Definitely an interesting article easy understood. I also read his reference article on What anticoagulant should you use. For me it would be recommendation #7 Continue with Warfarin.
If I would change, it would be to Eliquis.
opsyn - Thanks for sharing.
Annette

I like this one but I am not sure if they answer any questions. Seems like they are just as unsure as all of us....

Thank you opsyn. Both are very interesting articles. After reading the "Which anticoagulant to take" article I also fall into the #& category to continue with warfarin.

Steve

I don't the article is "interesting". "Disturbing" and "eye opening" is a better way of describing the article. I like the article because it cuts to the chase in a way that afibbers can understand.

Takeaways: Silent afib, whether pre or post ablation is real. Stroke is a possibility, even below 48 hours. A bigger factor than amount of time in afib is when you return to normal sinus rhythm after being in afib. It doesn't matter whether you converted by electrocardioversion, medical means, or self conversion. That explains why persistent and longstanding persistent afib have the same stroke risk as paroxysmal (actually, one study I saw had the persistent group as having slightly fewer strokes). This fact really sucks. Congratulations, you are back in NSR, but your stroke risk is up for 2 weeks after conversion.

After seeing so many people on various support groups with zero CHA2DS2Vasc scores having TIAs or strokes, the message for me is clear: anticoagulants are the insurance policy most afibbers need, given the lack of understanding of afib and stroke. Let's face it... doctors can't agree on the answers.

If your EP doesn't prescribe an anticoagulant and you have a stroke, it affects you greatly and only affects your EPs "batting average" for treatment success. That might sound hard, but it's something to think about.

I'm 65, so I don't have a zero CHA2DS2Vasc. My decision to anticoagulate was easy. I am in longstanding persistent afib asymptomatic afib diagnosed in my sixties, so my treatment strategy is pretty simple. Anticoagulation and a betablocker for rate control.

The people who are young, paroxysmal, active, zero CHA2DS2Vasc scores, and highly symptomatic have to make hard decisions. If I had that situation, I would be leaving a message on DR Natale's phone right now and begging for an anticoagulant... Eliquis would be the best choice for a person with this situation.

Again, I don't find the mechanism of stroke in afib "interesting" at all. I find it "frightening". And I also feel that once you have afib, whether you have a maze or ablation or not, you always have to worry about silent afib and stroke AND the possibility of it recurring. I think it is like drawing the Joker out of a deck of cards.

This whole atrial fibrillation thing has changed my perspective on health and what we take for granted. With what I know now, I would no longer have that feeling of invincibility I used to have... even if I didn't have afib. I thought I was in the clear if I didn't have a congenital heart problem or coronary heart disease. Now I know there are other things to worry about.

I think Bob Seger said it best in the song "Against the Wind" when he said/sang: "Wish I didn't know now what I didn't know then".

petey

Yep, you definitely don't want a stroke. Even though my stroke was relatively mild and I am pretty much fully recovered, this is a frightening, upsetting and potentially debilitating experience. I keep telling all the newbies on this forum not to rely on aspirin. It's fairly useless. I couldn't agree with Petey more, a stroke hurts you a lot more than the doctor! However, I'm still a Warfarin fan for now.

Paul: Yes, Warfarin is fine. I was just thinking that this young person who is very active would want the anticoagulant (Eliquis) they claim has the least bleeds of all 4 and still works as well as Warfarin (or slightly better). I also think it is the best choice for the oldest patients who have high HASBLED scores. I take Pradaxa as you probably know, so I am being objective about it. Since you are not in either of the above groups, any anticoagulant will work. -petey

Well said petey. As you know I believe in blood thinners after having my clots. And I am going to ask my Doc and insurance Co. about
Eliquis.
IMO, you are right on point.

Good post, Petey!

So going in to afib once a week for about 2-12 hours an episode seems much more dangerous than full time fib...shit...

Walt: We're all stuck with having to take anticoagulants. It's all about risk. But if you have a stroke that could have been prevented, a 2% risk means nothing. petey

Maybe one could take AA approach , one day at a time and the 2% chance would be reduced to a more tolerable risk.
I take 160 mg of Sotalol daily, recently have had a few episodes of a-fib lasting from 2 to 11hrs. My doctor has told me to expect for such incidents and I have not needed any help to convert. I also take Warfarin and it seems to work though my veins have started scarring. Sometimes it is hard to stay positive. I have gained so much information and understanding from this group, Marya

Digitalis maybe you should ask your Dr. about adding MK7 to your meds. My Doc did and it seems to help with the warfarin side affects.
Just a suggestion.