRT is not known to cause recurrent Afib.  Of course recurrence is possible after ablation, but you have had an excellent result so far, remaining in an normal sinus rhythm.  There is every reason to hope that the treatment was curative in your case.

If AF recurs, HRT may complicate the situation by slightly increasing the risk of thrombosis (clot) to the legs or the lungs.  Nevertheless, you would almost certainly be anti coagulated for the AF at that point, so I don't tend to think this would disqualify you for HRT.

Kathy, Wanda and rmaddy,
Thank so much for your feedback. I really appreciate your insight and knowledge as it helps ease some of the concerns that I have on taking this most positive step in my transition.  I'm going to proceed with the endocrinology appointment and keep my cardiologist, primary care physician and counselor in the loop and see where it takes me.  Thanks again!

Melissa