If the Bisoprolol is keeping AF under control Do I need Warfrin

[saralee21]

Hi, I was diagnosed with AF at the end of August following prolonged daily events over a number of weeks. Now that I seem settled on Bisoprolol 2.5mg split into 2 doses of 1.25mg and have had no further full blown episodes in the last couple of weeks (fingers and toes crossed). I am wondering if I need anticoagulation or not? If the prolonged periods of AF have settled with the betablockers is it still necessary I wonder?

Following diagnosis I was referred to the anticoagulation service who assessed my score as 2 possibly 3 because of a previous brain haemorrhage and induced stroke due to a further bleed during surgery at which point the internal carotid was embolised, but they where really not sure what to do, so they referred my case to the haematologists and I have not heard anything since.

I am now wondering if this is something I should chase up. Everybody seems so unsure as to what would be the best thing to do, including me.

You have all been so supportive and I would love to hear your thoughts. Thank You x

[jennydog]

You will receive lots of responses to your post and they will all echo what I am going to write. Do NOT think of stopping the warfarin, or other anticoagulant EVER.

[BobD Volunteer]

OK I would normally agree with jennydog but your case is a little different. Since you have had a haemorrhagic stroke in the past you don't fall easily into any one slot. In addition to Chadsvasc (score 2/3) you also need to include the HASBLED risk score which may say no anticoagulant. I'm no expert so I would go with what the specialists say . Not having AF does NOT remove the risk so as I said normally I would say you should be on warfarin or similar for life regardless of your frequency of events but the bleed risk also needs to be considered. Whilst many in the world of arrhythmia would like to say that AF needs anticoagulation regardless of Chads etc out of every 10,000 patients on it some will die from bleeds rather than thrombotic stroke so it really isn't a simple formula. To put it simply, you can be run over by a bus, have a bleed stoke or have a clot stroke or you could live to be a ripe old age. Nobody knows!

All that said I would not let sleeping haematologists lie in your shoes. Why not drop a line to them with copy to your GP asking what decision they have come to.

Bob

[saralee21 in reply to BobD]

Thank you for your replies. Bob, I will make contact with the anticoagulation service and see if they have come to a decision. I will also look up the HASBLED risk score. I have seen a cardiologist and he seemed a bit unsure too, being proactive in this seems to be what I am learning.

[Hidden]

No disrespect to Jennydog, because that's the type of response most of us would make.......Bob earns his stripes again!

John

[BobD Volunteer]

Sorry John --Don't have stripes any more I have stars. LOL

Bob