Looks like permanent AF

Thank you for this wonderful website and the tremendously helpful information available from so many people. I have learned so much about this condition that I could not have found otherwise.

I am an almost 83 year old male who has had Paroxysmal AF for eleven years. But the latest episode has been going for several weeks. I am on 10 mg Bisoprolol (previously on Atenolol 100 mg) and currently 5 mg Warfarin daily. B/P is normal and resting pulse rate below 70. The condition does not prevent normal activities, but I do have to take uphill walking a bit slower. my feeling at present is that I can live with it. I am also a carer for my wife. My INR was steady on 2.1 but has slipped down to 1.8; is this because of the irregular pulse, does anyone know? Another blood test due on 19 Feb may show an improvement, otherwise I suppose the Warfarin dose will be slightly increased again.

Grateful thanks for any replies.

Tony.

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Hi Tony, I have a permanent arrhythmia but it is controlled by drugs and I get very few symptoms. We had to try 4 or 5 drugs to get the one that worked on me. Now got a steady, normal pulse. Just wondered if you have seen a cardio/EP and tried other drugs or just been put on Bisoprolol?

Koll

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Thank you, Koll.

Saw a cardiologist last November, following a 10 or 11 day episode, the longest that far. After discussing the results of a 24-hour ECG and an echocardiography scan I expressed myself as satisfied with the current drug and anti-coag. treatment. I was offered Amiodarone, but did not fancy the possible (and some certain) side effects! I have been on Bisoprolol since November 2013.

I have an appointment with my GP on 24 Feb.

Thanks for your interest.

Tony.

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INR is primarily determined by the level of your warfarin dose but it can be affected by a range of items in your diet. But being in AF with an irregular pulse would not affect it. You say you are having another blood test on the 19th. Does that follow an increase in dosage? You certainly should have been increased with an INR of 1.8. I found there was too much 'suck it and see' in our warfarin clinics leading to unnecessary delays in dosage change rather than taking positive action as soon as it was needed.

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Thank you for clearing that point up for me. I have made no changes to my diet since first starting on Warfarin, which is why I wondered if the AF episode (still continuing) affected the INR level.

I was on 4x5mg and 3x4mg Warfarin for some time with INR at 2.1. Then I missed one day's dose of 5mg, and reported it at blood test; INR had dropped to 1.5. Dosage increased to 6x5mg and 1x4mg. Blood test one week later (5 Feb) gave INR as 1.8; dosage increased to 7x5mg.

I am sure that your comment is valid, but I think the local clinic is being cautious -- combined with the fact that they are short staffed.

Thanks again for your clarification.

Tony