Previous AF episode over two years ago. - Atrial Fibrillati...

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Previous AF episode over two years ago.

Takamine profile image
16 Replies

Hi I’m new to this site. I had A fib episode over two and a half years ago. I’ve just turned 65. Now the cardio nurse who I see yearly has suggested blood thinners. I would not ignore medical advice but still undecided at this point. As soon as you reach 65 of course the risk scores go up. I. Check my pulse very regularly in fact I get bit obsessed about it when I’m anxious. I was a nurse many years ago so I’m aware of how to check my pulse. I’m toldit will happen again , so far I’ve had ectopic beats but not another AFib episode. I realise the importance of blood thinners if having regular AFib it’s just on my mind most of the time just now which raises my anxieties about it. Not sure if I should start them yet. Just wondering what others think.

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Takamine
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16 Replies

I’m also a nurse (retired) age 64 with a score of 1 which will go up to 2 soon when I’m 65. Neither my cardiologist nor I felt I was safe to wait for anticoagulants and I have been on Apixaban for several months. My biggest fear was ischaemic stroke which is so often catastrophic. My fear of haemorrhage is far less. I guess it’s how the fear takes you.

I have read that many doctors underestimate the risk of stroke and overestimate the risk of bleeding.

Hope this is helpful, many others on this site may give you links to more technical info - mine is based on my gut feeling.

Take care

Pat x

Takamine profile image
Takamine in reply to

Thank you . It’s hepful.

Whenever we get this question raised it invariably means that the person asking knows the answer but is hoping to hear some reasoned answers to the contrary. Generally, they are disappointed and hopefully they don’t go on to become a statistic. We are not medically trained but as I understand it, if you have been diagnosed with AF, the risk of stroke remains with you whether or not you have AF. If someone’s CHADsVASc score is one or above and they do not have a known risk of internal bleeding then they are advised and encouraged to take an anticoagulant. Bear in mind they reckon there are in excess of 250,000 people in the UK who have AF and are not aware. Many have episodes when they are asleep and are totally unaware and all too often we hear of people who only became aware they had AF because they suffered a stroke.

Methinks you know the answer and as an ex nurse I am sure you know how devastating a stroke can be, not only for you, but your family and friends who are left to pick up the pieces. I make no apologies for being graphic, just remember there is no rewind button after the event. None of us like taking anticoagulants but is better than the possible alternative......

clincalc.com/Cardiology/Str...

clincalc.com/Cardiology/Ant...

What are your scores now?

What advice has your GP given you?

icklebud99 profile image
icklebud99

You may actually be having Afib episodes during sleep that you are unaware of and the sticky blood which is left in the heart could easily be shot out as a clot which is why anticoagulation is recommended. I would definately take anticoagulatoin as stroke can devistate your life. I take Riveroxiban with no problems at all, have had cuts which hardly take any time more so stop bleeding. Be safe.

Takamine profile image
Takamine in reply to icklebud99

Thank you much appreciated.

Morzine profile image
Morzine

I agree with icklebud....I had afib start last May,...two long few days attacks...since thrn nothing ...well nothing as far as I knew but the 24 hour monitor showed duferent, I get tiny afib I’m not aware of....and quite often......so these silent ones I Feel are the dangerous sneaky ones......I’m on tablets, I don’t give the apixaban anti coagulant a second thought except to think it’s a great little pill and stops the stroke issue being a major worry........be safe....

Takamine profile image
Takamine in reply to Morzine

Thank you all the replies have helped me make the decision as a stroke could be devasting.

Buffafly profile image
Buffafly in reply to Morzine

Ditto!

Sue5453 profile image
Sue5453

I too haven’t had Af for 2 1/2 years but I have been on a blood thinner since then I am on Apixaban apart from takeing it morning and night 12 hours between I don’t know I am on it but if I do go in to AF it helps me from haveing a stroke

cat55 profile image
cat55

Hi, I had my first encounter with AF when I was 47, I am now 63. Up until now I have been lucky and had fairly infrequent episodes, years in between, as far as I am aware! About 7 years ago my Chad s score was 2 and I reluctantly started Warfarin. Almost 3 years ago I changed to Apixaban. It do understand it is difficult to rationalise taking anticoagulants for something that occurs so infrequently, but the few episodes I have had whilst taking them I have been really thankful I have been on them. For me the thought of having a stroke because of AF keeps me taking the tablets. I too am an anxious soul and an ex nurse!! Best wishes Kath.

Takamine profile image
Takamine in reply to cat55

Thank you so much the anxiety takes over but after seeing these replies I’ve decided my anxiety will decrease if on a blood thinner.

Franny50 profile image
Franny50

Here's Dr. John Day on the subject of lifelong anticoagulation:

drjohnday.com/13-reasons-wh...

My thought is that In the U.S. lifelong anticoagulation for ALL over-65 females (even after successful ablation) could potentially yield billions to the drug marketers in revenue, since the stuff is priced sky high here. But of course there is always warfarin, with all its complexities and associated dr. visits and hassle.

I'm 69 and on rivaroxaban as I write this. Fortunately I have very good insurance. I am sincerely wondering if the chads-vasc scoring doesn't actually create free-floating anxiety among older women, and favor drug companies lifelong enormous profits.

I continue to mull these issues after years of afib.....

Takamine profile image
Takamine in reply to Franny50

Agree about the chads- Vasc. On my yearly hospital check up was feeling positive till they started talking about strokes etc . Came away feeling very anxious, which I never feel is good for AF.

Auriculaire profile image
Auriculaire in reply to Franny50

Thank you very much for posting this interesting article. I have read all the studies he links to and it seems likely that there are problems with CHADS VASc. I have read something before about concerns that it might not be universally applicable as the stats for it came mainly from Scandinavian populations and were not borne out in others even North American ones . Certainly one of the studies linked too shows a higher rate of stroke among Danes . Chinese and Japanese studies show no extra risk in being female.

I actually find it suspiciously convenient that this scoring system which mandates anticoagulation for a much higher proportion of the afib population (and suggests that all women no matter what their age or comorbidities would benefit because of being at intermediate risk) was developed just before the first NOAC became available.

Franny50 profile image
Franny50 in reply to Auriculaire

I agree with you. At least here in the U.S. I get the feeling that the drugs companies are the tail that wags the U.S. medical establishment. Doctors are terrified they might get sued if they don't follow protocols dictated by big Pharma and big medical device companies. I applaud Dr. Day for his forthrightness and candor. My own EP seems open-minded as well, fortunately. But many, if not most, find security in being in lock-step with their peers, who get their marching orders from big Pharma.

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