‘Resolved’ doesn’t mean ‘cured’

[Kaz747]

There is often debate on this site about whether anticoagulants are needed after successful ablations if the person doesn’t have a lot of other risk factors. I stumbled upon this article today which explains the ongoing risk very well. I like the quote “‘Resolved’ doesn’t mean ‘cured’”.

healthline.com/health-news/...

[BobD Volunteer]

Thanks Kaz. Pretty much what I have been saying for years. Knowing the right people helps!

[AIW58]

Hmm interesting. Still somewhat unclear for me. I know when I'm in AF, as many of us do. If no other risk factors for stroke then do I need to stay on anticoagulant. The article says that increased risk of stroke if people have a hx of AF but imply this is because of other risk factors or lack of awareness of AF episodes.

My EP says I can stop apixiban 3months post abaltion. I'll have a chat with him. I was only on it pre ablation as my CHAD risk was 1 for being femaie so wasn't started on it when first diagnosed.

Amanda

[Kaz747 in reply to AIW58]

I’m in the grey area with the sexless CHA2DS2-VA score with a score of 1 for history of hypertension (from my pregnancies but history is history). Under this system 0 is no anticoagulation and 2 or greater is anticoagulation is recommended. With a family history of strokes I’m happy to stay on anticoagulants.

heartfoundation.org.au/imag...

[AIW58]

Agree also like the term resolved rather than cure. I've called it remission before. I think it's disheartening (ha) to say it can't be cured. What we know is it can be resolved and people experience long periods of remission.

[Aus19]

Having already had one stroke likely caused by AF, I know that I will be gulping down Apixaban for the rest of my life. Oh well: at least they don’t taste as foul as the flecainide. Thanks for the article, Kaz.

[Hidden in reply to Aus19]

Suggest you don’t put tablets on your tongue as the bitter taste initiates the body’s defence mechanism making you gag and in turn making it more difficult to swallow the tab. Instead, draw your tongue back a bit, place your tabs in the space created & then knock ‘em back with a glug of water.

Using this method, I have no idea what any of my pills taste like.

Pat x

[Aus19 in reply to Hidden]

Thanks for that. I will give it a go.

[wilsond in reply to Aus19]

When I have to take flecanaide or any nasty tasting pills,I wrap it up in a little bit of sliced bread,or a spoonful of yoghurt...works for the dog too!!!lol!

[Finvola]

Thank you for posting this Kaz - required reading for every AF patient.

[Nugger]

If your the type of person that doesn’t show an interest in your health, checking your heart rate, blood pressure ect then yes keep taking the blood thinners BUT if you are pro active like I am, there’s no way I’m going into afib & not knowing about it.

I do take nattokinase as a backup

[Kaz747 in reply to Nugger]

I’m very proactive with my health too and fingers crossed my heart keeps behaving. I have worked on my diet, exercise, stress levels and sleep and am in better shape than I have been in years. I know all my numbers. Having watched people I know and love have debilitating strokes, I know that I’d rather have a little tablet every day than a stroke. I heard a cardiologist say recently that the best thing you can do to prevent heart problems is to choose your parents wisely! You never know when the heart will have a little wobble and my body has already proven that it can form a clot in my heart pretty quickly 😉

[Nugger in reply to Kaz747]

Remember, it reduces the risk, does not prevent!

[Kaz747 in reply to Nugger]

I know you that and prefer a reduced risk 😀

[brit1 in reply to Nugger]

do you just take the nattokinase or are you also on anticoagulants? I was on a protocol of nattokinase/garlic/fish oil etc but when my af episodes increased to monthly vs yearly for a short time in 2017, cardiologist put me on eliquis altho I am only taking 1/2 dose bid.

[Nugger in reply to brit1]

Just take the nattokinase

[Jjda]

I absolutely hate the Apixaban, but, even though I will continue to try and find articles to convince my EP I can come off it, I will stay on it, even though I have had an ablation and had no Afib for a year now. I am, unfortunately, the victim of sexism, and ageism, and have a CHA2DS2-VA score of 3. I am curious...what if a woman age 60 gets Afib, and has a "resolved" ablation. Would her EP put her on blood thinners when she turns 65, because she now has a CHA2DS2-VA score of 2?

[Nugger in reply to Jjda]

Yep, you women got the dirty end of the stick once again!

[Hambo444]

When they say there is more risk. How much more? The difference might be .001 percent but still be significant in scientific terms. I would be interested to see the statistics before being able to make an informed decision.

Actually just looked at study and it shows that the incidence of stroke for non af population was 0.74% and 1.21% for people with resolved af.

Assuming this study reflects the truth..one has to evaluate this increased risk of stroke (it is a 60% increase which equates to an extra 5 people per 1000) with any side effects of the drug..and whether the drug itself also increases the chance of negative outcomes..e.g. increased bleeding.

Additional points of interest:

Only 1.2% of participants of this study coded as 'resolved atrial fibrillation' had a recent record of ablation.

The study only included participants with a CHA2DS2-VASc score of ≥1. So results couldn't be extended to those with score of 0.

It mentions a different study which found stroke rates in patients with atrial fibrillation who underwent ablation were similar to those in patients with no history of atrial fibrillation (but did not factor in the use of anticoagulants)

There never seems to be a simple answer

[F-M-C-MM in reply to Hambo444]

Some very balanced views Hambo. Same size shoe does not fit all. Each A fibber must make their own informed decision based on an assessment of their lifestyle, and level of risk. Be careful of people who strongly advocate you take Apixaban for example. This view may be conditioned by the fact that they have other Comorbidities they are not telling you about. I am of the opinion there are no absolutes, CHADS vasc scores may be significant, but the idea that once you reach 65 it's blood thinning time is ridiculous as we all age differently. Keep in mind also the power of marketing by the huge pharma companies and judge for oneself!!

[Mayleen]

Read with interest. Thank you for sharing. Having had a blood clot I agree with the approach and can't see why not if the drugs are cheap and have few down sides. I think before things like the Kardia device people would not really know if they returned to AF due to the nature of diagnosis. I'm very grateful to have that little device. Best wishes to all Mary

[wilsond]

I was told by my EP that regard!ess of whether or not I have the ablation,and whether or not it is deemed a success,that I will remain on Apixaban for life,with my very strong family history if AF,heart disease and stroke.I am happy with that.

One thing I noted in the study was a contributory factor of 'scarring' in triggering Af...woukd this be from an ablation I wondered?

[Kaz747 in reply to wilsond]

I wondered that too.

[KipperJohn]

Have had 2 ablations in 2015 and 2016 but have never viewed them as a cure - i remain on Apixaban, Metoprolol, Losartan etc and would not feel comfortable coming off them unless strongly advised to do so. I prefer the term “in remission”, as I do for the prostate cancer I had treatment for for 18 months. I’ve not been discharged for either condition and have regular check ups, blood tests etc. It was stressed to me at time that the ablations were to improve quality of life - there appears to be no evidence of a cure as such.