Heart Rate and AF

[Leythersrus1]

Hi my heart rate zoomed up to over 130 normally around 57. Was in AE all day on monitor. They managed to get it back down. Increased Bisoprolol to 2.5mg. Suggested going on a blood thinner. Not to keen about that. AF went haywire but not sure why. I had just been on antibiotics for bite infection. Has anyone had similar experience with AF and would they recommend blood thinners.

[Hidden]

My understanding is that blood thinners are a primary element in managing AF: unlike SVT, it’s not just electrically increased heart rate, AF causes an impaired ability for the heart to physically pump effectively. This leads to an increased risk of blood pooling in the heart chambers due to irregular contractions, potentially resulting in clots that can then cause strokes. Blood thinners are used to prevent the pooling and reduce the risk of serious, potentially life threatening medical events.

[Hidden]

I've been on anticoagulants for about 20 years, first Warfarin and now Apixaban for the last 5-6 years. First thing I learned was that they don't thin the blood, but everyone calls them blood thinners. Don't take my word for it, the NHS has a page on the site about blood thinners, then another page saying how blood thinners (anticoagulants) don't thin the blood.

Anyhow, I know it's just a name, but I found that reassuring because I don't like the though of my blood being thinner, it's apparently not, it's the same viscosity, just doesn't coagulate as fast when I have a bleed of some sort because of a cut.

I've not had any problems I can think of, but Warfarin was a real nuisance because of l testing. No test with the new ones like Apixaban apart from blood/liver or something test once a year or whatever, not sure what.

I've had loads of cuts and bruises working, almost daily sometimes, and everything just takes a fraction longer to heal.

As I have AF, I am something like 5 times more likely to have a stroke, but the Apixaban reduces that risk down again by a lot, can't recall details but a lot. There is the potential rare risk of a brain bleed, which is why my cardio put me on Apixaban because, at the time at least (5 years ago), he said that was the least likely to cause such an issue.

Like all drugs, it's a trade off.

[Glen1677]

Charlie G is correct, during AF blood can pool and clot hence the increased risk of a stroke, blood thinners are used to reduce the chance of clots and thereby the stroke risk. It's by far the biggest risk factor with AF.

My usual HR is around 50 during the day and I rarely have AF at less than 230bpm and it can last for as little as 5 minutes or for over 24 hours. On average I have 3 attacks a week. I can't use beta blockers as I tend to end up in a heap on the floor.

I've just had ablation this week so will see how that goes but remain on Apixaban for the forseeable future until the ablation is settled and can be checked.

[kenhaem]

Yes definitely blood thinners if you suffer from AF . I am on Apixaban with no problem and reduces the chance of a stroke

[Markp7119]

I had AF in the night post cabgx4 in June this year Now on apixaban and Bisoprolol 2.5mg

Initially the bisoprolol made me giddy in the mornings but has now settled after 2 weeks

Apixaban will break down any particular clots that could cause a stroke due to AF

This is my understanding

Hope helps

[Desanthony]

I do wish Doctors and nurses wouldn't call anticoagulants blood thinners - they do not thin the blood. You can trigger AF with an infection so this may well be the cause of your AF. Anticoagulants are the first medication your Doc should put you on for this as it heightens your risk of stroke about 5 fold. Do you know your ChadsVasc score? If you are on bisoprolol or any other of the same type of medication as well and get side effects some people find it better to take it before bed rather than in the mornings as you generally sleep through the times when you would get side effects. I couldn't get on with any of these types of medication so just take apixaban (Eliquis) for permanent, low rate AF and still go to the gym 3 or 4 times a week and live a normal life for a 78 year old - which is probably why I have AF after a life as a high functioning athlete and trainer - but it makes me feel the best I can so wouldn't ever stop exercise just watch what I do and manage to keep my pulse down to 120 or under whilst exercising.

[Leythersrus1 in reply to Desanthony]

Hi thanks for the response. My risk rating is 1.I am 61 been on Bisoprolol for about 6 years but very low dosage. Now on 2.5. Also have stable angina. On amlodipine 5mg Aspirin 75mg.

You doing great well done.

[Hidden in reply to Desanthony]

Hi my chad vasc score is 4 have never had this explained,please enlighten me! Have occasional AF. MVR and arrhythmia, Cardioversion cancelled, on Edoxaban,ramipril and verapamil ,the latter seems to have corrected AF

[Desanthony in reply to Hidden]

It basically gives you an idea of your risk of stroke.

How best to approach stroke prevention in AF by using the CHA2DS2-VASc score?

In 2012, the European Society of Cardiology (ESC) guidelines recommended a clinical practice shift, to initially focus on the identification of ‘truly low risk’ patients who do not need any antithrombotic therapy. These low risk patients are those CHA2DS2-VASc score of 0 (male) or 1 (female). Subsequently, the next step is to offer effective stroke prevention (ie. Oral anticoagulation) to those with ≥1 additional stroke risk factors.

[Hidden in reply to Desanthony]

Thankyou, have been unable to find much information on this,so I assume female scale 4 is up the list a bit ! On anti coagulant so fingers crossed, many thanks

[Leythersrus1 in reply to Hidden]

Hi the way it was explained to me last week was the score was based on various risk factors. For example 1 point of aged over 65 1 for heart related. If you diabetic that was another. Morbidly obese another. So mine was 1 due to heart. Regards

[Hidden in reply to Leythersrus1]

Thankyou ,I am not diabetic nor obese. So assume it’s heart related. Will ask next time I manage to see cardio nurse. Lol. Useful information Thankyou

[Leythersrus1]

Thanks for responses. On Thursday a doctor went through the various drugs in AE told me one that was pretty new bo need to keep having bloods taken. I was sure that was going to happen. However when I returned yesterday for my ECG the HR was normal. Told me my risk score was 1 didnt seem to be really bothered about it. Just increased Bisoprolol to 2.5 and review in March.

[Desanthony in reply to Leythersrus1]

Don't know what the new medication was where you would have to keep having your bloods taken. You do get full bloods either once every 6 months or once every 12 months on apixaban but on warfarin - an older drug I think it needs checking every month or so. Anyway it seems you don't need to do this so glad things seem to have settled for you.

[Leythersrus1 in reply to Desanthony]

Hi sorry it was a drug that meant you didnt need bloods taken. They told me no longer prescribe warfarin use the newer ones. I will keep an open mind and maybe next year will be different.

[Rolo99]

I also had a low risk score and wasn't keen on medication for my AF although I have an ICD due to inherited Lamin a gene. I ended up having a heart attack age 50 due to blood pooling in heart. I am now on apixaban 10mg. No problems with it at all but I wish I had been given it sooner as would have prevented my heart attack.

[Leythersrus1 in reply to Rolo99]

Hi did you have issues with AF prior to HA?Given me something to think about now.

[Rolo99 in reply to Leythersrus1]

Yes for about 4 years. I was classed as borderline re medication as otherwise fit and healthy and risk of 1. Was previously on Bisoprolol but made me tired so Dr stopped it. Had regular ECG and checkups. I didn't like the thought of medication if I didn't really need it but I was ignorant of the risks of HA or stroke- that was something that happens to other people ha. I would go on Apaxiban if it is offered.

[Leythersrus1]

Update to my previous post I had telephone consultation with cardiologist on Friday following cancellation of my Septoplasty op due to increase in Meds.Cardiologist recommends replacing Aspirin with Apibaxin. Also he want me to wear heart monitor for a week.

Will see how it goes.