I have found this forum so useful since having my first paroxsymal a-fib occurrence two years ago at age 63. I had several occurrences of a-fib with fast heart rate of 110-150 bpm. Fortunately these all self-corrected to NSR within 1-4 hours. I am fit and not overweight and the a-fib usually happened when I lay in bed.
I have private medical care. My EP is Dr Shabeeh and following a range of tests he advised my heart is structurally ok. He gave me a pill in the pocket to take when having an episode but this made me feel drousy so I didn’t take it. He said my CHADS score meant that I did not need to take an anti-COAG. He recommended an ablation which he performed at London Bridge Hospital 18 months ago.
The ablation went well and I have been a-fib free since then. I had to take Apixaban for some time after the ablation as a precaution. I did find my resting heart rate was raised from 60 bpm to 80 bpm for a few months but it’s now back to original.
I recently had a NHS review with another doctor and although a-fib free they are suggesting I start taking Apixaban as I will be 65 in a couple of months. So I didn’t take Apixaban when I had a-fib episodes but now at 65 without a-fib it is suggested I start taking it.
So I’m trying to work out the risk vs benefit and would welcome any thoughts on this.
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rocketiii
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I had a similar history in that no AF for 12 months after ablation so I stopped taking anticoagulant - 2 months later I had a TIA. I was 63 at the time and my EP had warned me that as soon as I hit 65 they wanted me back on anticoagulant.
If you had no reason to not take it - why raise your stroke risk?
Sounds like my experience. No afib for 2 years and then wham a mini-stroke. I've taken Eliquis religiously since then even though I've been afib free since my ablation. It's not worth the risk or worry about another TIA.
Presumably you have at least one other risk factor (e.g high BP) which will take your CHADS VASC score to at least 2 when you turn 65 (of course there is no magic in the actual date!)? - at this point the balance of stroke vs bleeding risk tips in favour of taking an anti coagulant. My situation is similar (not 65 for a couple of years but other risk factors) although I am already on Apixaban due to these risk factors (and after a successful-so far-ablation). I would rather not be, particularly as I am very active, but on balance it seems to be the right thing to do.
Then with my lay person’s understanding I’m not sure why you need anti coagulation… sounds like you need to query and/or get another opinion
As has been said, once you reach 65 your CHADs increases by 1 point and most medics tend to encourage patients to take an anticoagulant. Many AF patients assume that if they have had a successful ablation then anticoagulation isn’t necessary but this is not the case. Once diagnosed with AF, the increased risk of having a stroke remains even after a “successful” ablation. Also bear in mind, arrhythmias can occur whilst you are asleep and you would be unaware. It is, of course, your choice but most are keen to avoid having a stroke.
Thank you for your message posted on the Forum, I can see some of the members have offered great advice based upon their own experiences. If you would like to contact Patient Services on 01789 867 502 or email on info@afa.org.uk , we will be very happy to help. In the meantime, please visit the AF Association webpage to download our 'Preventing an AF-Related Stroke' booklet: api.heartrhythmalliance.org...
I would also recommend registering for the 'Living with... AF' patient educational online event, that is free to view with unlimited access. You will have access to up to date information from the medical experts heartrhythmalliance.org/afa...
Once I hit 65 plus being female immediately affected my Vhad score & EP said I must go on anti-co ag. I've struggled with them due to bleeding so on half dose now.... I have mild P-Afib.Thing is your stroke risk rises so that's why they push them.
Several cardiologists have informed me, in the last few years, that there's been further discussion of whether being female should actually count in the CHADS/VASC score, and that it tends to be leaning away from female being a significant risk factor (or at least equal to the other factors). I was actually advised not to really consider it. I have the idea that sometimes certain kinds of guidelines are put in place by committees that are designing horses... Diane S.
It's the usual problem of trying to make us all fit in one hole. Such generic assessments has to be flawed & include people who dont need to be on anti-coag. The statins one is equally very poor! It's gives u 10points if you tick the Afib box without ticking anything else! In other words if you have Afib, no matters it's form, degree or cause you will be told to go on statins! Did big pharma design it??
All so true, waveylines... I'm interested in your being on 1/2 dose of AC; I bruise easily and maybe 1/2 dose would be adequate protection (not on any at the moment). As you say--never any consideration of our Afib's "form, degree or cause". My BP is low, my HR is usually 83-105 when in afib, and I have yet to hear a discussion of how factors such as these affect the need for AC's. Guess we have to keep doing that research!... Diane S.
My cardiologist would say it's an inadequate dose......I know this because I asked him. My GP says its better than not taking it at all....he's retired now but a wise GP. I agree with him. The bruising I could take....but the horrible vampire mouth aching teeth & being fast tracked twice in 6 months for bleeding I could not take. Whether it's right what I'm doi g is probably on the fringe because dosing is done in a blanket way.
Thank you for all these comments. I’ve also spoken to Tracy on the Patient Services line and I now have a clearer idea of the benefits and (small) risks. I think I will take the Apixaban.
It is simply because you are female and older. The statistics indicate you are more at risk due to these factors. My GP recently calculated my cardiovascular risk score, informed me I'm in danger pf heart failure within the next 10 years and therefore need statins. I'm 66, had an ablation last march, no AF since May and feeling pretty good. My BP tends to be high so I stayed on ACs. Ignored the nonsense re statins though!Only you can make the decision.
Did he actually say heart failure or a heart attack? There is some evidence from Japanese studies that statins actually contribute to congestive heart failure. There is a physiological mechanism why this might happen . Statins interfere in the same metabolic pathway in the liver that produces co enzyme Q10 as well as cholesterol. Co enzyme Q 10 is important in the process that converts food into energy and is crucial for good muscle function. Which is the most important muscle in our body?
I started suffering from AF in 1995 when I was in my late 40s. Apart from rate control with Sotalol and lots of periods of uncomfortable AF when stressed, I had no problems. Then having retired and at the age of 74, I was suddenly struck with an ischaemic stroke, something no doctor had warned me about. And all because I did not have something as simple and relatively harmless as apixaban, which I now have taken daily since 2020.
My advice to you would be to carefully weigh the health risks as apixaban is a very safe drug compared to very many others, and just because your AF is 'fixed' for the present, the episode when you don't even notice it, could be the one causing a stroke, particularly as you get older.
I just wish someone had advised me to take apixaban a few years ago, as although I am somewhat 'recovered' from the stroke, my life has been changed for ever. You do NOT want to go there!
From what I have been told and read, a single episode of AF is sufficient to confer the need for anticoagulation for life if the Chads score points to it. Also, I gather that no one truly knows the risk of thromboembolism in an individual case as the cause might be multifactorial, and include anatomical aspects of the atrial appendage, perhaps even, amazingly, the AF itself not being the cause.
There is plenty online, especially Google Scholar about this. It's unfortunate to have to take such a profound (and expensive!) drug, but that seems to be the reality.
I will be the same once I reach 65, consultant said anticoagulants at 65, age and female are the 2 rise factors I believe. Better than a stroke, although I will be disappointed when the time comes.
I have been taking warfarin since 2009. It's no big deal. Don't understand what there is to be disappointed about in taking a pill that can prevent a possible lethal event.
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3 months since ablation now getting ectopics
3 month post Ablation. EP say to stop taking apixaban.
Ectopic beats 18 months after Atrial Flutter ablation 
Had AF for 30 hours now (18 days post ablation)
4 months after ablation and Amiodarone will be washed out in 2 weeks time. All looks good after 72 hour heart monitor two weeks ago.
