Previous advice you have given was so helpful so wonder whether you could help me again with this one please … I am a 52 yr old female diagnosed with Afib in august this year. Went to GP complaining of chest pain/indigestion. He managed to capture AFib on ECG. Went down private route to see cardiologist who did an echo. He thought it could be percarditis. Said left atrium was slightly enlarged and some calcification, but nothing of significant concern. Also said there was no fluid re: percarditis. Still had intermittent chest pain/indigestion so did a Ct coronary angiogram. Had results yesterday and said overall good news as all the markers were ok and he would write up a report for GP and me. Don’t really know what this means and should have asked more questions but been suffering with health anxiety about this issue for a couple of months. I do feel very lucky and grateful for the good news, but am in a dilemma about the anticongulants. First of all he said it was up to me whether to continue them and then said because I don’t have any co-morbidities I should stop them, but may have to take them in the future. I am probably more scared of having a stroke than anything else. So my question is, should I stop taking them, do regular Kardia readings, monitor blood pressure etc with a view to taking them when I am around 60, or should I just continue with them at age 62. I have only ever knowingly had 2 episodes of AFib, once at the GP surgery and once about six weeks ago when heart rate when up 110 (normal heat rate quite low in high 50s). I don’t think I would have known about it unless I was having and ECG at the time. Thanks for taking the time to read and would be really grateful for any advice.
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It's a tough call isn't it ! I was given the same choice and decided to stop them - as soon as I went back into afib again I started to take them again. The link below might help. Your Chad's score could help to make your mind up.
I know what I would do in your situation - however I'm not a medic so sorry I'm not going to say. It's needs to be your decision (not very helpful I know). If you do stop then it's worth asking for an emergency supply in case you go into persistent afib.
Thanks for reply Paul. I do appreciate it. I have a score of 1 as a result of being female. Thanks for the suggestion about restarting as soon as I go into AFib.
The problem with that idea is that many people are asymptomatic and quite unaware they have AF. Your choice obviously but like you I am more afraid of stroke than anything and even though my AF was stopped ten years or more ago following my third ablation I still take warfarin and will for life.
I had a stroke in Feb 18, full recovery, no comorbidities, was 24 hr holter monitored, nothing found.
May 20 admitted to A and E, with dizzy spells and palpitations, stroke consultant in Feb 18 advised me any funny turns don't hesitate call 999.
Diagnosed with PAF cardiologist told me she was 95 percent convinced stroke was down to asymptomatic AF, changed from clopidogrel to apixaban in AandE took it ever since, wouldn't even think about stopping it when I was in hospital stroke ward I saw the devastation a stroke can cause
A friend of mine who was fit and active and relatively young (around 50 at the time) suddenly had a massive stroke one Sunday at church. He is lucky to be alive. They had to cut the top of his skull out to let the brain swell outside the skull or he would have died. He has some lasting problems and a dead arm and can't really concentrate well enough to work much.
That was all I needed to go to the GP and say "I'll have the anticoagulants please". I had been putting them off for a few years. As soon as I started them I felt a rush of relief. I hadn't realised how stressed I'd been about it all. I have never had an issue with them.
So, you do regular Kardia readings, BP etc. so what? Neither are that relevant in terms of having a stroke or not.
The thing that is relevant ... and I quote your words ..... "said left atrium was slightly enlarged and some calcification". Thats the one I'm afraid. To the best of my knowledge ( and I am not a medico ) that's where your stroke will emanate from.
Of course you may be adept at playing Russian Roulette ... kool.
As BobD says, how do you know that you are not asymptomatic and are having more AF events than you are aware of. I am and I am eternally grateful that back in the day my Cardio Consultant picked this up during my 6 day stay in hospital and went into writing on it. In those days I was 65. I'm now 78. Thank you Mr. Warfarin.
I'll quote you again ...... "I have only ever knowingly had 2 episodes of AFib, once at the GP surgery and once about six weeks ago when heart rate when up 110 (normal heat rate quite low in high 50s). I don’t think I would have known about it unless I was having and ECG at the time". That for me would be enough for me to challenge my medical team on the topic of being asymptomatic. It's your last sentence that would blow my mind.
You actually don't say why you are reluctant about taking A/c's. Why ? Just because you are 52 ? That is your calender age, I wonder what your heart age is ? Not trying to give you the frighteners - just put a perspective into the discussion.
It is important to realise that there is never a right and a wrong answer on taking ACs; this is because we don't know how the alternative would have worked out better or worse. So what are you left with?
You listen to the medics (bear in mind they will usually advise taking ACs if borderline due to influences, their training & professional indemnity), do as much research here and elsewhere as you can, weigh up your own body health state and lifestyle (re possible bleeds) and ONLY THEN take your decision.
I think Paulbounce is probably right in not disclosing his conclusion but this forum is all about different responses so I will mention mine albeit with the caveats that I am not a medic and only have a brief introduction to your circumstances.
I would say take ACs. Why. You are still learning about AF, recent diagnosis, maybe asymptomatic and ' I am probably more scared of having a stroke than anything else. ' You may, of course, take a decision later to stop for various reasons. If you do decide to take them Apixaban seems to be the favourite here but our CCG is pushing Edoxaban as cheaper and my cardiologist does not favour Rivaroxaban due to research in the States, which he didn't expand on.
I have paroxysmal AF and had a CHADS score of 0 before having a TIA (mini stroke) whilst reading about anticoagulants on this site in April and thinking I was lucky not to have to take them. It was over quickly and I have made a full recovery but have taken Edoxaban religiously ever since and I hate taking drugs. The TIA was a lucky warning, it could have been much worse. I do now have some anxiety about taking Edoxaban, especially as I am a keen cyclist, but I've learned to live with it. I take my pill at bedtime as I read that peak risk is in the morning so I like to know I have the drug coursing through me at a decent level at that time. If I'm going to go cycling, I only take half a pill at bedtime and the other half when I've finished my ride. I wear a medical bracelet and take a bleed prevention kit out with me, which includes a tourniquet if I go mountain biking - although only God only knows what I do with it if the worst happened.
Just saying my STROKE Left FRONTAL LOBE was at 2am. AN EMBOLIC STROKE. Carotid Arteries were clear but a shadow on my Thyroid was investigated. Papillary cancer all out incl 12 Right lymph nodes. 2 affected.
AF with the stroke.
As my CHAD score is needing an anti... I am reminded to take it.
No pills before except B12 nugget 1 per week. Systollic Reading high 150. 3 years later found I have a soft Systollic Heart Murmur.
I reckon I had AF before the stroke. Mine is classed as persistent but HB controlled. Night rate is always low at 47.
I’m 51, diagnosed with AFib at 49, very fit and healthy otherwise. I had an ablation in October 2021 and seems to have worked so far (other than countless etopics and breathlessness which is being investigated).
I’m still taking my Rivaroxaban as even though low risk, 1 on the chad score, I do have a history of stroke in my family so better to be safe than sorry as the AFib could be there but asymptomatic
I know this is an extremely personal decision, Jo, so I’ll just share my experience. I did not know I had AFib until 2 months AFTER the stroke it caused, at age 60, no other co-morbidities or symptoms. And because any episodes I’ve had since then have been extremely symptomatic and impossible to miss, I think the stroke may have been my first AFib episode. The cardiologist was happy when the AFib finally showed up because that allowed him to prescribe the NOAC. I had an ablation after having several episodes in short succession that landed me in the emergency room. I continued to have episodes about once a month for 2 years until I went on a 100mg x 2 daily dose in December 2020. No episodes since, but I can’t imagine ever going off the NOAC. I’m lucky to have little to no side effects from my current regimen of Eliquis (apixaban) and Flecainide, but it took me 2 difficult years to find the right meds for me. Wishing you the best of luck in finding what works for you - Juanita
i just saw my new Cardiologist with the same issue. I had covid and it seemed after that my heart went into Afib more often. Went to ER, had tests and showed the left ventricle could be swollen. I took that off to my cardiologist they took another EKG and it was okay. He said he wasn’t worried. he explained about blood thinners and said it was up to me to decided as I have no other serious issues. He did say aspirin was ok for now but when I turned 75 we would need to revisit the idea of blood thinners. I am currently 73. I take something called Nattovita which is an enzyme that includes Nattokinase which eats up anything foreign in the blood stream. I am lead to believe that includes blood clots. I have had Afib for most of my life, starting in my 20s. I just didn’t know what it was back then. I was highly encouraged with my new cardiologist when he said, his roll was my advisor not my boss. I thought wow that is a first I can work with this man. In the end we all have decisions to make. We need the facts for sure to make them.
hi I found your comments interesting. You’ve had AF since your 20’s, approx 40yrs now, what have you done to get it back into Sinus rhythm in the past and more so now as you are older. I’m in a similar boat having had an episode approx every 4-5 years over the last 30 years but now on drugs following my cardioversion till I go back to next Cardio appointment to make some decisions. I’m 64 and otherwise healthy
My episodes usually last about 12 hours and I just go back into rhythm usually when I divert my attention like reading or a quiet activity. I was on Tenormin for years because I was first diagnosed with a prolapsed heart value. But that was wrong, years later I had a horrible episode that landed me in the hospital. They gave me an injection of something which finally put my in rhythm. Saw the cardioligist had tests again but this time no prolapsed heart valve. Ugh! I was told I had pro lapsed heart valve syndrome. Given info to read about it. It really is an imbalance of the nervous system. The doctor told me then to take an aspirin a day, keep taking the medication and learn to meditate but also to excercise. So that is what i have been doing. However, as we get older things change. I asked about the “pill in a pocket” that several have talked about and he said NO, to that as it has horrible side effects. Ok then. They seem not to be worried because like you my health is good otherwise. What drugs are you on? It sounds like you have bad episodes, I don’t think mine are that bad. I personally think afib is an electrical issue but the real question is what throughs off the electrical balance? Being sick? Covid did a number. Is it WI-FI is is 5G? Or simply age and wearing out. I wear an Apple Watch and watch closely my excercise heart rate and I have had to put my foot down with my sons who seem to think I should keep up with them. We all have to figure this thing out and what triggers us. Sometimes it my husband, LOL!
thanks for reply, my recent AF was after 5 years of no AF, anyway my HR was around 85 at rest at the time. I went to Cardio and he put me on 100mg Flecainide, 25mg Metropolol and Apixaban. Approx 4 weeks after he did Cardioversion to put me back into Sinus. He then halved the dosage of Flec and Metro and said see you in 4 weeks to review drug regimen. I’ve learned that whilst AF has many similarities with us all it still can be a very individual condition and react or respond in different ways between us too
Isn’t that strange that it was so long between episodes for you. Did you have undo stress? I find that is another trigger. I also find that the difference in doctors, your are on 3 meds I am on none right now. How long were you in Afib? At 85 BPM at rest doesn’t seem so bad. Please know I am not giving advise just curious.
I was in AF for a few days and usually exercise fixed it but this time I was going overseas a few days later for a holiday week and Cardio said go on Meds this time for a month and if not in Sinus we can do cardioversion. I’m hoping to wean off them soon, maybe stay on thinner still working to understand the risks either way. Yes my HR was reasonable at 85 when at rest when I was in AF though it raced quickly to 150-170 when I was running. Yes I agree stress seemed to be a factor with me especially when I added caffeine or alcohol. It seemed to hit me the morning after when I went for a run or paddle. Ive learnt not to exercise after coffee or alcohol. Now that I’ve gone through this again I’ve decided to cut caffeine down to one a day and have started decaf coffee, and have started zero alcohol beer and will limit myself to 1 glass of wine.
You may want to look at how much you are running, I have learned that over excercise can cause problems too. It sure is a balancing act. Perhaps not run while in Afib.
In my humble opinion since there will always be a chance we might go into Afib again regardless of how controlled it is now I will not chance having another stroke. Some folks on here have said they will start them again if they go into afib but that might be too late if a clot forms for example if you were asleep or before your blood has a chance to thin in time when you start taking them again. God bless and good luck.
You may have a clot regardless of whether you take them or not.
There is risk of bleeding internally in taking them.
I have noticed that the PRADAXA 110mg twice day has a 33% risk of heart attac. New to me.
But I have persistent AF. The rapid should be under control.
There is risk in living. The specialist feels that the limited AF that you do get is not worth the risk as above.
My own opinion is that you are lucky and no I wouldnt take them.
I chose PRADAXA (without being told the above risk) because it was twice a day and could be reversed in the case of an operation in an emergency. That I feel is a biggy.
Report hopefully will answer your questions. Make the decision on ac's based on advice of GP and cardiologist.
Would also ask to wear a holter monitor for an extended period 24 hrs a day to better determine your condition and afib status. Better than the Kardia but do continue to monitor with the Kardia.
I am like you and terrified of stroke. They are going to have to fight me and pull my blood thinners away. I do not want to stop taking them unless they were to have one of those surgeries where they close that area off instead. Previously it was also mentioned having a watchman installed. It was decided I do not need that. My new cardiologist said I will most likely continue to stay on it. Even on it I just had a bout of a fib since the end of April but thankfully I like to think my blood thinner kept me from having a stroke. I started to have symptoms similar to my very first a fib event where I blacked out and hit my concrete floor face down. I realize now that I was lucky I was able to get up and someone was watching over me that night.
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