Having been diagnosed with Arrhythmia, I will shortly start taking 5mg Apixaban twice a day. This causes me much concern.
Will I be able to lead a normal life, eg play golf, go abroad on holiday etc and will I be able to have a couple of glasses of wine each day? I am currently a regular social drinker and I go to the pub most days. I am aged 78 and a widower. I enjoy meeting up with friends. I am active and enjoy a good social life.
Any help, advice which you give would be greatly appreciated.
Many thanks.
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Brancaster1
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Yes there is nothing stopping you doing all those things and can't imagine why you would think you would have to stop them other than the alcohol as this often triggers AF so it is best not to drink alcohol. What type of AF do you have? I was first diagnosed with persistent AF - that is in AF all the time but able to be returned to Normal Sinus Rhythm (NSR) by cardioversion (CV). My trigger seemed to be lifting heavy weights - yes I know at my age I should know better I am the same age as you but still try and act like my younger self. So although I avoided alcohol it didn't effect me and send me back in to AF so I did indulge in a small glass of wine with my meal after abstaining for about a year. I now have permanent AF - that is my Electrophysiologist (EP) has discussed with me the fact that after 3 cardioversions my heart has remodelled itself and therefore further attempts to return me to NSR would not be likely to work so I now live with AF all the time. I still go to the gym every other day - sometimes every day but since Covid have only played golf once. So far have not been abroad for holidays since Covid either as my first trip abroad would have been to South Africa in October for my nephew's wedding but other than the Covid restrictions stopping us the Bride to be had been in contact with someone who tested positive for Covid about 48 hours before the wedding so it was cancelled. The wedding is now in early January but again South Africa is on the "red list" so we have decided even if flights do resume to South Africa again we are not going but will go later when it is safer. Same with visiting our Grandson's in Florida although flights resumed in November my daughter-in-law is an intensive care sister at a University hospital there and she is adamant that things are really not good there and it would be better to avoid travel there if possible. So all I am doing is cat sitting for a friend just before Christmas!
Have you been referred to either a cardiologist or an Electrophysiologis. A referral to see an Electrophysiologist (EP) is best as they specialise in AF more than a cardiologist does - a cardiologist is a "plumber" and an electrophysiologist is an "electrician" and Af is a problem with the electrical impulses so best to get a referral to an EP.
Many thanks. Greatly appreciated. I have an irregular heart beat but I do not have much more information. Will investigate further. Again, many thanks.
The short answer is YES Brancaster and welcome to the forum. The bad news is that alcohol and Arrhythmia do not go well together so that’s something you need to think about. There are several types of arrhythmia, the most common being AF (Atrial Fibrillation) so it would help if we knew more about your diagnosis.
Apixaban is an anticoagulant (we try to avoid blood thinner because they do not thin the blood) and it is prescribed to help prevent the stroke risk which is much higher for folk with AF. Most are apprehensive about what might happen when they take it but the reality is that most people find it makes little difference to their normal lives. There have been a number of posts recently about anticoagulants in general and Apixaban in particularly so can I suggest you scroll back a few days and read them. You could also type Apixaban in the search box top right of this page and that will provide you with lots of information, comments and views about anticoagulants……
Yes you will Brancaster1. It's entirely human to be somewhat afraid at the news you are to be taking a 'blood-thinner'. But, firstly Apixaban belongs to a new group of anti-coagulant medicines which are more trouble-free than warfarin ever was or will be, and secondly, except in a small minority of cases, causes few to no side-effects. You will not suddenly have to wrap yourself in cotton wool. And I do sometimes wonder why we all get so jittery around anti-coagulation when really it is the risk of stroke we should all be worrying about. Five times more likely to have a stroke than the person standing next to you! That's huge but we choose to focus our worry on the medication that's most likely going to stop this happening.I've been on Apixaban for a little while, with a minimum of inconvenience. And that is just remembering to take every dose regularly and to follow the advice given just in case we were to have a really major bleeding incident. Take your pills with no fear Brancaster1 and continue to enjoy your life with a brain and limbs that are working well and will hopefully continue to do that for many more years to come, with a greatly reduced risk of stroke.
Welcome to the Forum, I am sure all our members will make you feel welcome and share their own valuable advice and experiences with you. AF is a very individual condition and triggers can vary from person to person. If you would like more of an overview of the condition, may I recommend downloading the A F Fact File from the website heartrhythmalliance.org/afa... You will also be able to view many videos from our Patient Education Platform too. Alternatively, if you would like to contact our Patient Services Team, then we will be happy to help : info@afa.org.uk
Hi. As others have mentioned, alcohol can be a trigger for AF and even though I don't think it was mine, I've still avoided it for the past 5 years and still managed to enjoy a very active social life with soft drinks.As for Apixaban, yes I do get a bit more in the way of bruising as I can be clumsy at the best of times. Also, as I wield a scalpel for work on a regular basis (foot health practitioner), I am more mindful than most about cuts but otherwise I carry on as normal and happier that my stroke risk is reduced. 😊
HiI have been on these meds for three years and have no fears as they are keeping blood clots at bay I hope. I do not bleed any heavier if I cut myself, just scared if I fall and hit my head. I have the occasional drink still. Keep going you are doing well xx
Well now. Alcohol is often railed against, both by the medical staff and also people on this forum. Nevertheless, I have continued to enjoy an occasional drink of beer throughout my AF journey, and now that I've had an ablation and begun to feel more normal (jury is still out on this) I can enjoy one even more often. Red wine is definitely out though, I used to love a red wine with a meal, but it no longer agrees with me, so I will only drink white.
The advice I will give though is that you MUST remain well hydrated. I found that drinking a glass of water for every glass of beer worked for me. If you are out in a pub with friends, they will not embarrass you for doing that, and it will also slow you down so you don't drink as much.
If you are worried about the anticoagulant effect, don't. I'm a hand tool woodworker as my hobby, and often cut myself, even quite badly. It's slower to stop the bleeding, but not so much as to notice. Your main danger is with a bang on the head resulting in a bleed around the brain, but your age gives you more vulnerability to that anyway.
Many thanks.Greatly appreciated. Very reassured by all the helpful responses that I have received via HealthUnlocked.
I don't wish to lecture to you, but a couple of glasses of wine each day exceeds the standard recommended limit (14 units, or about 7 small glasses of wine per week) for anyone, let alone for someone with AF. Alcohol is known to impact on AF. I would suggest discussing with your GP.
You are lecturing and you are wrong. 14 units a week are not 7 small glasses. According to AlcoholChangeUK's unit calculator 7 small glasses (125ml of 12% alcohol ) constitutes 10.5 units so well within weekly limits. Doubling that would bring one up to the old limit of 21 units for men which is probably much more realistic in terms of limit. There has been some controversy about dropping the limit to 14 units for men and women alike given that women need to drink less than men as alcohol is more damaging to their bodies.
'You are lecturing and you are wrong. 14 units a week are not 7 small glasses. According to AlcoholChangeUK's unit calculator 7 small glasses (125ml of 12% alcohol ) constitutes 10.5 units so well within weekly limits. '
The NHS notes that "The recommended weekly limit of 14 units is equivalent to 6 pints of average-strength beer or 10 small glasses of *low-strength wine*" [my emphasis]. The strength of wines varies considerably, a Barolo, for example, often has above 14.5% alcohol content; so your 12% figure cannot be assumed to be relevant.
Furthermore, the Evening Standard observes that "A standard' glass of wine used to be 125ml...but the majority of bars and pubs have scrapped this in favour of a "small" serving of 175ml or "large" at 250ml which is the equivalent of a third of a bottle of wine." So a "small" glass need not refer to 125ml. Thirdly, Brancaster1 asked if it was reasonable to drink a *couple* of glasses a day, which would clearly exceed the recommended limit even on the most optimistic assumptions.
"There has been some controversy about dropping the limit to 14 units for men and women alike given that women need to drink less than men as alcohol is more damaging to their bodies."
Possibly-different countries have different limits- but the relationship between alcohol and AF, which is what is pertinent in the present context, is not at all controversial.
The AlcoholChangeUK's calculator actually gives specific figures for alcohol strength and glass sizes in ml so more accurate than "small glasses" and " low strength "which is vague. What is a "small" glass? How full is it? How low is low ? I doubt many people drink Blue Nun at 8% these days .Giving an actual amount in mls gives people a much better idea as at home they can actually measure how much they drink in the glasses they use. They can also look on the bottle at the strength of the wine and make adjustments though that is more difficult. However it is unlikely that 7 125ml glasses of stronger reds would exceed the 14 unit weekly limit. The calculator gives units consumed for 175mi glasses too. Anybody who thinks a 175 ml glass of wine is a small glass is full of wishful thinking. As for the relationship between afib and alcohol this an individual matter . Some people here are triggered into afib with just a sip of alcohol . Others can drink moderately without it affecting their afib. Suggesting that another poster should discuss his drinking with his GP is patronising at best.
"However it is unlikely that 7 125ml glasses of stronger reds would exceed the 14 unit weekly limit. "
Clearly, that would depend on the exact strength of the wine. But this is, in any case, of little relevance since Brancaster1 referred to drinking *two* glasses of wine per day.
"As for the relationship between afib and alcohol this an individual matter. Some people here are triggered into afib with just a sip of alcohol . Others can drink moderately without it affecting their afib. "
It's not just a matter of whether drinking alcohol triggers AF for a given individual on a given occasion. The situation with regard to drinking alcohol is not static. Someone who is able to drink alcohol today without getting AF, may find that it becomes problematic in a years time. Drinking alcohol makes progression more likely. The general advice from cardiologists is to keep consumption very low or at zero level.
"Suggesting that another poster should discuss his drinking with his GP is patronising at best."
My suggestion was that he discussed *the relationship between alcohol and AF* with his GP, not his drinking per se. This should have been obvious, since I was responding to the original email where he asked: "will I be able to have a couple of glasses of wine each day?"
"Drinking alcohol makes progression more likely. " Is their evidence of this? Brancaster might be the person you are responding to but will not be the only person reading this thread. My beef was with the imprecision of your original comment that 14 units a week was 7 small glasses. I would agree that 2 glasses of wine every night is probably too much for a person with afib. Though I am not sure that cardiologists here in France would not consider that low consumption! Of the 3 cardiologists I have seen not one has ever asked me about whether I drank or how much let alone advised against it.
"Drinking alcohol makes progression more likely. " Is their evidence of this? "
Yes. Studies show that even "moderate" drinking makes progression to persistent AF more likely.
"Brancaster1 might be the person you are responding to but will not be the only person reading this thread. My beef was with the imprecision of your original comment that 14 units a week was 7 small glasses. "
In fact, I said "a couple of glasses of wine each day exceeds the standard recommended limit (14 units, or *about* 7 small glasses of wine per week)" which is a true statement. Two glasses of wine per day unquestionably exceeds the recommended limit. And to say that 14 units is *about* 7 small glasses is also correct and is not imprecise since it builds in a certain margin of error (it is not imprecise to say of a tree which is 10m tall that it is "about" 9-11m tall).
" I would agree that 2 glasses of wine every night is probably too much for a person with afib. Though I am not sure that cardiologists here in France would not consider that low consumption! Of the 3 cardiologists I have seen not one has ever asked me about whether I drank or how much let alone advised against it."
That is just anecdotal evidence. The general medical advice is that alcohol consumption should be kept low or at zero level. The advice may be tempered depending on how they think the patient will receive the advice or on the precise circumstances of the patient.
"Your idea of what is imprecise is very different to mine -especially your tree example."
In statistics *precision* just refers to the reproducibility of a result. So if the estimated range of the tree's height is reproducible, then it has precision.
Many thanks. Greatly appreciated. Sorry - not of Norfolk stock. Born and bred north of the border but now living in Surrey. Would have been delighted to meet up with you in your local. Again, many thanks.
Hi Brancaster1I have an arrhythmia, atrial tachycardia and lots of ventricular and supraventricular ectopics. Because the atrial tachycardia mimics AF this is what they initially diagnosed. I’m on Apixaban and still play golf, enjoy the occasional glass of wine or gin and tonic but not every day. I now limit myself to once every one or two weeks. The rest of my life carries on as normal. Walking, gardening, enjoying the grandchildren……. Just continue to live life as you would, but maybe think about limiting the alcohol to once or twice a week.
The only things I would add to the good advice given to you above is that I discovered eventually, and only by chance - that you shouldn't take Ibuprofen with anticoagulants and you shouldn't have grapefruit. I think that fish oils are also a no-no. It's worth checking with your pharmacist or GP. I'm sure there is stuff about that on this excellent forum too.Hope all goes very well for you.
According to Kriegler, foods with a high amount of added sugar can contribute to inflammation and oxidative stress, as can industrial seed oils such as safflower oil, sunflower oil, corn oil, and soybean oil. Alcohol is another pro-inflammatory agent, he says. "When alcohol is metabolized in the liver, the by-products are highly inflammatory and create a great deal of oxidative stress, which can damage cells and tissues throughout the body. Alcohol also lowers inhibitions and can disrupt healthy blood sugar balance,” Kriegler says.
Guess you've got the message by now. The above quote is from wellandgood.com in an article called "The Anti-Inflammatory Diet Was Just Linked to a Lowered Risk of Dementia and Cognitive Decline"
Sharon Feiereisen
Sharon Feiereisen・December 4, 2021
Your choice as always. I'm 78 and been on Apixaban for a couple of years. (No side effects) After having a major stroke. Trust me when I say you don't want to risk that. It does change your life far more than having to take a couple of small tablets every day.
I, too, was having a hard time accepting it but this Forum turned me around . I realize I’m protected now. No side effects, no bruising. I don’t even know I take it. Good luck!
There's been a bit on here about alcoholHere's my 2 penn'orth, for what it's worth.
I tend to agree with Auriculaire.When younger, and had paroxysmal AF (rarely), I knew that alcohol was a trigger. But, I needed a hell of a lot to pull the trigger. Maybe 20 units in one night would do it, but much more likely that I'd get away with that or more.
In my late 60s, I found myself in a stressful situation, and drinking pretty much every night. Not getting drunk - certainly not 20 units! - but, still, a few drinks every night, and more at weekends. I think that stress was the primary cause of my persistent condition, tiredness the secondary, and alcohol the third.
My view is that we're all different. If your physiology is used to regular alcohol intake, and you have no indication whatsoever that this is triggering AF, then I wouldn't worry too much. Just be careful. Don't "go overboard" - rein yourself in on social occasions. More importantly, I would suggest that you regard paroxysmal AF as a "warning" that your heart is not appreciating your lifestyle. So, what I would do is either ration your visits to the pub, or if a daily visit is important, then have a few days when you drink little or no alcohol - shouldn't be problem these days with low-alcohol drinks, or maybe tea or coffee (as long as caffeine doesn't set you off). And, as has been suggested, stay hydrated.
Anticoagulants? I've been on both Warfarin and now Apixoban. I'm certain I can't tell any difference between them, and equally certain that I feel no different to when I was taking nothing at all.
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