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Atrial Fibrillation Support

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anticoagulant

Mabal profile image
39 Replies

Good morning all

I have probably a silly question

I am female age 56 not that fit, should do more exercise.

My Apple Watch is set to show any signs of AF

It has shown 2% or less week 17-23rd

And same week before

(I have only just set it up to show this)

I had a successful Cardioversion back in Oct 21

Saw Cardiologist in Jan 22 who stopped the Apixiban

I am currently taking Bisoprolol 5mg

And thank god I have not felt or had any AF episodes since and remain in NSR

Although now my Apple Watch has shown 2% or less ( I no this is very small figure, not sure what that means really)

Should I be taking Apixiban ?

Do you think I should speak to doc regarding this ?

I do random manual pulse checks and always regular and random ecg on my watch and always NSR

Thankyou for taking the time to read this

Hope it makes sense

Have a good day 🥰

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Mabal profile image
Mabal
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39 Replies
sassy59 profile image
sassy59

My Apple Watch also shows 2% or less which I’m not concerned about. I’ve never seen a cardiologist and am on Rivaroxaban, Bisoprolol and Losartan. So far so good.

If you’re concerned about anything to do with medication then do speak to your doctor. Wishing you well.

Mabal profile image
Mabal in reply to sassy59

Thankyou for your reply

From what you have told us, bearing in mind that I am not medically trained, the answer is likely to be no but it has to be properly assessed using the CHADsVASC system of scoring. It may not be appropriate to you, but for the benefit of others, if medication is taken to control blood pressure, then the patient needs to still add a point for high blood pressure. As has been said, this is best discussed with your Doctor but there is no such thing as a silly question. No one should take anticoagulants or any prescribed medication unless it is recommended and prescribed by a Doctor……l

Mabal profile image
Mabal in reply to

Thankyou for your reply

BobD profile image
BobDVolunteer

The secret is to find out what your CHADS2VASC2 score is. I am a great advocate of anticoagulants but it must be admitted that they are a risk / benefit equation. You can google CHADSVASC and do your own calculation but it is important to remember that scores can't be removed, so for example even if your blood pressure is normal but you are on medication to control this you still have to include the score.

If you score one then anticoagulation is voluntary , two, reccomended and three or above essential.

Mabal profile image
Mabal in reply to BobD

Thankyou for your reply

Vonnegut profile image
Vonnegut

We are all different! The lowest dose of 1.25 of Busoprolol brought my heart rate down too low and made me feel extremely tired so I was advised to stop taking it by pharmacist and doc after three days! Only take it on the extremely rare occasions when I have an AF episode with a very fast heart rate - (the 1.25 dose). Good luck with finding what suits you.

Mabal profile image
Mabal in reply to Vonnegut

Thankyou

Martharose03 profile image
Martharose03 in reply to Vonnegut

I am new to this having stopped Bisoprolol due to low heart rate (43) with medical advice, am now to take as ‘Pill in Pocket’

Not sure I understand when it is needed, maybe it becomes obvious. I have been uncomfortable with HR of 180 bpm stuck it for half an hour, then it naturally reduced!!

Vonnegut profile image
Vonnegut in reply to Martharose03

You need a Kardia to check what your heart is up to and a prescription for Flecainide which has more chance of getting your heart back to normal as Busoprolol only reduces the heart rate.

Martharose03 profile image
Martharose03 in reply to Vonnegut

Thanks for your advice

Vonnegut profile image
Vonnegut in reply to Martharose03

Good luck!

mav7 profile image
mav7

Should I be taking Apixiban ? Do you think I should speak to doc regarding this ?

Yes, with the Cardiologist who told you to stop. Maybe ask to take an EKG and wear a holter monitor to confirm.

Mabal profile image
Mabal in reply to mav7

Thankyou

Buzby62 profile image
Buzby62

As I understand it Apple Watch/iPhone AF History is an alternative set up if you are known to be having AF episodes so as you don’t get Irregular Rhythm Notifications. Irregular Rhythm Notifications are not available while AF History is enabled.

2% or less AF History is the result I get if I’ve had zero AF that week which would be the same for someone that has never had AF. If I was AF free for as long as you appear to have been following a procedure, I would revert settings back to Notifications and disable AF History. You would then see exactly when AF was detected (if any) rather than a percentage for the week. Hope my opinion is helpful.

Mabal profile image
Mabal in reply to Buzby62

Very helpful Thankyou

Buzby62 profile image
Buzby62 in reply to Mabal

I would just add that the Apple Watch is not a continuous monitor like a holter monitor. The watch only does background checks in certain conditions, eg. when sitting quietly at rest, I believe this is the same for both AF History or AF Notification modes, hence the 2% or less result as it cannot accurately confirm zero AF.

Mabal profile image
Mabal in reply to Buzby62

thankyou

TopBiscuit profile image
TopBiscuit

The '2% or less' response from the Apple watch is the standard response when there's been no AFib registered. ie, if you have it set to monitor AFib that's the lowest it shows - it doesn't say 'no AFib occurred' it says '2% or less'. That's been my experience anyway.

Mabal profile image
Mabal in reply to TopBiscuit

Thankyou for your reply

secondtry profile image
secondtry

I am with your cardiologist and I would start saving for an annual private appointment with him/her. I have had annual appointments with mine and found it useful in reducing anxiety and building a joint agreement on the best way forward.

Mabal profile image
Mabal in reply to secondtry

thankyou

Ppiman profile image
Ppiman

A doctor will calculate your personal risk, and from that decide whether you need to take action against possible future blood clots. Having any risk factors such as sleep apnoea, high BMI, inactive lifestyle and so on might all be added into the calculation.

Another thing you could do is run an ECG for a longer period. Your doctor might be willing to prescribe this or you can buy a Wellue AI 24-hour monitor and do it for yourself to show your doctor. The Apple Watch ECG monitor only checks for irregular pulse rather than actual AF, so is far less useful for the purpose you need.

Steve

Mabal profile image
Mabal in reply to Ppiman

Thankyou

Silky57 profile image
Silky57

Hi there. I’m in an almost identical position to you but without the cardioversion. I’ve only ever had one episode of AF (less than 30 seconds) picked up on an iwatch. I’ve seen my EP this week & had this very discussion.

My CHADS-Vasc score is 1 (female), so I will caveat his response by telling you to make sure you know yours.

With lone AFib, one short episode, no current episodes, wearing an iwatch with Notifications turned on (turn History off as Buzby said), and the fact I’m very conscious of irregularities in my heartbeat, then declining anticoagulation is currently the right decision for me. He’s supportive of a pill in the pocket approach in my case. If anything changes, I have a pack of anticoagulants ready to go in my cupboard immediately. Also, I realise age will flip my score to 2 when I reach 65, but at 56 that’s a way off.

I should tell you though that other medics will advise you differently. You will not get a consensus on this one from the medical fraternity. We are in a little grey zone with mixed research & advice. It is therefore important you look at your own risk factors and discuss them with a medic who sees the whole holistic picture of your personal health.

Wishing you all the best.

Ps the comments about the 2% or less are also correct. History is set to show that as a minimum, never 0%. It’s in the blurb.

Mabal profile image
Mabal in reply to Silky57

thankyou

Karendeena profile image
Karendeena in reply to Silky57

I thought taking anticoagulants as a PIP wasn't recommended as it's unlikely to be successful, at least that's what my EP says. I think there are inconsistencies between consultants and medics which is a bit of a worry

Silky57 profile image
Silky57 in reply to Karendeena

The are most definitely differences in opinion, which makes it difficult for us to know if we’re doing the right thing! He took my whole medical history into account, his knowledge of relevant research and my personal wishes and then agreed. He said he’d rarely agree pip as a sensible way forward but felt it was in this case. Interestingly, he also said there was talk of doing more research on this as it would seem logical not to be medicating people when they are not experiencing Afib. But little appetite from pharma to run the research as it would cut rather than boost profits.

Vonnegut profile image
Vonnegut in reply to Silky57

I tried to “like” your comment re drug companies’ concerns but the “like” went from 2 to 1! It needs a little help with addition!

Silky57 profile image
Silky57 in reply to Karendeena

And following my response below, a quick Google found this interesting article on new research on ACs as PIPS.

onlinelibrary.wiley.com/doi....

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

The question is WHAT IS YOUR SCORE.

Female 1

65 or over 1

AF 1

Some specialists say keep anticoagulants to minimum so if AF infrequently try

PIP Pill in Pocket.

But for those who are anxiety driven, then PIP is not for them.

You need to put yourself in a place of trusting your judgemeni.

I had a stroke at 70 year with AF. Not on any drugs. Not offered anticoagulants.

But 4 days later whilst having my carotid arteries check for build up cholesteral but mine were clear. But what it showed was thyroid papillary cancer. Removed 2020 February 4 months after the stroke. 3 years free of cancer.

Talk it over with your GP. But opinions differ.

Make the best of decisions. Yours is the one which counts.

cheri JOY. 74. (NZ)

Mabal profile image
Mabal

thankyou

mjames1 profile image
mjames1

If you don't need an anticoagulant, why would you want to take it? Thinners have their own risk profile. BTW the Apple Watch, not very reliable with afib burden. Better to do a two week zio patch if you want to be sure.

Jim

Mabal profile image
Mabal in reply to mjames1

Thankyou

Mgal profile image
Mgal

I think you'll find that this is a 'function' of the AppleWatch accuracy. It doesn't monitor AF continuously and 'less than 2%' is as low as you'll get - ie undetectable!

Mabal profile image
Mabal in reply to Mgal

Thankyou

Karendeena profile image
Karendeena

Hi there Mabal, I would say "once with afib, always with afib", the problem is it never actually goes away and you could have short episodes and not no it. My brother had undiagnosed afib and unfortunately had a stroke. I wouldn't risk it and stay on anticoagulant

Mabal profile image
Mabal in reply to Karendeena

Thankyou

fibnum profile image
fibnum

Definitely do more exercise. I don't know about the Apixiban, but exercise is a sure benefit.

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