Dx'd with AFib but not able to take anticoagulants

[Mary10]

Dx'd with AFib 15 months ago but taken off anticoagulant/eliqiuis due to heavy bleeding, probably caused from bronchiectasis flare. Had a Trans esophageal echo earlier this week. Waiting for results. At this time Dr's don't see anticoagulants as a choice for me in preventing a stroke. Wondering if any of you has had similar situation. Thank you in advance. Mary10

[clanmags]

Sorry to hear that, Mary 10. How soon after taking the anticoagulant did your bleeding start? I ask because I am in the process of being checked for blood in my urine after taking warfarin for the past 4 months.

[Bagrat]

No advice but all medication has to be weighed upto assess whether it is right for you. I have always said that statistical evidence helps the professionals plan the care needed for everyone but statistics do not really impact on the individual. You don't know where on the "bell curve" you are. What I mean is there are always exceptions, people who do just fine while breaking all the rules and those who do everything they should and still have a stroke. Your choice seems to have been made for you just try not to worry ( I know that's not easy at all). Look round at the 90 year olds who have smoked every day since they were 10!!

[CDreamer]

I haven't personally had this situation but I know others have posted that they have but I don't know if they are still around? I know there are other options if you are concerned, some of which are surgical - is the Watchman device for stroke in AF'ers who can't take ACs???

If your CHADSVasc score is high, have you been offered other options? Have you asked or researched these options? Have you looked on the AFA website?

[seasider18]

You should be a candidate for a Watchman or Amplatzer devices.

Sounds from Dx'd that you are in the U.S.

wsj.com/articles/fda-approv...

[Mrspat]

Is it me? There is no X in the word diagnosed. I found the heading for this post unintelligible until I read the context.

[CDreamer in reply to Mrspat]

Text speak - or txt spk I should say. 12 grandchildren and my husband and I spent hours yesterday trying to work out what they were talking about on the family chat.

[Mary10 in reply to CDreamer]

Gotta keep our sense of humor!!

[Mary10]

Thank you for your comments. In answer to one of the questions, I had bleeding off and on during the 8 months that I was on anticoagulants, but after the heavy bleeding which took me to the emergency Dept by ambulance x2 and admission to hospital for a couple of days, my Cardiologist back in Boston took me off them. He mentioned the Watchman as a possible solution, which a couple of you also suggested, but that would require being on anticoagulants before and after the procedure. At this time I think that would be too risky. Thank you again for your help and interest. Blessings, Mary10

[AnneTS]

There is an option for the very few people who cannot tolerate anticoagulants and that is an IVC (inferior Veena cava) filter. It is fed through the inferior Vena cava vein near your neck and then opens up like an umbrella to catch clots that might proceed to the lung and brain. A radiologist fits it. I'm afraid that I don't know much about it except that I have to have one fitted before any major operation when I am taken off warfarin and heparin as I have a faulty blood clotting gene. The IVC filter is then removed after a week in my case but can stay in place permanently in some patients. Are you sure that it is the anticoagulant to blame for your bleed? The reason I query it is that in May I was urgently admitted to hospital with a massive bleed to my kneecap (I know, what a weird place to have a haemorrhage!!). The only explanation that the hospital could offer was that I had not long started Amiodarone which enhances anticoagulants. Just a thought. I do hope you get it sorted as these bleeds are never nice are they?

[AnneTS]

Just looked up IVC filter which specifically protects against pulmonary embolism when not able to take anticoagulant. The Watchman seems to cover doing the same thing but for the prevention of strokes. Both items seems similar mechanically but are inserted in different areas to achieve slightly different preventative functions. Sorry if I mislead anyone. I don't know how common it is in the UK to have the Watchman fitted. Has anyone won the forum had one fitted?

[Mary10]

Thank you so much annel for your kind responses. I will definitely look into the ivc filter. I do have minor bleeding from time to time due to bronchiectasis flare but nothing like the massive bleed the last two times. . Surprisingly though, since off the anticoagulant in Dec. I have had no bleeding. The only other thing that Is different since then is that I am using a nebulizer with albuterol and hypertonic saline. Wondering if that has had effect on bleeding? I will check that out with Doctor. FYI, my friend had blood pooling of blood on her knee which was caused from a knee replacement which she had 7 months previously . She is fine now. Blessings, Mary

[Mary10]

I had TEE Trans esophageal cardio gram done a couple of weeks ago in Boston. Not my favorite test! Dr. said test showed no surprises! We talked about Watchman device. The problem is I would need to be on anticoagulants before and after the procedure which they hesitate to do because I'm prone to bleeding. Any other suggestions welcome. Blessings, Mary10

[PeterWh in reply to Mary10]

Ask them to compare, explain and quantify the short term risks (of going on an anticoagulant and then having a watchman device inserted) against the long term risks of not having Anticoagulation and not having a watchman device.

It could already be that the risks of having a watchman now are lower but if not now then for sure at sometime in the future it will be because as people get older the risk of a stroke goes up.

A few years ago the only option was warfarin. However now we have the NOACs and certainly apixaban has a lower bleed risks. Also until a few years ago they would only do procedures if someone was on warfarin before and after. Nowadays NOACs are accepted for some. Ask if this applies for watchman at centre you go to or if not find out which centre(s) do accept NOAC (if any).

I am not medically qualified.

[Mary10 in reply to PeterWh]

Thank you so much for your reply PeterWh. It was my Boston Electophysiologist who said I would need to be on the anticoagulants before and after Watchman devise. He said it would be up to me to make the decision?? One thing I do know is that I don't ever want to chance hemmoraging like I did when I was on eliquis and needing to be rushed to hospital by ambulance. The source of bleeding was bronchiectasis flare up. Mary10