AF Association

Paroxysmal AF patients have as much stroke risk as persistent AF patients.

Hi all,

I follow the American cardiologist Dr John M on social media, and in a recent post he states that Paroxysmal AF patients have as much risk of stroke as persistent AF patients.

Does this not mean that all AF patients should be on anticoagulation therapy?

Full article: drjohnm.org/2014/08/two-af-...

Romeo

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Basically yes if they have any other risk factors such as age. gender, high blood pressure (even if treated) or prior stroke. It is also interesting to understand that ablation, stopping the AF ,does not remove the risk due to changes in the atria which may allow blood to pool or eddy.

Many people assume that successful ablation removes all risks but sadly it does not according to the experts I have spoke with.

Bob

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Hi Bob interesting to hear your views on Stroke risk post Ablation my EP Dr.Mathew Wright informed me that Ablation removes the risk of a Stroke once in NSR.of course one could have a Stroke for other reasons. I work in health care and will seek other information on this and think I will continue to take Riveroxaban as my Chad score is 3. I am now 13 days post Ablation which took 7 hours under GA. I am pleased to report so far so good I have had several ectopics which is pretty normal for me but it has been great to not have AF. for 13 days keep up the good work Bob best wishes Hazel

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As usual experts seldom agree! In the end we all have to take a view on these things.

Bob

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Bob's right. I woote to my EP, Prof Richard Schilling (one of the country's top EPs), a few weeks ago on this very point. I had an ablation with him 4 years ago which was successful. With a CHADSVASC score of 2 he suggested I remain on warfarin. The evidence to stop is not strong enough currently.

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Thanks for that Mark, that is what Richard told me too.

Bob

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Hi Hazel. How do you find Rivaroxaban? I'm on warfarin, but if I have to be anti-coaged for life, I'd actually prefer one that doesn't interfere with food. I'm due to see my EP 5 months post ablation on October 22nd, so I've a while to go yet. I've no idea whether I'll be advised to carry on with anticoags or not (my EP is Prof Gill from St Thomas's). Trouble is my GP won't prescribe anything other than warfarin at the moment.

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Hi Therealsue Riveroxaban is the only anticoagulant that I have been on for AF.although many years ago I was on warfarin after a leg injury which I found so time consuming and restrictive. I have been on my present anticoag for about 4 months and I don't feel any side affects to date ,warfarin I understand thins the blood but riveroxaban stops clots forming the only draw back if you were to have a major bleed with warfarin you would be given vitamin K but with the new class of anticoags there is no antidote although I understand there will be in the near future, I am 2 weeks post ablation and dare I say it no AF. I will probably have to stay on anticoags but will be guided by my EP.heres hoping life can get back to some form of normality and my good recovery continues best wishes to you Hazel

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Thanks Hazel :) and all the very best with your recovery. Sue.

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Hi Therealsue, my EP is Prof. Gill as well. At the 5 month post ablation follow I did not see Prof.Gill but one of his team, so assume the message would have been the same - I was warned against stopping anticoagulants as the risk of stroke remains. I am female and over 65, but fit and with no other health problems.

Hope you are recovering well and feeling good.

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Hello Porridgequeen. Thank you for that. Were you on warfarin before your ablation too?

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Yes I was on warfarin and had a devil of a job keeping in range for the 4 weeks before the ablation. I lost a few weeks but St Thomas's admissions were wonderful and slotted me in with a week's notice as soon as I was stable. Couldn't praise Prof. Gill, his team and the ward staff enough for their care and attention.

Hope you are feeling better every day.

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Thanks again Porridgequeen. The prof didn't have me on any drugs prior to the warfarin in preparation for ablation. I just think he's wonderful and whatever he advises re: anticoags, I'll do. I really don't like the dietary restrictions of warfarin though but my GP won't prescribe rivaroxaban. I hope you continue to be well. Sorry just realised I'm repeating myself re: GP and NOACs. It just shows you what I spend most of my time thinking about!

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It's interesting to rad Dr John M's comments on the heart~mind connection too.

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As evidenced in many of my posts, I am a huge fan of Dr. John M and one of my favorite quotes of his is "I think AF occurs when homeostasis of the mind, body or soul is disturbed", which is exactly the same mantra of my EP when he says "your AF is a manifestation of your global health" Amen to that. My journey has been all about restoring homeostasis and going back to where my body was before the factors that caused my tipping point into AF. That said, I am going to be on an anticoagulant!

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hi romeo,speaking from recent experience.... I have paroxysmal af for now. was only on statin,bisoprolol,aspirin.in april I had a stroke! now this coagulation scenario did come up with my chats with the cardiologist and explained that the af was becoming more severe right up to the stroke and and why was I not given anticoags.........the answer I was given was it was done on the balance of probability. you wouldn't believe whats in my cupboard now,good luck.

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