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Advice:
Coumadin or Aspirin?
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Hi all,
I am new to this group and am trying to find a better way to manage my A Fib. I have had paroxsymal A Fib for 3 years. At first it would happen once every 4-6 months. My internist and cardiologist both agreed that I did not need to take coumadin. I have a CHADS score of 1.
I have been taking 325mg of aspirin daily. The episodes have gradually increased in frequency and now it seems to happen weekly. I am worrying more about my stroke risk at this point. What do you all think? Are most of you taking coumadin? Is there a time frame for when a stroke is most likely to occur? After an hour in A Fib, after 8 hours???
I will be going back to my internist soon and plan to get a referral to an EP. Right now I take Toprol daily, and cardizem and ativan at the start of an episode. The cardizem seems to help, (and the ativan keeps me from losing my mind) and I usually convert to NSR in 3-6 hours. But now I am losing 1 day a week to this beast and I'm hoping that other meds or ablation may be more helpful. Thanks, so glad I found this group.
Posted on 01/08/11, 08:06 pm
15 Replies | Most Recent Add Your Advice
Reminder: This is a support group for Atrial Fibrillation (AFib). We trust you will do your best to remain positive and helpful. For more information, see our rules of the road.

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Advice:
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Reply #1 - 01/08/11  10:07pm
" Personally I would find episodes one day a unacceptable for a reasonable quality of life. I was objecting to one day a month! My specialist would probably want me on Warfarin (Coumadin) if was having as many episodes as you. However, I have had A-Fib for 20 years and some Atrial Flutter with very fast pulse rates for up to 10 hours but on an average 3-4 hrs. I haven't had a stroke but then again my heart is very healthy otherwise. I am reluctant to take Warfin as yet as I do have trouble with side effects and I can't be bothered doing it as yet. I may not have a choice later in my 70's but I am hoping to stay stable with my current meds. I feel fantastic at the moment (particularly with a CPAP machine used for 10 months). This has only happened with trial and error with meds over the years and now I have struck the right formula for now. Keep up the search, it would be great if your quality of life improved more than this. Keep un in touch with your treatment etc. Best wishes, Ruth "
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Reply #2 - 01/08/11  11:47pm
" Thanks for the feedback Ruth. How often do you have an episode? Have you had an ablation?
Weekly episodes only started happening in December, and I thought maybe it was because of the Holidays, extra stress, eating things I know might trigger it (chocolate-sugar). I'm still not sure if that is the case. But if this continues, I agree it is interfering with my life too much. I try hard not to let it rule my life. So I am keeping a careful record and trying to avoid any triggers until I see my Dr. I think I am leaning toward coumadin at this point. As troublesome as A Fib is, a stroke would be much worse. "
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Reply #3 - 01/09/11  6:19am
" Better safe than sorry. I'm on Warfarin and it has no side effects at all whereas asprin really tore up my stomach. I feel much safer with Coumadin (Warfarin). My AFib never stops so I'm really at risk for a blood clot. Metoprolol has got my heart beat at 60 but I'm always in AFib. I'm lucky I don't feel it. I take beta blockers and Cozaar so that helps too. "
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Reply #4 - 01/09/11  10:03am
" Since my CHADS score was also 1, my cardiologist also recommended aspirin only. But then other MD's disagreed, taking a more aggressive approach. With a CHADS of 1, it is possible, but maybe you want to talk with your MD to be sure. Coumadin is a pain but provides more protection against blood clots/stroke. It's basically gambling and what you feel OK about. But daily afib (yes the holidays may contribute) also means its pretty active. So much of medical care is based on cost/benefit and statistical probability, so its usually a "gamble" with care. "
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Reply #5 - 01/09/11  10:05pm
" HI, I have had two EPs tell me that Asprin would be fine for me as I have a healthy heart and am in my 50s. They said that they don't like to use Coumadin unless there are other problems or your over 65. Coumadin has many side effects and require blood tests. I am taking 325 mg of Asprin a day. I have had A-Fib for 30 years. It started in my twenties. I have about 2 episodes a month...I am on Norpace CR and Toprol XL twice a day. I hate the A Fib episodes and have wondered if an Ablation would help me. I read on this site that so many people have Ablations and they still have A Fib so what's the use of getting an Ablation? Good luck and your EP should be able to give you some good advise. Take care.. "
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Reply #6 - 01/10/11  12:06pm
" Is anyone taking Dabigatran.

I took this piece of info from a study.

"Dabigatran 150 mg twice daily was superior to warfarin in efficacy (thromboembolism prevention) and similar to warfarin in safety (bleeding rates), whereas dabigatran 110 mg twice daily was noninferior to warfarin in efficacy and appeared to be safer." "
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Reply #7 - 01/10/11  2:04pm
" Thank you everyone for the feedback.
Jahennes, I have heard that the FDA is soon to approve a new drug that can replace warfarin for patients with A fib. I believe that may be dabigatron. I think it is in use in Europe, not in the USA yet. It sure sounds good doesn't it. It certainly would make life a bit easier.

Mulelady, I am in awe! 30 years is a long time to live with this. I fear going into A fib someday and staying there. You give me hope that it might not happen. Ablation does seem to be a crap shoot. I may consider it even if it would just improve things. The only thing I have tried is the current drug regimen, but I think it is time to try something new. What a journey this is. I must say that I am learning to find more balance in my life because of it. "
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Reply #8 - 01/10/11  2:37pm
" After 3 ablations, 13 cardioversions, and 15 nights in the hospital, I finally convinced the EP to write a prescription for Lorazepam so I don't lose my mind either...the stress of recurring events has sent my blood pressure through the roof by the time I get myself to the ER for a reboot (cardioversion). The addition of Lorazepam is welcome relief for what it is hard not to feel is an emergency! "
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Reply #9 - 01/26/11  6:30pm
" I just started taking dabigatran etexilate (brand=Pradaxa). It is supposed to be much better than coumadin. I am preparing for an ablation on Mar 10 (my Aug 09 ablation for atrial flutter never took since it appears I have afib instead!). The doc told me with Pradaxa I don't have to have weekly blood draws to check INR. I'll keep you posted. "
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Reply #10 - 01/30/11  4:33pm
" I'm also only on the aspirin as well..I really don't want to be on the Warfarin, although there are newer and much better drugs now. My episodes aren't that frequent, it's been 15 months since a true episode that lasted about 2 hours. I'm on Rythmol and Xanax at the moment coupled with the Ecotrin. I found the coated aspirin doesn't bother me at all. Good luck and I'm so glad I found this group as well. I've been pouring over the questions/topics and not feeling so all alone. "

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