Hi Forum. At my pre op assessment (for hip surgery) last Monday the ECG showed AF. No symptoms at all, I walk my dogs +/- 4 miles daily. My BP machine shows normal resting heart rate and BP. So on strength of one ECG my GP has prescribed anticoagulant tabs which I know is for the AF risk of clotting. She has also referred me to the cardiologist, who replied with take the anti coagulants and have the surgery - no follow up. However the GP has asked them to see me in case I need cardio version! I want to wait until I see the cardiologist for the echo before I go down the medication route.
I don't take any other meds.
Unwisely I did drink a large coffee on an empty stomach and quite a bit of rushing around just before the ECG.
So my first question is should I take the anticoagulant tablets or wait until I have had the echo ?
My second question is - if I have AF would I be able to feel it?
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Morges
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Too many have found about their AF after it has caused a stroke because it was asymptomatic and they didn’t feel it.
In 3 years I only had one episode confirmed on an ECG at my surgery to confirm what my watch was saying. None of the investigations recorded any AF but I know I had 40+ episodes recorded on my watch.
Here’s a link to all the patient information. Have a look at the AF Fact file and FAQs to start with.
The gadgets are not for everyone and they definitely can cause more anxiety if you are that way inclined. You will find lots of opinions on the forum. For me I wanted to know and without my Apple Watch I would not have known where I was. Now I can identify AF just by taking my pulse and there is information in the above link regarding the Know Your Pulse program. There’s a lot to get your head around and I was the same as you regarding medications in the beginning but when you hear the horror stories a stroke can cause it makes sense. The more you read and understand the better.
You’re in the right place here.
Use the search bar to search previous posts on anything,
click on peoples badge to look at their profiles, posts and replies, I have replied on a few about the wearable devices.
Also see Related posts when you’re in a post or pinned posts for important information.
Thank you. I trained as a state registered nurse many years ago (but specialised in surgery rather than medical hence cardio ignorant) so I can and do monitor my pulse - the b/p machine only uses portion of a minute for pulse so I always take it over a full minute. I have an irregular pulse anyway thanks to Left branch block which again was picked up by chance 3 years ago, but no treatment deemed necessary. So between that and possible AF....
Absolutely worth it. Even if you're adept at taking your own pulse, the documentation is invaluable when you see your doctor. Both the Kardia 6L and the Apple Watch are medical grade devices and I recommend either from both research and personal experience.
And yes, you can have a fib without knowing it. And if that's the case, it doesn't necessarily require surgery(ablation) nor would it necessarily be beneficial. An electrophysiologist who knows your medical history would be best to advise you regarding anticoagulation and next steps.
"And yes, you can have a fib without knowing it. And if that's the case, it doesn't necessarily require surgery(ablation) nor would it necessarily be beneficial. "
Jim
Assuming the ablation works, why wouldn't it be beneficial? I would have thought not going into AF would reduce risk of both stroke and remodelling of heart.
I had Afib that I did not feel, but docs and ecg could detect, for many years. A miracle I did not get a stroke.I refused anticoags. and then had a TIA.it was also found I had a hole in my heart.I then took Warfarin for about 5 years and am now on Apixaban. Various other heart 'ailments' have crept in over the years but at least I am now doing my best to keep strokes at bay.
If asymptomatic, how do you know that you've only had one AF event? The challenge with being diagnosed with paroxysmal AF is having an ECG taken while you're in AF.
I suspect I had AF for a few years before it was diagnosed. Even wearing a Holter monitor for 24 hours the year before I was diagnosed with PAF didn't pick it up. So some of my "episodes" were blamed on GERD and others on ectopic beats picked up by Holter monitor.
My AF was eventually picked up in a visit to ED while still in AF where it was finally picked up on ECG.
Hi Morges, we’re all so different with our experiences of AF. My sister (also diagnosed during assessment for hip surgery) is symptomless and happy to take an anticoagulant and leave it at that. I opted for cardioversion as I heard the sooner you get treatment the more likely the success and then later took the ablation route. But do definitely take the anticoagulant until advised otherwise!
I would say, take the anticoagulant, knowing the odds of stroke with a fib. I will be on at the rest of my life, and I don’t mind it beats the alternative. I was put it almost immediately after my first a fib episode, but I did have a lot going on. They can always take you off stuff but to risk, especially having hip surgery is not something I would suggest. In the office of my cardiologist he actually has a big chart and part of that is the dangerous of clotting with hip surgery. I’m not making this up it’s real. I would say be safe, not sorry, but that’s me. Good luck. I never had warnings. My first warning was waking up on the floor twice in one night not having any idea what happened it would be nice if a fib could send us a telegram or a text, but it doesn’t do that.. Your GP sounds very on the ball. You should be thankful. My primary was as soon as he learned what happened but if you don’t have doctors like that, it’s very scary.
you may not be able to feel anything - I imagine that if they are considering cardioversion you are still in AF. Depending on your age and other factors you would routinely be given anticoagulants. Be pleased it was detected! Sorry to add another health journey though
After many years with paroxysmal AF, treated successfully with Flecainide I was found to be in persistent, though asymptomatic, AF. My Flecainide was stopped I was no longer benefiting from it. I have taken an anticoagulant for many years, though originally was prescribed aspirin.I have acknowledged that my persistent AF is permanent.
I see no benefit in spending good money on any gadget to tell me I'm in AF. I go on how I feel.
If you get a watch, whether Apple or Wellie or something else, the chances are that you'll let it rule your life. You'll find out that you have asymptomatic episodes while you're asleep, and become anxious, wondering what's happening, rather than going on how you feel.
It's quite possible that you are in AF all the time. If it's asymptomatic you won't feel it. If it is all the time a watch will be of no benefit.
It's likely that no one, not even a leading cardiologist, can answer your question, but, for sure, it is not good to have to take anti-coagulants for life. And yet, the balance of risks points to the need for just that, hence your prescription. After my single episode of AF following an ablation for a different arrhythmia in 2019, I was told that meant "blood thinners for life", so that's what I take first rivaroxaban, now apixaban. I wasn't about to question a heart specialist.
Since then, I have had an infrequent but increasing number of AF episodes. That's the nature of this arrhythmia ("AF begets AF", they say): the heart cells change and cannot change back (they are a unique cell in the body and have no means to replace or repair themselves). So, they become more likely to spasm and quiver chaotically rather than pulsate healthily, and, with that, bring along the risk of embolic stroke. Thank goodness for anti-coagulant medicines, I say.
I believe, too, that it is "asymptomatic", ignored or unnoticed AF that still is a leading cause of stroke.
Many people don't know they have AF and have AF for many years before it is picked up on a routine check. A BP monitor will not always pick up AF a Kardia monitor and things like that will. Also not all home BP monitors will be able to record the correct BP whilst in AF. Certainly if I was you I would take the anticoagulant until you see your cardiologist or preferably an Electrophysiologist (EP) If you are to have a cardioversion/ablation then you would need to be on anticoagulants for at least 21 days prior so if you start taking the anticoagulant now you will be ready should you need one.
Maybe hang fire with the anticoagulants until you've been able to find out more about your afib, carry out a personal risk assessment, weigh up the pros and cons, and ideally discuss with a cardiologist?
I've had PAF for 15 years and choose not to take anticoags because of their side-effects and how those would impact my pretty active and healthy lifestyle. That is my informed choice, based on my (regularly updated) careful risk assessments, and this process is of course different for everyone.
If you are asymptomatic you cannot know whether your afib was a one off. You might have had it for awhile. They will take you off the anticogulant for a few days for your hip replacement anyway. A Kardia device is handy and you can send the ECGs to your email and print them . I don't use mine much as I can always tell when I go into afib even though my symptoms are not severe. I hate taking Apixaban as it gives me side effects but having had a TIA I would not dream of not taking it.
there are many things to be considered before someone goes on anticoagulants. They are very serious. Drugs and consideration is needed by a cardiologist specialist. It depends on if you have the comorbidities listed on the scoring system and how old you are and how often and how long you get atrial fibrillation. All the best.
I, like you, was diagnosed via a blip on a routine ECG. But rather than putting me on anticoags I was given a Holter monitor to wear for a week. That picked up a 2 second blip "suspicious of atrial fibrillation". I have never had any symptoms but do get palpitations occasionally (the Holter didn't record any of these even though I noted them). I was then put on apixaban. This was in 2016. My GP also added bisoprolol.
I have never had any side effects from the apixaban (now edoxaban) as far as I know, though I'm still trying to find out if my regular diarrhoea is linked - I don't think so, as it started in 2021.
Anyway, the AFib has never been confirmed but I'm told I should still stay on blood thinners. I suppose they think its not worth the risk. My main bugbear is not being able to use ibuprofen for my aches and pains. Also your travel insurance goes up a lot!
PS I have a Fitbit set to detect AF but in two years, it's never found any.
Have you visited the AF Association website? whereby you will find a complete overview of AF, from symptoms to treatment options: heartrhythmalliance.org/afa/uk
To respond to your question, AF is a very individual condition that often can be difficult to initially 'capture' and many do experience the painful symptoms, however, many do not and are considered to be asymptomatic.
In a nutshell, the issue requires an individualized risk benefit analysis balancing the reduction in risk of an embolic ischemic stroke with oral anticoagulants vs increased risk of an intracranial bleed. I have a low CHA2DS2-VASc score. In addition, I have an active lifestyle (exercise is correlated with decreased stroke risk) and ingest on a daily basis turmeric, ginger, mushrooms, green tea, and a few other compounds with anti-coagulant properties. I am also a whole food plant based eater which may increase my risk of hemorrhagic stroke significantly (bmj.com/content/366/bmj.l4897). Therefore, for myself, I am not taking oral anticoagulants YET.
Hi, when i go into AF, just feel tired no palpitations and can't feel my pulse at my wrist as its usually over 150. Docs could put you on a holter monitor for period to see if it catches anything. Your age might influence medics re stroke risk hence the anticoagulants, I've always got on with so I'd go with them,
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