Pill in the pocket? (2) incidents in 4 years!

[MrGC314]

I had one incident of Afib in October of 2020 and another in September of 2024. My apple watch let me know on both counts. Never felt any of the fluttering, palpatations, or any different. 2 events in four years seems so odd and I'm forever keeping my eye on my apple watch and Kardia device. Good blood pressure, non-diabetic, if anything, a low heart rate hovers anywhere from 49-60 at rest which doesn't seem to be anything alarming to my cardio doc or PCP.

My cardio doc has me on eliquis, 2 -5mg daily which I don't enjoy taking and tried to convince him to let me go with a "pill in the pocket" standard of treatment. He didn't want any part of that suggestion.

Just wondering if anyone has had incidents of afib once every so often. In my case, 2 in four years. Also wondering if anyone has had afib events based on acid reflux or GERD which I seem to think plays a part in both of my events as they occurred after a large spicy meal. BTW, the last afib issue lasted 2 days and disappeared.

Thanks in advance for any/all advice.

[jeanjeannie50]

In my experience AF started very slowly at the beginning, like one episode a year, then two attacks and went on increasing until I was having an attack every 6 weeks. We are all so different though and it looks like you may have identified a trigger for your occurrences. I hope so for your sake.

Wishing you a life free from AF.

Jean

[MrGC314 in reply to jeanjeannie50]

Thank you, Jean! Wishing you good health!

[mjames1]

My cardio doc has me on eliquis, 2 -5mg daily which I don't enjoy taking and tried to convince him to let me go with a "pill in the pocket" standard of treatment. He didn't want any part of that suggestion

I see you're from the United States, where PIP anticoagulation seems to be more widely accepted than in the UK, but apparently your ep is not one of those.

Some will try to simplify it, but I see it as a complex decision involving not only your CHADS risk score, but also your afib burden, lifestyle and personal preference.

There is a multi institutional trial just beginning called REACT-AF that is looking into this very issue.

Meanwhile, if you disagree with your doctor's approach to anticoagulation, by all means get a second or third opinion. And of course, do your own research.

Jim

[MrGC314 in reply to mjames1]

Thanks, Jim for taking the time to respond.

[Cavalierrubie]

Yes, acid reflux can trigger an AF episode. I also have a hiatus hernia. It’s best to watch your diet, and not eat large meals, and definitely not eat for at least 3 hours before bed. It affects the vagal nerve that is in close proximity and which controls the digestion. It’s described as vagal AF. You are very fortunate to have such a low burden of AF., but once diagnosed an anticoagulant is needed because it can return with a vengeance and also you can have AF in your sleep. 2 days is a long time in AF. Do you have a PIP to stop this?

[MrGC314 in reply to Cavalierrubie]

Yes, I went on eliquis immediately after visiting my family doc and cardio doc. Neither were that concerned that i was in any danger. My cardio told me to call him if I go back into Afib for more than 5 days. All my other numbers are great and this is like a side show that doesn't see to alarm them. I dislike taking eliquis but it's better than dealing with a stroke.

[Cavalierrubie in reply to MrGC314]

Personally, l wouldn’t let my AF go on that long. Even though your numbers are within range, l would be concerned with the strain on my heart and possible damage. I just take myself off to AE if it doesn’t stop. The rule is, any chest pain, breathlessness, dizziness or fainting then 999. The paramedics told me they would rather come out to me than have it develop into something more serious. Listen to your body. None of us like taking an anticoagulant, but better to be safe than sorry. Take care of yourself.

[MrGC314 in reply to Cavalierrubie]

thank you for your response. Greatly appreciated. Glenn

[marcyh]

In my last cardio appointment, I asked the same question. Except that I have been AF free since my second ablation. (I had a heavy AF burden.) I don't have apparent adverse effects from Eliquis but I would take one less Rx med. He said no, it's at the moment of conversion from AF to NSR that the heart tends to throw a clot. But as long as I don't have AF, isn't that enough reason to go off? I think so.

[MrGC314 in reply to marcyh]

Thanks for your reply, Marcy!

[joaniei]

I have not had an episode of a-fib in the 3 years since my abalation. Before that I would get an occasional episode like one every other year. I still take Eliquis twice a day as I am not willing to take a risk on a stroke or death. I have the Apple Watch as well & see my cardiologist every 6 months.

I am 75 years old & have been taking the same dosage as you, for about 10 years. I don’t have any problem taking the pills. To me pills versus stroke or death, take the pills!

[MrGC314 in reply to joaniei]

Thanks, Joan for your reply. We are the same age and although I hate taking the blood thinners, like you said, it beats the alternative. Prior to your ablation, how often were you getting afib episodes?

[Pigleywigley]

hi, I have PAF, approx 12 episodes in 4 years. I have PIP flecanide, and up to now works as a solution for me. Dr Gupta has a YouTube clip on GERD & AF links.