I am very confused about AF. I've just been diagnosed with a slow AF and a heart rate of around 57 pm. All I've been prescribed is the blood thinning drug apixban. I've not started taking it yet because I'm worried about the bleeding side effects. I've read a lot of posts on here of people mentioning different drugs such as flecainide, Bisoprolol, Edoxaborn, Remipril. I'm wondering if any of those would help me.
Cat.
AF can be a very confusing and frustrating condition. I've had it for five years. Although the main indication of AF is a erratic trace on an ECG, the risk to you is having a stroke. Having an erratic blood supply causes the blood to form clots that can travel to the brain. Not a good situation, so the research has shown that taking a 'blood thinner' can help prevent this. Apixiban is a very safe medication, but like everything can cause side effects. It might help you to have a chat with the BHF nurses as well as read their very useful info sheets on medications. Flecanide, Verapamil, Biosprolpl ect all do different things to try and reduce the erratic beats, but they do nothing to help prevent strokes. You've certainly got a valid concern. I think we all have been concerned about our meds at some time or other. Talk to a professional you trust who can talk you through everything. Good luck
Hi WH thank you for your easy to understand reply. You've described what the other medication is that some members mentioned are for. I've had so many health problems this last while and now this AFib . I've had a couple of bad bleeding incidents needing hospital treatment that I'm terrified of any more. Where do I speak with a BHF nurse ? Do you mean on here ? Thanks again. Your advice is appreciated.
Edoxaban is also a blood thinner,your blood gets thicker as we age and af means heart not pumping in regular beat so blood thinners help prevent clots that can cause strokes, the only thing to think is if you cut yourself it may bleed a bit longer still stops,the other meds you mean do different things,you need to have trust in drs
Bleeding was my biggest fear when prescribed Rivaroxaban. I had always bled profusely, dental extraction for me meant 2 days before the bleeding stopped, and I was told before an operation I would need a drain as I was "a bit of a bleeder."With AF because the heart doesn't beat efficiently blood stagnates so you are in danger of clots.
In all honesty I don't bleed as much now if I cut myself as I did before needing them.
Anticoagulants are the primary defence against AF-induced blood clots which can result in strokes etc. Apixoban and Edoxaban come from the same family of drugs known as DOACs.
One of the side effects of all blood thinners is that bleeding can be difficult to stop and users may bruise more easily. My wife is on Edoxaban and a few months ago she did cut her finger. After applying pressure for slightly longer than might be normal, the bleeding did stop with minimum blood loss.
Ramipril and Bisoprolol are NOT anticoagulants.
From the BMJ:
‘The risk of AF-related stroke can be mitigated through anticoagulation, with a 66% risk reduction with vitamin K antagonists (VKAs) and at least similar effectiveness with non-VKA. Stroke rates in patients with adequately anticoagulated AF are similar to those of patients without documented AF.’
Edit: If you are concerned enough about bleeding to discourage you from starting/taking an anticoagulant then I suggest you ask your GP surgery to assess your ORBIT bleeding risk score as described in this NICE guidance.
cks.nice.org.uk/topics/atri...
PS Slow AF was a term that I had not heard of before: everyday is a school day!
Hi, I’m 77, male, have AF, diabetes and a history of pulmonary embolisms. I’ve been on warfarin or edoxaban for many years because of dvt or blood clots on my lungs - probably an inherited trait. Please don’t worry about bleeding - I’ve never had a problem with it, just make sure you tell your dentist or nurses you are on anti- coagulants when you need treatment. (People call them ‘blood-thinners’ but this isn’t really how they work - they interrupt a chemical stage of the clotting process, not making your blood ‘thinner’).
Anti-coagulants should protect you from having blood clots in your lungs (serious), heart or brain (probably fatal) which can be a risk of AF and are all much more serious than bleeding. As a young technician once said to me “Oh, so you’ve cheated death twice now then!” because my clots were only in my lungs.
The other drugs you mention such as Bisoprolol and Ramipril do different things that you probably don’t need. Bisoprolol is called a beta-blocker - it slows your heart rate so your heart doesn’t work so hard. Your heart rate already seems OK. Ramipril is called an ACE inhibitor. It relaxes your blood vessels so they get wider and this reduces your blood pressure and the stress on your heart. So again, if you don’t have high blood pressure you probably don’t need it.
Do ask your GP or nurse to take the time to explain these things to you, and take someone with you if you can. It can be hard to take in all this medical stuff when you’re stressed out and someone else can remind you what was said afterwards, or even take notes for you.
And sorry for such a long-.winded reply!
Hi gkj, without wishing to criticise the helpful information, I think the reference to "heart or brain (probably fatal)" is slightly OTT. I had a mid cerebral infarction, (brain) stroke, with total right side loss, sight and hearing but was given textbook emergency care and was thrombolysed, walking out of hospital three days later. Yes some issues but not fatal. The risks did rise with thrombolysing treatment with a 1:10 risk of a poor outcome.Two years later I had a sudden cardiac arrest caused by a left ventricular tachycardia while running on a Parkrun. Brilliant help from fellow runners, quick emergency response and I recovered. Perhaps seconds away from fatality but.... Tests for HA, cardiovascular disease etc all were negative although troponin levels were raised. This is not always an indicator of HA. The likely cause was embolic (clot) or some other unknown non-ischaemic cause. Given heart damage (scarring) was evident in the left ventricle, probably an earlier embolic event on the internal heart blood supply left the conditions for a future LVT. I will never know for sure.
BUT both events were completely out of the blue. I have absolutely no awareness of my heart beating (or not) . But after the stroke which was recorded as cryptogenic (no obvious cause) an implanted loop recorder ECG found Afib for which I was medicated with Edoxaban. The ILR recorded the LVT helping diagnosis of my syncope (collapse) event.
Even though I am alive and after a pretty awful month for my mental health today I ran (or as a fellow runner encouraged me to keep plodding!) my first Parkrun in 6 months.
And my conclusion for catoutdoors to ponder and who has the dilemma, if I had that prognosis and recommendation I wouldn't hesitate taking medication to improve my outcomes and lower the risk of a future serious event. Which is real but not inevitably fatal.
But I never stop worrying about the next event and I have no idea how to avoid it.
Cheers #chinkoflight
First of all,I emailed the BHF about medics,and the BHF itself calling anticoagulants ' blood thinners'The reply was that its an easier term to understand. I have replied with a formal complaint for the following reasons:
They do not thin the blood they just slow down the clotting process.
They do not make us more prone to catastrophic bleeding, but take longer to cease. There are tried and tested methods in cases of accidental bleeds, antidotes ( reversal agents)and compression the main ones.
Blood thinners are antiplatelet medication such as aspirin. These are used on a different aspect of the blood making it a less sticky consistency. No good for AF patients
It is exactly the reason you are scared to take this vital medication because of the term blood thinners that makes me concerned and angry at its use.
AF is a manageable condition,but the main problem is a much higher risk of stroke due to the erratic heat causing clots,if untreated by anticoagulants.
If you score over 1 on the Chadsvac scale( which takes into account things such as blood pressure,ahead etc) then you would be unwise not to take the anticoagulants to say the least.
AF strokes are amongst the worst for fatality and poor QOL if survived.
Please consider your health,and talk to your prescriber if you can for further reassurance.
On the AF side, I had slow AF too,and atrial flutter,which is a fast arrthymia.
I was on bisoprolol only,asked several times about anticoagulants but was told by gp not needed. After I had a mini stroke that decision was swiftly reversed !
Medication held it steady for a long time but eventually I was offered an ablation which saw both off.
HOWEVER, I shall remain on anticoagulants for life and glad to do do. This is because AF is incurable. It may be dormant for periods but can return at will,then we'd be unprotected.
Head over to the Arrythmia Association on Health unlocked for invaluable support.
Best wishes ❤️
You can call them anything you want --,(most doctors called them "thinners" so I'm gonna stick with that) -- but the fact is that these drugs do increase your bleed risk.
That's why we have several risk scales to help guide us to whether or not the risk of blood thinners (anticoagulants) is outweighed by the benefit of stroke prevention. . That becomes an individual determination and eventually a decision between you and your doctor.
Jim
As Wilsond has explained, this is not. a blood thinner, it is an anticoagulant . It does not affect the viscosity of the blood, it helps prevent blood clots forming , travelling to the brain and causing a catastrophic stroke.
I have been taking Warfarin , an older style anticoagulant if you like, for well over 20 years and have never had a problem with excessive bleeding . Indeed I consider it to be my friend and would hate to come off it.
I've been on warfarin for 6 months now; no issues so far. They do make high-tech plasters which promote coagulation, but so far I've found the bog-standard ones to still work fine for me.
To simplify --
Blood thinners -- prescribed to help reduce stroke risk where it is determined by both doctor and patient that the stroke risk is greater than the bleeding risk. Some people need them and some don't and with some the need is questionable.
Bisoprolol -- a beta blocker that primarily reduces heart rate. Since your heart rate is already slow in atrial fibrillation, that's probably why it was not prescribed.
Flecainide -- A class 1c antiarrhythmic that can be used daily or as needed (PIP). It can potentially keep you in normal rhythm or convert you back into normal rhythm from atrial fibrillation. Another way to keep normal sinus rhythm is a catheter ablation.
It sounds like your medical team is content for you to stay in atrial fibrillation rather than converting you back to normal rhythm. There can be pluses and minuses to this type of approach with someone in slow atrial fibrillation who is asymptomatic. It should be further discussed with your medical team and if you're uncomfortable with their decision to leave you atrial fibrillation, or need more reassurance, a second opinion might be in order.
Jim
Worry about not taking it!
See my reply below to gkjowett who gives very helpful information. My experience is very real, I wish I had been prescribed medication and Afib detected at an earlier opportunity. Some events may have been avoided. Hope it helps to consider what is right for you.I have also had unrelated major stomach surgery with a very big scar whilst on 'thinners'.
Hello there Please do not worry about Apixiban I have had Atrial Fibrillation for 13 years I had a pacemaker put in four years ago as my heart rate was around 45 with shortness of breath
I can still feel the fast heartbeat occasionally and they check the pacemaker annually ,they can tell if I’ve had a spell of AFib.We need the Apixiban to prevent blood clots that could happen with the fast heart rate.It is one of the best. Drugs as far as I know.Although saying this I did have a few BP nose bleeds a couple of years ago they said to cut down on the Apixoban and take it once daily instead of twice It seems to have done the trick and I have had no further bleeding,I hope this eases your mind
Apixaban is an anti-clotting medication, it does not thin the blood, but most medics refer to it as a blood thinner. Like you I was very concerned about a cut or scratch so I bought a box of Curad Quickstop Instant Clotting Bandage. Called a bandage, but is a box of 30 plasters. This works fine for use after blood tests,etc. There is also a gauze, Cut-Eeze CM0568 Soluble dressing for large wounds. Not needed this yet, so do not know how effective it is.
I keep them handy for peace if mind, but so far have not needed either in an emergency.
Aggressive Afib
Concerned.😨
Organic or Mechanical Valve - This is the Question?
AF and knee arthritis
On the list for an ICD
