AF Association
13,271 members16,143 posts


Rosyg has raised the issue of anticoagulants and when they should be prescribed. I wondered if everyone on here had a firm diagnosis before warfarin or NOAC was prescribed. I was pretty sure that I had AF and so was my GP but took about 8 months before this was confirmed by ECG and during that time I did feel very vulnerable. Assuming that the person would be prescribed anticoagulants if there was a firm diagnosis, is there an argument for earlier anticoagulants "just in case" or would this be too dangerous?

5 Replies

It is a balance as I have said many time between the risk of stroke and that of a bleed. CHADSVASC only applies when you have a diagnosis of AF which as we know raises your stroke risk by a factor of five. Prescribing anticoagulants "on the off chance" would most likely result in a greater number of serious bleeds than prevented strokes so one needs to be pretty sure.


After emergency admission to C Care, I was prescribed Apixaban by a hospital cardiologist on the strength of a copy of my GP's ECG which caught the end of an episode of PAF. It took another 5 months for it to be caught again by a holter monitor and full diagnosis followed. In those 5 months I had around 40 episodes of arrhythmia, so I'm grateful to have had such good early care.


Balance is required, but it is truly frightening how long it took from my first of many episodes until prescribed NOAC. Even after hospital admission and ecg confirmation, my then cardiologist was practicing in the dark ages saying, "Well, you have only had one confirmed episode, so medication and anti-coagulant are optional." So fortunate to hear of an afib specialist in my city and receive proper treatment.


Im 55 and was blue lighted to hospital twice with rapid heart beat and breathlessness. First in early june when I had numerous ECG's and heart scan, then told I had an arrythmea and had to take away nd wear a heart monitor for a week. Was told to take a beta blocker as a pip if needed but never needed to. Then early july I was blue lighted again with more aggressive and prolonged rapid heart beats nd breathlessness with rib tenderness, and kept in for 24 hours given intrevenous chemicals to slow heart rate of up to 185 bpm. I was then told I had AF and the associated risks and given bisoprolol to take everyday and sent home.

Its now nearly end of September and ive seen my doctor once scince then because I was in shock, anxious and scared. The doctor felt my pulse, said I was in NSR and asymptomatic even though i felt light headed, breathless and kept getting strong rapid beats now and then which was scaring the life out of me but anticoagulants were never mentioned...only betablockers.

I received an appointment to see a cardiologist Oct 5th but in the past months have never been told I needed to be on anticoagulants. Ive had AF episodes but were controlled by the beta blocker.

I expect ive been at risk!



I am sure you have seen the many posts on here about when it is considered you should be on anticoagulants. You are fairly young and if no other issues your doctors may take the view that you do not need them. Other doctors recommend taking them - but there are risks either way. So read everything, look up your chadsvasc scores etc and have an informed discussion when you meet your cardiologist. Check also that this cardiologist is an EP as they are the specialists in arrhythmias.

Try not to worry (easy to say) but it does get easier as you learn more about it.

Good luck 🍀 on 5th. Marie


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