I was diagnosed w AFIB in May ‘23. Cycling has been my jam for 10+ yrs with 150-200 mi/wk the average during cycling season. Just am day 5 post ablation and have seen HR at very slow walks peaking at 145bpm. No sign sof erythema and no fatigue.
My resting HR is in the high 40’s low 50’s w peaks 150-160 bpm.
Trusting these spikes go away as I heal. Will not want to ramp workout unless these spikes subside after some time.
For those (M 61yrs 220lbs no smoke and very light drink) who have decided w Doc to get off of blood thinners (Eliquis 10mg) -how long post surgery did you decide to do this?
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Sucessful ablation does not automatically mean that stroke risk is reduced so most of us stay on anticoagulants for life. Of course if your Chadsvasc score was very low and you were only anticoagulated for the purpose of the ablation aand recovery that might be possible. Best be guided by your EP.
It varies by ep. I'm a CHADS 3 (2 points for age) and my EP told me we would evaluate thinners at 3 months post ablation, depending on my afib burden at that time. A previous EP told me I should be on thinners indefinitely unless the current research changed. I'm from the US.
Speaking of research, the React-AF trial has just gotten underway in the US to study whether short afib episodes require daily anti-coagulation even with higher CHADS scores.
Do not be swayed by anecdotal stories here about strokes, because there are also anecdotal stories about major bleeds.
Stick to what your EP tells you, the science and your own independent research.
Hi mjames1I'm not clear why you make this comment -
Do not be swayed by anecdotal stories here about strokes, because there are also anecdotal stories about major bleeds.
Is it consistent or helpful to your general answer or to the person asking the question? Experiences of stroke might be very relevant and providing they are based on fact, relevant when explaining why anticoagulants are used when Afib is detected. Experiences of bleeds are not likely to be caused by anticoagulants or exacerbated by anticoagulants since an arterial bleed for example is highly likely to cause a problem with or without anticoagulants.
The exception might be the potent meds used in thrombolysing treatment for a stroke which do carry a high 1:10 risk of a bleed. I have had thrombolysing treatment having taken antiplatelet meds an hour earlier.
I thought it helpful because the thinner topic/decision can get very emotional here and elsewhere. I'm not saying anecdotals should not be posted or taken into consideration, but not at the expense of evidence based decision making. Thinners can be lifesaving or counter productive, depending on a myriad of factors.
I'm with you on the sterile debate some anti meds people bring to HealthUnlocked. I think that's what you're saying!On your point about accuracy, I know you were responding to the post title, but anticoagulants are not 'thinners'. It's the sort of emotive, incorrect shorthand that gives rise to irrational , negative fears and anxieties around the use of anticoagulants. Its quite subtle too to pose two counter arguments in the same sentence as if they have equal value. If, there are positive and negative benefits to DOAC's, no evidence of a myriad, on a continuum of effect or impact then it is not a normal distribution but skewed heavily to the positive outcomes with a very low incidence tail of negative outcomes excluding side effects which are not in themselves evidence of the medication not working.
The new study you point to in the US will of course review all the evidence gathered since the introduction of Afib treatments. One would expect a huge bank of data to provide insights and refinement of target groups for maximum benefit. Evidence evolves, treatments change and fine tunes population based interventions to do the greatest good towards personalised treatments, the 'holy grail' which science is working hard to achieve.
I have a LINQ implant which is an example of this movement.
For better or worse, ep's and medical scholars use the words "thinners" and "anticoagulants" interchangeably. Both in the US and UK. And at least in the US, "thinners" is used most often. And remember your heart is not being attacked when you have a Myocardial infarction (MI). Yet we all call it a heart attack and we all know what is going on
This AHA research paper titled "Blood Thinners for Atrial Fibrillation Stroke Prevention" is just one of many cases in point.
I think most ep's would not press you to continue thinners, especially if your afib burden remains low after your ablation. At least not in the US. Personally, especially given you passion for cycling (not a low risk sport for bleeds) I would not continue with thinners if in your cycle shoes
Your AF may well have been caused by your exercise regime. So, the ablation may not be effective unless you moderate your workload. I used to cycle a lot (e.g. Hayling Island to Paris and back, South Downs Way) but moderated that after my ablation. I did have runs of high rate (180 bpm) for a week after the ablation, but those did settle down. Your anticoag decision should depend on your CHADSVASC score. The ablation, whether successful or not, does not affect this decision. Incidentally, I did have a TIA at age 58 despite having a score of zero and being as fit as a fiddle, so it's not foolproof.
🤔I need to do some more research on this important area. What is still not clear to me is whether the TIA can confidently be attributed to having had AF or is it more likely the company AF keeps ie other causes (eg genetic propensity) that would have resulted in the TIA even if there had never been a history of AF.
Yes, the latest thinking is that the TIA and AF had a common cause. Possibly inflammation from too much exercise in my case, together with a genetic component.
Hi I’m 52 now, diagnosed with AFib at 50, had an ablation 2021. I used to cycle and run a lot but with advice from my consultant no longer do it as was told it was probably my exercise regime that bought the AFib on in the first place so just walk now 🙁 I’m still on anti coagulants though as a precaution.
I am 7 months post ablation and my EP did ask whether I would like to come off the apixaban last month as my CHADs score is 1. I thought it was too soon so we agreed to keep me on them for now to see if the AF came back. I was only put on them in Feb 2022 after 10 years with AF, as there was a push by NICE to get everyone with AF on them ( saw this on TV a few weeks ago). I am glad I did as my AF burden increased dramatically this Spring.
After a recent visit with the cardiologist my chads has gone from zero to 1 because of high blood pressure reading in the visit.!! But at home it’s always spot on. So I start anticoagulants soon.!! It doesn’t bother me but just one high reading after a very stressful drive to the appointment has put me up a score😳 I will mention it on my next visit in 4 months.
Many doctors would never base a blood pressure decision on a single reading. My personal doctor takes my home blood pressure readings, more seriously than those in the office. He says that's my real blood pressure not a one off at the office. Influenced by many things.
Thanks Jim. Iv got app with doctors next week to start me on anticoagulants so I may start then until I see the cardiologist next year and show him all my home readings.? I’m not against taking the anticoagulants at all because I was on them at the start of my afib. but I feel I may actually not need them at the moment.???? Although I am getting little episodes of afib in the early hours that last around 30 minutes to a hour so wether it’s because of this I don’t know.??
When you need thinners, you need them. When you don't, they can be counter productive. I don't think anyone will disagree. Hopefully you will make the right decision.
I definitely agree Jim and I will be on them as soon as doctors prescribe me them next week👍 But I think it would be a good idea if I take my home blood pressure readings with me on my next visit to him next year as well. Iv no worries about taking anticoagulants at all if I need them, but I don’t want to be taking them if I don’t really need to because of one higher blood pressure reading on that morning when all the rest are normal.
I can only say I was diagnosed with AF, prescribed Apixaban but did not take it and had a major stroke 4 years ago. I've never had an Ablation though as my consultant did not think it was necessary. Fortunately the stroke had no effect on my active lifestyle after I came out of hospital, and I'm cycling almost every day, and do weights now at my Doctors advice, but I'm 80 soon and enjoy being active, so what's the point in worrying about doing something that you enjoy at that age? Something will kill me sooner or later anyway. I believe the bleed risk is very low with Apixaban anyway. I don't drink though, and would not dream of doing so with AF. I switched to a vegan diet last year and my BP has been very low since then. I would not dream of stopping Apixaban though personally as the stroke risk can only increase with age.
Thanks Roy Keep going w your regiment. Cycling into your 80’s is great. Cycling is great for the joints, the ticker, socialization and mental health. Ever since diagnosis I have been off the bike but will be getting back on soon. I did not want to burden my riding buddies with riding with someone who would stop because one of the group (knowingly) members could have an AFIB attack and slow everyone else down. I also did not want to burden someone who may see me “bleed out” if I had a serious crash. I did get a medical bracelet. Still trying to figure things out.
You might look into a good electrical assist bike. With it, you will be able to keep up with your buddies with the exact amount of effort that you want to put in. Many of them are indistinguishable from Road bikes.
Alternatively, You can also easily install a mid drive motor on your current bike. Not only more cost-effective, but you will have the bike you're used to. The Bafang 750 is one of the good mid drives but you could also get away with a smaller motor like a 250-350 if they are not too many steep hills.
The only other point that my GP pharmacist told me that swayed the decision was that AF stokes are usually not mild and can cause life changing results. Whether this was a scare tactic to get me to go on them I cannot say
I had an AF Stroke Sept 2019. And found 4 days later with Papillary Thyroid Cancer. On no meds except SOLGAR 1000ug 4 days week I keep my level B12 at 700-800.
Put on Metoprolol (useless - breathless, no energy, fatigued and pauses at night - stroke was at 2am). Also PRADAXA 110mg x twice. (Later discovered research says no anti-co.agulant with Cancer). Cancer removed 4 months later.
Stroke rendered me unable to talk clearly, dropsy in right hand with fingers swollen, dropped mouth. Ischaemic - Embolic type small brain site found left frontal. 4 years 3 mths down track still got a bit of the above. Keeping TSH 1.5-2.5.
The risk of stroke with AF is high. No bleeding being a risk having the odd fall, including bang on head, cut hand 10 days ago and 2 operations in last 10 days. No problems. I was late by 2 years 3 months in being on the correct med to CONTROL rapid H/Rate and CONTROL OF BP.
Health - there are always risks. Too late if we don't take up research to guide us.
I have a recent Raleigh bike in my garage I would love to get on. But hills both side of me!!!!!
I no longer ride regular bikes. I have 2 ebikes. You can still get plenty of execise by going further, or selecting the lower levels or NO motor assist. Going up hills is a breeze AND if my knees or heart complain, just use the throttle during those times. Proces here have dropped dramatically due to overstock and probably new models coming.
My daily driver is an Espin Nesta 20" 4.0 wide tires and cost me $1400. Now they have a sale and it's $800!! A bargain.
I had ablation about a month ago and my EP is advising to stop thinners 2 months post ablation. I’ma little younger than you and BP fine so apparently low stroke risk. In USA.
I agree with BobD, you may wish to ensure that a stroke does not occur from clots. These may develop more easily since you are active. I take Nattokinase 2000FU natural blood thinner and it dissolves clots.
I motorcycle, ebike and hike.
I take 2000FU (Fibrilytic Units) 1 capsule /day of Nattokinase along with additional thinners such as Vitamins "E" and "D". I also take 2 Turmeric capsules daily (800mg) each.
So far I've been fine. The side affects of the prescription thinners seemed to awful for me to deal with so I went natural. The Nattokinase is know even by nih.gov here in USA as effective as big buck clot dissolving drugs.
Check my post at healthunlocked.com/afassoci...
for more details. Good luck in your life endeavor.
If I even considered natural B12 Solgar works, I would be reported by my H/Specialist which one did last year when 1 x 3 mth prescription went. unacknowledged! I was furious as I did argue that I had taken PRADAXA regularly.
A friend run out of her PRADAXA for 5 days and had a mild stroke.
Could folks go down the road of the reduced 110mg PRADAXA x twice day?
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