Anti-coags?

[Kbuck1234]

Hi all,

Wanted to get views on this. Had AF once and CHADSVASC of 1 which is for high blood pressure which I monitor weekly and take meds for and is now always below 120/80 , or thereabouts. Age 48.

Prof. Schilling was on the fence about this.

Thanks

[Barry24]

Hi Kbuck1234,

Prof Schilling, as you are no doubt aware is one of the Top Experts in the country on AF. If he is on the fence about whether you take AC, then the decision is purely yours.

If it was me I would use the safe option and take them.

Best Wishes

Barry

[Hidden]

My feelings much the same as Barry's. Couldn't argue with the Prof.!

Personally I would take them. You can't undo a stroke as has often been said on here.

Sandra

[rosyG]

You need to look at your Hasbled score too to se if you have any risk of bleeding-

Score of 1 is difficult and you will have to decide yourself- Hypertension is one of the important factors for af- do you know if you had it for a long time before you started meds?? Probably difficult to know but if you have some idea you may be able to judge if you have suffered any effects from it?

I don't know what you should do re anti-coags but I would try and change your diet and exercise so that your blood pressure comes down naturally

[BobD Volunteer]

It is important to understand that just because your BP is controlled does not remove the score which is for life regardless. Don't think that you dodge that issue as you do not. Presumably since you don't say other wise you are male so no extra for being female.

Many people do feel that if you have AF then you should be on anticoagulants regardless of score but current guidelines are not so. It does therefore end up as a personal choice.

You also say that you have only had one AF event but how do you know this? Many people are asymptomatic and the first they know that they have AF is when they are struck down by stroke so please don't make assumptions unless you have an implantable loop recorder which proves your theory.

OK it is a difficult call at your age and I'm sure that the jury would be split but I for one would think very long and hard about the consequences and then go with anticoagulant.

[Kbuck1234 in reply to BobD]

Bob thanks

Do these Anti-coags wash away any existing clots that might be present?

[BobD Volunteer in reply to Kbuck1234]

Anticoagulants work to stop clots forming, they do not "wash them away". For that you need a clot busting drugs.

[Kbuck1234 in reply to BobD]

Bob

I am unclear about clots. How long do you need to be in AF for them to form and how long do they stay in the body?

How do we know we don't all have a ticking time bomb? Should we all take a dose of clot Busting drugs to clear the decks?

[BobD Volunteer in reply to Kbuck1234]

That is an interesting question but I do feel that you are worrying too much. Read the fact sheets on the main AF Association website on stroke risk and you will understand a little better. Clots if they form generally do so because the blood in the left atrium and more particularly in the left atrial appendage is not flowing freely and pools whilst the person is in AF. A return to NSR can cause any clot formed to be ejected into the main blood stream which in turn can cause a stroke. Preventing clots from forming is the priority hence anticoagulation.

Nobody knows how long you need to be in AF for clots to form but generally 24 hours is considered safe when considering cardioversion with some doctors prepared to do this up to 48 hours. Age and other risk factors change the likely hood of clots forming hence the CHADSVASC system.

Go read and maybe you will understand more.

Bob

[Kbuck1234]

I think my trigger was alcohol which I now drink in moderation. I have had a lot of monitoring and always NFR. I check my pulse regularly so could only be getting runs of AF in the night possibly when asleep but I feel it's unlikely. Are the coags available on the NHS?

[PeterWh]

Yes coags are available on NHS. You need to do calls re by prescription or annual pass. Someone told me private prescription was much cheaper for warfarin. I am over 60 so get them free. However if I wasn't and had to pay I personally would pay!!

I would definitely seriously consider coags and personally unless hasbled shows up badly for you. I personally would definitely take them. I have seen the effects of strokes on a number of people, including someone of 50, which were devastating. if you are asymptomatic or largely asymptomatic you could even be having AF runs in the day without realising it let alone at night. To me if professor schilling is on the fence he hasn't said no so again I would take.

Over to you!!!!!

[Therealsue]

My EP (Prof Gill) also left the decision up to me. I'm 59, female with a successful ablation behind me, On paper, with a CHADsVASC of 1, I don't need them, but he didn't argue when I opted to stick with them. It makes me feel happier and I don't have any side effects (on Rivaroxaban).