Should I be on anti -coagulants ?

[carmelanna]

I had a catheter ablation 3 years ago in UK which was successful. Does this mean I am cured? I was advised to stay on Anticoagulants (the new type ) for 6 months but then given the option to come off them which I did .However my new G.P has advised that I go back on them .I'm not sure . I recently have been getting the fatigue again but that could be my job and the long hour ?Any advice will be greatly appreciated.

[Amysmeats]

Hi I have Complex CHD but I wasn’t on anticoagulants for years so if you don’t feel you need them I’d wait until you see your cardiologist. Do you have CHD or arrhythmia? If you’re starting to feel symptoms of heart failure then they should refer you if you aren’t with out patients still. I’d say listen to your body more than someone who has recently met you.

[BobD Volunteer]

There is no evidence that successful ablation removes stroke risk in AF. As one leading doctor said it is not AF that causes the risk but the company it keeps. Any treatment including ablation is only for quality of life (QOL) as tere is no cure as such so I for one agree with your GP.

[Norm in reply to BobD]

I can only reiterate what BobD has said and add that apparently the newer anticoagulant drugs are not licenced in the UK where the patient has had a heart valve replaced.

[radagast58 in reply to Norm]

I had an artificial aortic valve replacement last year and am now on warfarin therapy. I think DOACs are not currently licensed in the UK simply because there are no long term studies available to demonstrate their efficacy. My INR is stable and I have blood tests monthly

[Norm in reply to radagast58]

Yes I had Aortic Valve replaced Jan 2016 with tissue valve and have Warfarin. Test about every month or so but depends on INR. I only found out about other anticoagulants when I asked GP if I could change and she said no and explained why.

Waiting for referral back to cardiologist as not seen them for two years but got to wait until December for appointment. Still suffer from Post Perfusion Syndrome aka Pumphead but not as bad as it was. Still alive.

[radagast58 in reply to Norm]

How does your pumphead manifest itself? I didn't find the surgery as traumatic as I expected even with some post operative complications

[Norm in reply to radagast58]

Pumphead appears to be about memory loss. Apparently caused by very small particles, air bubbles or bits, very very small while on the pump, by-pass machine. Not every one gets it but many do and each one is different.

Mine is very much short term memory, but not every time. I also had a really bad time initially post opp with insomnia. It is like I slept but the brain was always awake. Again not as bad now but as I also now have prostate cancer I am up four/five times a night for pee which does not help.But as I say every one is different. My operation went OK it was the post opp, was very traumatic. I also had a few months with atrial fibrillation after the opp but fortunately have not had that since cardioversion in Nov 2016 but always expect it back at anytime.

Docs don't take any notice of pumphead but as I say every one is different.

[radagast58 in reply to Norm]

I must admit my short term memory has definitely suffered and I also suffer chronic anxiety and worry about stupid things that wouldn't have bothered me pre op

Sorry to hear of your diagnosis

Kindest regards David

[approaching in reply to BobD]

I just came from a presentation where the Cardiolgist said ablation was a cure for A fib !, i know that is not what is usually said. He actually used that word without any further explanation!

[BobD Volunteer in reply to approaching]

The top people here in UK may not agree and always say that any and all treatment is only ever for quality of life. OK symptoms may dissappear but that does not make it a cure.

[Finvola]

Our stroke risk is assessed, not by the absence or presence of AF but by our individual CHA2Ds2VASc score:

mdcalc.com/cha2ds2-vasc-sco...

These pointers are assessed as the company which AF keeps - in Bob’s post - and I believe do not get removed, even with successful treatment (eg Diabetes). Anyone with a score of 2 - should talk to their physician about anticoagulation.

There has been some discussion recently whether being female warrants a point in the scoring but many of us prefer to be safer than to risk an AF stroke. Hope this is of some help.

PS - It is worth noting that AF itself doesn’t count in the score.

[carmelanna]

Dear All,

Thank you for your replies it means a lot . My CHA2Ds2VASc was only 1 ( 1 point for female) . But recently I've been feeling fatigue and just off kilter so I need to speak again with my G.P .All the best carmelanna

[AIW58]

Hi I hope to be off my apixiban next week after my follow up appt with EP. 4+ months post ablation.

Great to hear you have been free of AF for so long. The tiredness could be many things assuming you have checked your pulse and AF has not returned. Your GP should run some simple blood tests to check your Hb and thyroid function. If those ok have you looked at lifestyle, your sleep pattern etc.?

Good luck

Amanda

[Dodie117]

You could invest in a Kardia machine to check if you are concerned that AF is returning. If you feel odd beats it will do a mini ecg at home and tell you if you are in AF.