Atrial Flutter: is it a long-term condition?

[Billypoodle]

Good evening, about 4 years ago I had an episode of atrial flutter which was treated by cardioversion successfully. I was then prescribed Apixaban which I took for some time but it made my skin very sun sensitive. I took myself off it and took instead 75 mg of aspirin a day. Has anyone had a different treatment which avoids the need for Apixaban altogether?

[scentedgardener]

There are alternatives to Apixaban, Edoxaban or Rivaroxaban to name 2 of them. Edoxaban and Apixaban don't suit me, but Rivaroxaban does.Aspirin doesn't work in the same way, so it's my understanding that it isn't enough protection against strokes when you have a atrial fibrillation or flutter, but I could be wrong.

I was very reluctant to take an anticoagulant, as I've always had a problem with bleeding too much but AF has changed that, and even on anticoagulants I don't bleed anywhere near as freely as I used to.

It would be worth a chat with your GP ti try a different one.

[Billypoodle in reply to scentedgardener]

Thank you. I tried two other anticoagulants which had a horrendous side effect, all over rash and violent nausea.

[scentedgardener in reply to Billypoodle]

Oh, I am sorry. It's rotten when you react to meds I think it's still worth having a chat with your GP, or if you don't want to do that you can have a chat with the British Heart Foundation's cardiac nurses. They might be able to give you some advice.

[MountainGoat52]

My thoughts are exactly those of scentedgardener. It would be better to seek a review with your GP than just trust aspirin to protect you from a possible stroke due to your AF. My brother is on Apixaban which thankfully suits him, but he was advised that there are alternatives should he ever have issues with it.

[CDreamer]

Anti-coagulants are always first line treatment to minimise the biggest risk factor of stroke but there are other and newer anti-coagulants which may suit you better. Do you know your CHADSVASC score? Have you had recurrence of Flutter? You ask a strange question

Has anyone had a different treatment which avoids the need for Apixaban altogether? No!

You say you ‘took yourself off Apixaban and take Asprin’. Asprin is an anti-platelet and not an anticoagulant, it has it’s place but not as a prophalactic for reducing stroke risk for people with arrhythmias. It also has a high risk of causing internal bleeds, damage to stomach lining when taken long term.

Yes, unless treated, atrial flutter can be a long term condition but ablation is an effective longer term treatment than CV but if not currently experiencing AFl that wouldn’t be a choice I would suggest. Even treated, it is thought that the risk of stroke does not diminish after treatment so there is still a need for anticoagulation which poses the question as to what actually increases risk of stroke? Is it the arrhythmias or the company it keeps?

I have accepted I am on anticoagulants for life now, don’t want to be but the alternative is not a choice for me as my CHADSVASC is 4.

Most of us with arrhythmias accept we are on anticoagulants for life but sometimes finding the one that suits you is trial and error.

I would suggest, as both the other responders have, to seek a review with not only your GP for alternative anticoagulant advice but specialist regarding long term prognosis and treatment.

[clagmeister in reply to CDreamer]

Following a stroke brought on by undiagnosed AF/Flutter I was put on anticoagulants. As a long-term bleeder, the medication worsened my problem and I underwent a heart procedure known as a Left Atrial Appendage Occlusion. This involved shutting off that part of the heart where most blood clots form with an inserted device that opens like an umbrella. So I don't use anticoagulation to manage the stroke risk and for the past three years everything has been fine. I do take beta blockers and statins to manage the AF.

[CDreamer in reply to clagmeister]

That’s a different story - was it surgical removal of LA or Watchman device? Even after some LAC procedures there is a small risk which remains so there is normally an assessment between which is the higher risk. I would still seek advice about taking Asprin as the risks of internal bleeds from Asprin are higher than from anticoagulants.

[clagmeister in reply to CDreamer]

Watchman device fitted about three years ago. I don't take Aspirin or anything else that is likely to thin the blood.

[CDreamer in reply to clagmeister]

My ref to asprin was to the OP.

[Alixia]

I had an ablation in May which has been successful. Not sure how long it will last though! Do you have symptoms with your AF?

[hearty1]

I have been taking Apixaban and other medication for over six years for Atrial Fibrillation and Heart Failure. I have had no problems with any of the medication. I am so grateful for the NHS. I wish you well.