Does one AF episode warrant medication

[Morges]

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. I have not started them - partly because the GP wants to see my blood test results - although when I spoke to the hospital I was told they are all normal - the GP has not yet contacted me herself.

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 question is - does one episode warrant treatment?

[Tos92]

Hi Morges,

I’m sure others will be by to offer their experiences however, you might also find it helpful to join the AF community as well and post the question there.

healthunlocked.com/afassoci...

All the best.

Tos

[Morges in reply to Tos92]

Hi Tos92 - good suggestion - thanks.

[Vegart]

Hello, Morges. Atrial Fibrillation can mean an increased risk of unwanted blood clots and therefore of having a stroke. If you had a stroke before you get to have a stroke, then that could scupper you having the hip op. I would speak to your GP, who could explain the need for anticoagulants. Your GP Practice might be able to do a follow up ECG, on-site., to help you to decide whether you will take them. Some home blood pressure machines claim to be able detect AF, which might help you to find out whether the AF is more than a once of, though the machine might not be accurate.

[Morges in reply to Vegart]

Hi VegartThanks for getting back to me.

The GP has now been in touch - she is very much on the ball - I changed GP for that reason.

The cardio dept. has replied to her and advised I should go ahead with my surgery and take the anti coagulants. The GP has insisted they send me an appointment tho and see me pre op. I'm very happy to wait.

My Omron only shows irregular heartbeat not specifically AF. As I always have an irregular pulse thanks to left branch bundle block it's not a great help. LBBB also increases risk of AF.

I'm going to go and get my prescription today and start the anti coagulants - it's the same one as the post surgery anticoagulant which I took for 4 weeks when I had my other hip op, which is when the LBBB was picked up.

[Vegart in reply to Morges]

Good Morning, Morges. It is good that people on this Forum have helped you to decide what to do. It is fortunate that the anticoagulant medication that you are going to take is the same as before., and that you had before, after an operation similar to that which you are due to have. You are lucky to have been able to get a competent and responsive GP.

[Lowerfield_no_more]

The majority of people on here are not health professionals. They only have their own experience which may not be the same as yours. I suggest that, until you get to see your cardiologist, you chase up your GP rather than wait for her to contact you, or talk to the BHF Heart Helpline nurse as below, and you should then get a professional response to your question.

bhf.org.uk/informationsuppo...

[Morges in reply to Lowerfield_no_more]

Thank you so much. So great to have this forum to help think through the important issues.

[Samazeuilh2]

I am not medically qualified, but I would say that it’s not a known fact that you have only had one episode of AF. Rather you have had one detected episode of AF; it cannot be assumed there were not others. You should ask what your CHADSVASC risk is- this is used to determine whether an anticoagulant is necessary.

[Morges in reply to Samazeuilh2]

Good point, thank you.

[Engineer46]

Here's a link to the CHADVASC2 calculator that your GP will have used to calculate stroke risk and whether an anticoagulant is advised. As others have said, if you are asymptomatic you can't say that this was an isolated incident. Taking your pulse manually will tell you whether you are in AF at any time, as the pulse will be irregular and with no pattern to it.

mdcalc.com/calc/801/cha2ds2...

Best wishes,

Paul

[Morges in reply to Engineer46]

Thank you Paul. I will check out that calculator.Yes I take your point about manual detection of AF. I'm slightly skewed as I have LBBB so often irregular. But I have picked up that LBBB often leads to AF.

I'm off to the chemist this morning to cash in the PX.

[scentedgardener]

As someone who has known episodes of AF I have to say that the start of all my issues was that I had episodes of AF that woke me up. How many more did I have that didn't wake me?I also was extremely reluctant to take anticoagulants as I've always had a problem with excessive bleeding, so much so it's on my hospital notes. I was totally baffled by their insistence that I take them, especially as I bruised and bled less than before so to all intents and purposes they appeared to be doing the opposite of what was required. I tried 2 other kinds which didn't agree with me and it wasn't until I was in A&E after a nasty bout of AF a doctor discussed it with me, and did an extra test that showed my blood was on the brink of clotting, and had I had any indications of a clot I wouldn't have been allowed home.

It then dawned on me that even with very free flowing blood the action of AF can seriously alter how your blood behaves.

[Cavalierrubie]

The answer is yes. The most important is the anticoagulant. The other meds. can be sorted out with your Cardiologist. I was diagnosed with just one ecg. It is difficult to detect so l am grateful it was found. It is not life threatening but can cause a blood clot. You can have AF in your sleep. I think once it has been diagnosed you have it, and it is a rogue condition that has a mind of its own. Unpredictable, so you have to take precautions for when it decides to rear its ugly head. We were all very fit, l think, so it is a big shock and scary when it happens. I wish you well on this journey. It is possible to have a good quality of life still, so don’t get discouraged or let it define who you are.

[Arrowe]

I can’t give any advice as I’m not qualified to do so. I do feel that anticoagulants are advised for you in order to avert a possible emergency. I think you should take them for the time being. I’m sure the doctors have your best interest in mind.