Interesting article...Speaking to a number of specialists who agree the CHADS is all we have but not an ideal way to predict a stroke I believe they are looking for a much more scientific approach to this subject and researching if they can track down a gene that make people more at risk of stroke......
CHADS: Interesting article...Speaking... - Atrial Fibrillati...
CHADS
Yes CHADSVASC is not perfect but it is all we have right now. There has been a search for the holy grail for some time now.
The CHA2DS2-VASc score calculates stroke risk for patients with atrial fibrillation.
My EP has informed me that my CHA2DS2-VASc score is 1 because of my age of 70.
However he sees no reason why I should be coagulated even though I am at Low - Moderate Risk.
He has taken the view that I don't need coagulating for two reasons.
1. After ablation some 7 years ago and a routine follow up at 70 on 48hr halter monitor showed 'events' limited to less than 1% of total beats.
2. Ultra sound scans shows my heart structure to be sound. ie no left atrial enlargement.
What doesn't come across in this forum is the incidence and length of time that sufferers are in AF. Is it Paroxysmal AF or persistent AF or permanent AF that determines whether one should be anti-coagulated.
If Paroxysmal is it a day of AF that says one should be coagulated and if persistent one week of AF should be coagulated.
I am still classified as an AF sufferer and have been so for 17 years but following PVI 7 years ago now limited to daily/events of ectopics with occasional 10 second bursts of AF. So am I really no risk as am only low level PAF.
The CHA2DS2-VASc must only be a guide as someone in permanent AF is at the same level of risk as one who gets irregular bouts of PAF that seems to me to a bit non-sensical/illogical.
So does any one have an opinion/experience as to how long one should be in AF to be classified as at sufficient risk to be anti coagulated.
Concerning the genetics, the research is hunting for one gane, rather a couple of them.
See this paper: Stroke genetics: prospects for personalized medicine
Thank you for posting very interesting article
Interesting- always cautious with advice from people saying 'blood thinners!!"
The research I like to believe is the piece quoted by York Cardiology on one of his recent videos which showed that the risk of stroke is much more closely aligned to comorbidities than anything else.
Very interesting. I would like to know if any research has been done into the stroke risk of the general population in the same age group and with symptoms measured in CHADS2. ie my score is 3 , female over 65 and hypertensive, I think the risk is 3.6%. What is the rate of stroke in women over 65 and hypertensive, who do NOT have AF?
Listening to Sanjay Gupta, he says it is not the AF but the company it keeps, hmmm.? So therefore logically the risk factors are there regardless of AF or not.
I am about to try my third lot of NOACs , apaxiban and rivaroxiban both have me bad headaches and tinnitus, and I would really not have to take anything.
Grumpy ;o))
That's interesting. I'm getting mild tinnitus in the past few weeks, first time in my life. I've been on Apixaban for a year now; wonder whether that might be it. Not a problem at the moment but if gets much louder it will be.
I assume it's tinnitus. It's like constant background white noise.I can cover up my ears and it's still there, in my head/ears.
Koll
Mine is like going into the bush and hearing a chorus of crickets all the time. Its much reduced now after being off xarelto for 8 days.
Yes, your description is similar to what I am hearing. It's very annoying, but nothing more than that at the moment. Going to see the doc about it shortly, see how that goes.
Thanks
Koll
I too have tinnitus, I'm on rivaroxiban, bisoprolol and. Atervastatin. It is bearable at the moment, but it does affect my hearing slightly, I wonder if there is a link?
Does anyone on warfarin experience tinnitus. I started having it whilst on Clopidogrel, so was expecting it to go when I changed to warfarin, but it seems worse now.
I've had tinnitus for many years take flecainide and bisoprolol and pradaxa
I have tinnitus: been on amiodarone (4 years), flecainide (10 years), sotalol, atenolol, diltiazem occasionally. Tinnitus and AF meds could be a good area for research. Was exposed to loud sounds only very occasionally ... nothing like the youngsters these days.