Was diagnosed with AFib in Feb 20 during an operation under general anaesthetic. Next episode was in Aug 20 since then I have had attacks every 3-4 weeks. I had a private echocardiogram and consultation with a cardiologist Nov 20. Echo was normal and he laid out a 3 point plan, I am now on stage 2, 1.25 Bisoporol and Flecainide 50mg twice daily. The attacks are much less severe and I recover quicker since being on the above however they are still coming every 3-4 weeks. The cardiologist”s last step was to take Apixaban, I have an appointment with the GP later this week to discuss it, in the experience of members am I at the stage where I should be taking an anticoagulant? The cardiologist also said if the attacks cannot be controlled with medication I should get myself on the NHS wait list for an ablation which I am also going to discuss with my GP.
Anticoagulant?: Was diagnosed with AFib... - Atrial Fibrillati...
Anticoagulant?
I agree 100% with both strategies. AF makes us five times more likely to have a stroke so anticoagulation should be encouraged. There is a score system CHADS2VASC2 which you can google and do for yourself if you are honest with the answers but do understand that say if you take blood pressure medication but have normal BP you still score under that heading. Similarly any cardiac issue still score even if treated. .
One word - IMHO - YES - but that is a decision only you and your doctors can make as to what is right for you. If your CHADS SCORE is 0 - your risk will be less. 1 is advisable 2 or more - no question unless you are at higher risk for bleeds.
I came off A/Cs after successful ablation & no AF for 12 months, against EP preference & had a TIA a few months later.
I’ve now been on Apixaban for some 5-6 years with no side effects, no excess bleeding so am happy to have that protection.
It’s interesting . If you stop long term aspirin your risk of having a heart attack goes up by a third and although the trial lasted 3 years the suggestion was it didn’t return to normal . I know they don’t work in the same way but I wonder if something similar could happen if you stop anti coagulants ( pure conjecture on my part, not aware of any trials etc ).
Thanks, because of the frequency I’m getting attacks I will feel happier on anticoagulants, I will certainly be discussing in full with GP.
I would. If your attacks are frequent it is the safest option
Sounds like you are fortunate and have a good, forward thing medical team watching out for you. Many people are apprehensive about taking anticoagulants but provided there is no history in your immediate family regarding internal bleeds, it really is not as bad as some folk think. BobD has provided you with the information you need to establish whether or not there is a need so I will try and help on the more practical issues. I take Apixaban and whilst there are other types of DOAC’s, similar principles apply to all. If they are deemed necessary, and at your age it is more than likely they will be recommended, you should have a blood test to check your kidney function. This is important because unwanted chemicals leave the body in your urine. It is NOT because they affect the kidneys. Assuming all is well, the kidneys are checked every 6 or 12 months depending on personal circumstances. As far as everyday knocks, cuts and bangs are concerned, there should be little difference to what you currently experience. Cuts may bleed a little bit more, bruising may be occur more frequently and excessive sneezing could bring on a nosebleed but from my experience, there is not a lot of difference from before. NICE guidance provides more information and I’ve added a link below.
cks.nice.org.uk/topics/anti...
Many of us here have had ablations but I think that’s a story for another day once you have had further discussions with your Doctor’s. I should point out that I’m not medically trained and therefore strongly recommend that you verify everything you hear on this forum with members of your medical team.....hope this helps.
Thanks for your reply and sound advice, I will certainly feel better when on anticoagulants, I have read a lot of material on AFib and the risk of a stroke does worry me a lot!
Have you identified any risk factors other than exercise and possibly anxiety for your AFib?The first thing I did after self diagnosis of AFib was to get myself on to warfarin.
Magnesium? Statins?
I’ve been on statins for about 20 years due to family heart history., cardiologist thinks that’s a big positive. I’ve been very fit and active, AFib has curtailed this a bit but in between attacks I keep as active as possible walking 5 miles most days. No running or cardio workouts but keeps me ticking over.
T3 (tri-iodothyronine) and TSH levels to rule out subclinical hyperthyroidism? Any family history of auto immune disease?
I’m not familiar with those conditions but at the beginning of my AFib journey my GP did do full blood tests including the thyroid which came back normal. No known autoimmune in my family but sadly my wife suffers from Lupus
Standard thyroid function tests may miss early thyrotoxicosis which can provoke AFib.
I do like the sound of your team. I couldn’t agree more to both suggestions. I am on apixaban and have an annual blood test and that’s it. Just getting over 2nd ablation and was the only way to go for me personally. Let us know how you get on with GP and what you decide. Take care.
Hi, I am in Apixaban the last two and half years and no problems. I don’t even think about it, it’s a routine , same tablets as you flec and bisoprolol. Thing is with AFib, you can get small AFib in the night and not know about it. That’s what my cardio says happens to me. So Apixaban is as far as I’m thinking the amazing little wonder tablet to help stop strokes which is more a prob with AFib. Sue
Without reservation, YES you should still be taking the anticoagulant. Of course, this is _your_ choice to make, but I believe that a five times greater chance of stroke than the general population is too much risk for me.
The general view is that the risk does not diminish, even if the AF is stopped by whatever means, the AF is a symptom of something that also brings stroke risk.
I'm just surprised they did not start you on Apixaban first to give you protection from strokes! Trust me you do not want to experience a stroke like I did because I did not want to take Apixaban. Biggest mistake I've ever made not taking it. But it was the first medication I was prescribed, not the last and if you get an irregular heart beat a clot can form at any time. All the best.
Roy
If you are having regular episodes as described I (67yo with Lone PAF) would go on anticoagulants and as offered go on the ablation waiting list. However my priority would be to ask the cardiologist if you can try a medium dose of Flecainide (200mgs/day) in the meantime as it is important you stop those episodes completely before your heart gets used to flipping in and out of AF. Like you 100mgs didn't stop my AF but 200mgs did and I then decided to postpone the ablation...that was 7 years ago and after adding many lifestyle changes still AF free.
Thanks for your advice, I have wondered if an increased dose of flecainide would help. I’always get A fib mornings when I get up, on drs advice if still in AFib as the morning goes on I take another 50mgs flecainide and i always revert to normal Rhythm within a couple of hours. I will discuss with the cardiologist and hopefully try it.
Also suggest you ask your cardiologist whether it is OK to be taking an extra 50mgs frequently. I say this because my AF was pm/evening/night and I suggested to my cardio that I take 50mgs morning and 100mgs afternoon but he said not good to give the heart a 'rollercoaster' of the drug better a regular sufficient dose. So I took a regular 100mgs morning and afternoon and he has been right so far.
Thanks for pointing that out, but when I say extra, on cardiologist advice I just take the tablet I would have taken in the afternoon so still only taking 100 mg per day. When I was on just 1 x 50 mg per day he told me to take another, sort of PIP and it always reverted me back to normal.
Just a little follow up, talked to my GP who definitely thinks I should be taking an anticoagulant, been prescribed edoxaban which was one of the options laid out by the cardiologist. Further talks with the cardiologist planned to discuss an ablation.
Hi there, I was on exactly the same meds as you when I was diagnosed in July last year. I was great on this combination for 4 months then suddenly I stated getting episodes again. I paid to see an EP and he changed me to Sotalol 40mg twice daily and Apixaban 5mg twice daily. I am much better on this combination but still get 'flutters' often every few days but they don't last long. Definitely get on the anticoagulants the risk of stroke is 5 times higher if you have afib and sometimes you don't even know if you are having an episode. In my opinion the stroke risk is to high to ignore
New Anticoagulant looks promising
Anticoagulant and bleeding - your experience? 
Severe light head attacks
Would I be considered for an ablation?
anticoagulant 
