New to AF: Hello I am a fairly fit 65 year... - AF Association

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New to AF

Lizziebgood
Lizziebgood

Hello

I am a fairly fit 65 year old, non smoker, don't drink, not overweight but for the last three years I have had two or three episodes of AF a year. They have never lasted longer than 5 days and usually shorter. The GP has said to taking aspirin daily would be ok in my case. However I feel I need a second opinion. Any advice welcome. Sorry if this has been asked already. Thanks Liz

29 Replies
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BobD
BobDVolunteer

Hello Liz and welcome to our world. Sorry to say that you GP is well off base. Aspirin is as much use as a chocolate tea pot where stroke prevention in AF is concerned. Please get to see a proper doctor who understands these things.

What other drugs are you on for AF? You may think that you only have a few episodes but many people are quite unaware of them so this is very risky. At your age and being female you should be on anticoagulant medication. The amount or frequency of AF events has no bearing on your risk. You have AF so you have a risk and CHADSVASC (look it up ) gives you a score of 2 with no other factors.

If I were you I would demand to see a specialist in arrhythmias and don't be put off. It is your right!

Go to AF Association website and download the CHADSVASC calulator and any other informataion you can find and go bang a desk or two.

Lizziebgood
Lizziebgood
in reply to BobD

Thank you Bob. I am on no other medication and your reply confirmed my suspicions. I shall get back to the GP tomorrow. As I cannot trust his advice I shall ask to see a specialist. He did say warfarin was an option but never mentioned any other options and recommended aspirin for the time being.

I gotta say Lizzie, I totally agree with BobD

Morzine
Morzine
in reply to Lizziebgood

Phew Lizzie I agree with bob! I’m new since May and I was put straight on tablets. Anticoagulants are essential, i soon learnt that. I’ve only had about five episodes. Also I think you need a specialist because they put you in a 24 hour monitor,,,,,mine showed I have tiny ones I don’t notice in the night....I’d insist as bob says, if he’s funny, pay this one time and go private

hock217
hock217
in reply to Lizziebgood

See a specialist and wear a monitor with at least 6 leads for at least a week. I wore a ten lead for a month which picked up SVT. Good Luck.

Hi Lizzie - aspirin is no longer recommended in place of an anticoagulant for AF patients. Anticoagulation is usually recommended for patients who have a CHADS2VASC score of 2 and above. The link below will show how to calculate your own score:

clincalc.com/cardiology/str...

I would certainly seek a second opinion regarding anticoagulation.

Lizziebgood
Lizziebgood
in reply to Finvola

Thank you Fintvola. I am a 2 just being me. Is warfarin considered an anti coagulant? Many thanks Liz

Finvola
Finvola
in reply to Lizziebgood

Yes, it is and there are 4 modern ones - (called DOACs) Apixaban, Dabigatran, Edoxaban and Rivaroxaban. If you go to the main AFA website and look under patient information, there are leaflets explaining each of them.

My score is also 2 and I was prescribed Apixaban which I’ve taken for 5 years without problems.

You have had AF for 3 years lasting up to 5 DAYS and your CHADS2 score is 2 and your GP gives you aspirin!

Assuming there is no contraindication to anticoagulation, in your position I would see another GP in the practice in the near future, perhaps younger and better informed about NICE guidelines, to discuss starting a DOAC while waiting to see an EP.

You can’t risk a stroke while waiting several months to see an EP on the NHS for advice on anticoagulation. £200 will get you a private opinion in a week. Then revert to the NHS for the tests.

If you opt for the NHS route, if you do nothing else at this stage, get that second opinion about a DOAC as soon as possible.

Justinerose
Justinerose
in reply to oyster

I am on Apixoban to thin my blood

oyster
oyster
in reply to Justinerose

Hi Justinerose

What sort of valve repair did you have? Just interested with you being on the apixaban rather than warfarin, or do you have AF as well?

Justinerose
Justinerose
in reply to oyster

I had a leaky mitral valve repair, which was successful but left me with heart failure and AF which has since been fixed with a cardioversion process..

Sorry to trouble you. Are you living in the UK? I'm surprised to see you are on Apixaban not Warfarin if you had an artificial valve replacement.

Morzine
Morzine
in reply to oyster

Yes go private I agree, just this time get ball rolling!

netie54
netie54
in reply to oyster

I couldn’t agree more !

I'm sorry to say but your GP doesn't seem very well informed about stroke risk and AF. S/he is wrong and BobD is right. "A Proper doctor" in this context would be an Electrophysiologist (a specialist in the electrical systems of the heart) , but even an up-to-speed GP would be giving better advice than your current one.

It doesn't matter how generally fit and healthy you are nor how infrequent your AF episodes are. As a 65 year old female you really ought to be taking an anticoagulant to reduce your risk of a serious stroke.

Do please post again with any further questions you may have.

Hello Lizzie :-) I think you are in the UK so it might be a good idea to read the N.I.C.E guidelines for ''Atrial fibrillation: management '' and even print them out and take them to you GP.

The Guidelines....

nice.org.uk/guidance/cg180/...

Note this part..

''Do not offer aspirin monotherapy solely for stroke prevention to people with atrial fibrillation.''

Thanks to everybody. I am armed with good information now.

If you feel the need to monitor your heart rate/AF at anytime , get yourself an Alivecor ECG(Amazon) which works with a smart phone. You can always email results to your GP/Specialist. I have found this to be highly useful. An anticoagulant is a must.

Lizziebgood
Lizziebgood
in reply to Magson

Is that the Alivecor® Kardia Mobile EKG costing about 99 pounds?

lallym
lallym
in reply to Lizziebgood

Yes, that’s the one. You can use it to do a sort of mini ecg to check your heart. It’s specifically designed to pick up AF.

I would say the priorities now are to get referred to an EP (this is a cardiologist who specialises in the electrics of the heart as opposed to the plumbing) and to get anticoagulants. Warfarin, until recently was the only one available. It requires quite a lot if testing and monitoring. There are new ones available now on the nhs that require little testing. I am on apixaban and have no problems with it. I have 6 monthly blood tests to check that it’s not having any adverse effects on my kidneys. So far all good.

This can all be a bit mind boggling at first but arm yourself now with information and it all gets easier as you learn. Knowledge is power. Your GP is like a lot of GPS, way behind the times on the best way to treat AF.

Good luck 🍀

Jesus take the wheel!!! I remember years ago my GP told me my problems where due to the weather being so changeable 😂 What the ............

Yes , that is the one although I see on Amazon they have the same one lower on the page for £85.99? You can download the Kardia app on an Apple or Android phone and it is very easy to use.

Hi Lizziebegood

The regulars on here are giving you sound advice as always. Your GP is clearly unaware of or is ignoring current NICE guidelines for minimising the risk of stroke in patients with Paroxysmal Atrial Fibrillation. Aspirin is potentially worse than useless.

Warfarin would probably not be first line therapy and unless there are contraindications you would be a candidate for one of the DOACS (Direct Acting Oral Anticoagulants). Minimal side effects and no need for frequent blood tests.

Please don't think I'm trying to alarm you but it really concerns me that you are not properly anticoagulated and this is a priority that needs addressing urgently. You need to see a competent GP (Not the one who prescribed aspirin!) who is able to manage your AF safely until you can see a cardiologist who specialises in the management of cardiac arrhythmias.

In the event of a further episode of AF I would suggest you seek emergency medical advice particularly if the event is prolonged and is accompanied by shortness of breath at rest, chest pain or tightness and dizziness or feeling faint.

I hope you get this sorted

Kindest regards

David

Hi Lizzie,

I've suffered paroxysmal AF for 30 years which over the past two or three years has become persistent. As others say, Aspirin is useless at preventing strokes. I've recently had an ablation to try to prevent AF and was put on apixiban (anti-coagulant) prior to the procedure and have been told to keep taking it for 3 months after. Because my CHAD2VASC score is zero, my EP is quite happy for me to come off of the apixiban after the 3 months. AF on its own does not cause strokes, it's the comorbidities that cause the strikes. If you're healthy in all other respects there's no need for anti-coagulants. However, being a women gives you a CHADS score of 1, also your age may give you a score of 1, giving you a total score of 2. With a score of 2 you will need anti-coagulation, therefore I'd recommend that you see a cardiologist rather than only your GP. A cardiologist may also prescribe beta blockers to control your heart rate when in AF.

Good luck.

I am on Apixaban I haven’t had a 5 day one for 2 years I have a few hours one but that’s all

5 days is a long time in AF? Sounds like you need a doctor to refer you to a specialist. The anticoagulant argument is something to seek medical opinions about. You might also be prescribed medication to stop the AF when you get it instead of waiting 5 days. My wife’s mother has permanent AF and macular degeneration. It is possible that the blood thinners may have accelerated the macular degeneration. She is almost blind.

Just a quick update. I visited the doctor on Monday and was recommended Apixaban straight away. So blood was tested and today is the first day on Apixaban. The doctors surgery has two ecg printouts of two episodes of AF which they are going to send to a specialist. So I feel I can relax now knowing everything is under control.

I would like to thank everyone that replied and I am following up on all these useful suggestions.

Liz

Hi Liz :-) good to hear you now have anticoagulation and a level of security.

I have been on Apixaban for 18 months with no problems and have been told I must make sure I arrange a blood test with my GP every 6 months to check liver and kidney function .

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