Warfarin advice

I had an AF episode that I was totally unaware of whilst having a knee op ,I have never had any AF before or since last week I had an ECG, a 24hr Holter and an Ultrasound all came back normal with no problems whatsoever I was put on warfarin after the AF episode because they said i should have a cardioversion if the heart was still in AF which I'm told I no longer need..as I am not seeing the specialist until March 2015 why am I still on high dosage of warfarin my warfarin nurse has told me until she is told otherwise she is trying to achieve the 2.5-3.5 level,...my question is whether I need to stay on warfarin as I may never have another AF episode again...I feel unwell on my dosage and I feel I am taking a powerful drug just in case of an episode of AF that may never ever happen... I am 58 don't smoke/drink and not overweight and healthy apart from the warfarin..

9 Replies

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  • The dose of warfarin is not relevant, only the INR. You can always stop warfarin but you can't undo a stroke. You do the maths and make you own mind up . It is quite possible for people to have events they are not aware of by the way.

    Bob

  • I agree with Bob think carefully read about the condition dont rush

    into anything. I wore a 24 hour holter which picked up nothing, wore

    one for 7 days which picked up prolonged episodes and episodes I

    was unaware of.

  • I agree with Bob think carefully read about the condition dont rush

    into anything. I wore a 24 hour holter which picked up nothing, wore

    one for 7 days which picked up prolonged episodes and episodes I

    was unaware of.

  • After my 1st Cardioversion I was started on aspirin. It was only after my 3rd I was warfarnised. I've always been told that AF is not a critical heart condition but it is a mega stroke risk.

    Knowing what I know, despite the diet and lifestyle changes - I'd rather be on the warfarin than nothing.

  • I agree with the comments above- Our anti coagulant clinic aims for an INR between 2-3 for AF- I know the aim is higher if one has other health issues, but if not I think it's normally 2-3

  • G'day Steve,

    Of course its your call, do what you want. Sad to say though, and I wish I could be more comforting, but at some point your AF will return, and who knows the next one could generate a stroke.

    I'm one of those who can be in AF and not know it, just like BobD says ! However, I'm now reasonably confident I have my AF under control through a combination of meds and diet .... but I don't trust this mongrel of a condition and I'd never claim to be cured because it could hit me again any time.

    Good luck.

    John

  • There's an air of disbelief about your post, and I think there are many of us on the forum who have lived healthily and didn't expect to have something wrong with the heart and find if hard to accept at first. It's the heart's electrics that are up the creek with AF, not the heart itself, although AF tends to make the left atrium enlarge. Unfortunately once the electrical system has discovered that it can cause chaos, it tends to do so more and more, although in between, ECGs etc appear to be normal. Your AF is almost certainly going to happen again and get more frequent. It may take a long time for it to do that, but you are already at risk of a stroke, hence the warfarin. There are alternative anticoagulants and there's loads of information for you to look at here. But we have all hoped that our first brush with AF would be a one off and it doesn't usually work like that. You don't mention if your appointment with a specialist next year is to see a cardiologist or an electrophysiologist (EP). You can always make a private appointment with an EP and swiftly gain a fuller understanding of your situation and the ways forward.

  • Well, I'm 57 and on 8mg of warfarin a day - everyone is individual and it takes more to get some people into the range they want than others... It's not the dose but the result that counts. I went two years between my first AF episode and the second, but they've been more frequent since then. Never count your chickens, I say...

    Lis

  • Many thanks for all of your advice..my main gripe is a total lack of information..I have had all the tests etc and then have to wait nearly 6 months to hear the results..it seems pretty pointless wearing a 24hr holter if the Paf can come and go as it pleases without me even knowing..so I guess it's stick with the warfarin on ever increasing dosage until I see the main man again again who will spare me 2 minutes of his precious time...

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