Stroke worry!

[Kaiser78]

Both my gp & my cardiologist have told me to stop taking warfin since it's now nearly 5mths since my ablation, but I'm still getting af episodes every other night ranging between 5-60min, I'm otherwise really healthy and 36, but I'm worried about having a stroke!

[Rellim296]

You've two issues here, surely.

You are the one who has to live (or exist or not live) with the consequences of a stroke, so if you have concerns you surely should not feel pressured to stop an anticoagulant. Strokes can happen to young people too.

Secondly, are your AF episodes being looked at with 48 hour monitor? Might a second ablation improve the situation?

[Kaiser78 in reply to Rellim296]

I've to get a ECG 24hr tape in September, my current episodes are not as bad as before my ablation but more frequent , which was my second, I got nearly 7yrs free of af with my 1st ablation

[Rellim296 in reply to Kaiser78]

All of that sounds good, except the return of AF! I'd point out that you have AF every other night and try for longer monitoring.

[BobD Volunteer]

The point is do you have any other risk factors? If your CHADSVASC score is zero then there is little to gain from taking wafarin under current guidelines as your risk of bleeds outweighs the stroke risk but if your score is even 1 then it is up to you if you carry on taking it.

I agree that you should continue your quest to get rid of AF even by a second or third ablation.

Bob

[Kaiser78 in reply to BobD]

Hi bob, my score is 0, it said I should take 325mg of aspirin but I've read you guys saying that's no good for af?

[BobD Volunteer in reply to Kaiser78]

Aspirin has been discredited for primary stroke prevention and is no longer recommended in UK. It can cause just as many bleed problems (gastro intestinal) as warfarin with none of the benefits. It does have some uses in cardiac care , just not stroke prevention.

Bob

[AnticoagulateNow in reply to BobD]

I can't agree with your comments about risk factors Bob. You know that the risk of bleeding in an otherwise healthy 36 year old with a well managed warfarin regime is significantly less than the risk of stroke without anticoagulation. This demonstrates the nonsense of CHADSVASC guidelines which, quite wrongly, tell us that a score of 0 or 1 means we don't need anticoagulant. That's just not true for most people. Even with a CHADS score of zero, we are five times more likely to have a stroke than someone without AF. That risk, for someone with no particular propensity to bleeds, is totally unacceptable.

Kaiser 78, you are right to be concerned.

[BobD Volunteer in reply to AnticoagulateNow]

I understand your point but the problem is that since even the latest NICE guidelines do not change the position and in fact as the PDAs made available to allow patients to make informed choices major as much on HASBLED as on CHADSVASC it is going to be very difficult to persuade any doctor to prescribe anticoagulants to an other wise healthy young person. Your opinions are just not reflected by current guidelines sadly. Many of us were very sad that the new guidelines and CARE AF website did not just decree AF-- give anticoagulants - but it didn't, so your energy should be directed to the powers that be. You are already preaching to the converted here.

[AnticoagulateNow in reply to BobD]

Many do understand that Bob but clearly, from the posts on this forum, many more do not. And CHADS is largely responsible for that misdirection. My own experience has shown me that you sometimes have to 'persuade' reluctant medical practitioners to give you anticoagulants, and through this forum, afibbers should be advised to do just that.

If, at the end of a consultation, a patient simply accepts the misguided assurance that "You will be fine without anticoagulants" then that patient is taking a significant risk. It should be made perfectly clear to the cardiologist that you, and importantly your dependants, are terrified of the stroke risk should he/she "insist that you remain unprotected."

"How on earth would my family cope without me?"

An appointment at the warfarin clinic is now being arranged as you speak.... but, in the unlikely event, it doesn't work then your medic is even more of a dumb ass than you first thought and it's definitely time for a new one!

Of course, there may be compelling medical reasons why some patients can't take anticoagulants but unless those reasons are clearly conveyed to the patient, then they should dig their heels in. So much depends on it.......

[BobD Volunteer in reply to AnticoagulateNow]

No argument from me

[feejbee]

I had an ablation 15 months ago for AF , Atrial Tachycardia and Flutter.It has been amazing and seems to have worked but and this is a big BUT it can come back at anytime (and my understanding is ,that not everybody is aware that it's going on) therefore so can the stroke risk.I was one of the unlucky ones that almost as soon as I developed AF I had a TIA and then a stroke.

As you are still having episodes of AF ?There is no way anyone would convince me to stop an anti coagulant even if supposedly I'm "cured"

Fi

[Kaiser78]

Im not aware of having a chad score?? Sorry haven't heard of this? They told me I'm too young & healthy for permanent warfin!