Blood thinner or not

[Seamab]

I was diagnosed with Afib in January 2022.So far my episodes have been infrequent,although they can last for 8 or 9 hours. However this month I have had two episodes.On diagnosis the consultant didn't put me on a blood thinner because he said my risk of stroke was very low.However, now it appears the condition could be worsening,and my ChadsVasc score is 1(due to my age=71) I am wondering if I should be on a blood thinner?Also, because my episodes tend to be quite long ie 8 or 9 hours with a heart rate of approx 150,I wonder if I should have a 'pill in the pocket'? I would appreciate any thoughts as I'm relatively new to this! Thanks.

[Blackcatsooty]

dear Seamab

These are matters for your GP to advise. Pill in the pocket would probably make you feel easier.

Blood thinners probably unnecessary. But it really is for a medic to tell you.

If you need blood thinners, I have found them brilliant. But I need them. I take clopidogrel. Great care needed when shaving and extra care when doing everything. It’s a pain when I can’t stop the bleeding. But I cope with that easily.

Sooty

[Seamab in reply to Blackcatsooty]

OK thanks for that.

[Blearyeyed]

It sounds like you definitely need to discuss this with your Cardiologist.If you aren't due for a review you can contact your named Consultant via their Secretary and ask these questions and ask if they could call back with a reply.

They usually do so in a few days for non urgent enquiries but ring back if you don't get a response.

It is quicker doing it this way than sorting it out via your GP whom would have to double check with the Cardiologist in case they want you to have some tests before putting you on a blood thinner or a PIP.

[Seamab in reply to Blearyeyed]

OK thanks for the reply.

[Engineer46]

Hi Seamab,

A ChadVasc score of 1 is given to men aged 65-74 with no stroke risk factors other than age. When you reach 75 and assuming no other risk factors have emerged, you will get a score of 2.

A score of 0 is regarded as low risk and probably not requiring anticoagulation, 1 is regarded as low-moderate risk and anti-coagulation should be considered, 2 or above is moderate-high risk and anti-coagulation is advised. Her's the calculator that the doctors use:

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

However, whether anti-coagulants are prescribed should be a conversation between you and your doctor about whether you engage in any activities that could lead to a head injury and whether you are steady on your feet - in other words are you likely to fall and cause a bleed on the brain that could be exacerbated by an anticoagulant.

Most people here don't appear to suffer any side effects from taking one of the current anticoagulants, which only require a blood test every six or 12 months.

As to your heart rate during AF, although not dangerously high it must be disconcerting, especially as it lasts for several hours. I would discuss this with your GP, who could prescribe a rate-control or rhythm-control drug as a PIP.

Best wishes,

Paul

[Seamab in reply to Engineer46]

Thanks,that is very helpful. It suggests I probably should be on an anticoagulant as my score is 1 and I don't have any of the risk factors you mentioned.I have an appointment with my GP tomorrow so I dan discuss that with him and also PIP.

[Quovadisuk]

The CHAD score runs from 1-9 , but this has seemed to have been reviewed and changed to 1-6 dependent on who uses what scale . If you are 1, then you are at the lower end of the scale . It may be worth getting a new assessment if your condition is getting worse . Blood thinners should be taken on a regular basis and not Ad -hoc and also needs to discussed with your care specialist . I take Adoxipan after changing from Apixipan that gave a severe allergic reaction, so you need to be aware of side effects when discussing blood thinner meds . I have a CHAD rating of 5 so can to a certain extend speak with some experience . Trust this helps .

[Seamab in reply to Quovadisuk]

Yes that is helpful,many thanks.