Good suggestion, Scott. I'm on Pradaxa but my blood seems to clot even faster than before I started taking it. I've asked my PCP for that test, too.

I asked my PCP for the PT/PTT test. Here's what he said: "Not really a way to monitor Pradaxa - bothers me too. Wish we had a way to know that it was doing its job."

Thanks, Yogacat, for the web address. I found it unsettling, too. In fact, I was afraid that I was going to go into a-fib while I was watching it! I didn't, thank goodness. I did find one thing confusing: I thought that a blood clot could be released when we go back into NSR - wouldn't that mean that those with permanent afib would have LESS risk of stroke than those with paroxysmal afib?

paroxysmal versus persistent and permanent:


It is true that switching from afib to NSR is the dangerous time (if not anticoagulated), but they don't have some mathematical answer. I guess if you definitely have afib every 2 years for 24 hours, you have less time to get a clot, BUT you probably wouldn't be taking a blood thinner. I have looked for info everywhere on this topic and that's the best I could come up with. All you can do is use the CHA2DS2Vasc system to determine risk.

petey

Here is what I found terry... 3 different takes... 1) The same risk, 2) At least as much risk, 3) More risk for Paroxysmal.

http://eurheartj.oxfordjournals.org/content/29/7/915.full

Conclusions
The results of the EHS-AF indicate that risk for stroke in paroxysmal AF is at least comparable with that of persistent and permanent AF and potentially even higher following cardioversion. These findings strengthen the ecommendation that in the presence of appropriate risk factors, clinical subtype of AF, as defined by the
ACC/AHA/ESC management guidelines, should currently not influence the decision to anticoagulate. Therefore, we should at present abandon the paradigm that in paroxysmal AF patients anticoagulation may usually be withheld.




www.ncbi.nlm.nih.gov/pubmed/18334476



During 1 year following cardioversion, paroxysmal AF patients had a higher risk for stroke (P = 0.029) and any thrombo-embolism (P = 0.001) than persistent AF patients.

CONCLUSION: In the Euro Heart Survey, paroxysmal AF had a comparable risk for thrombo-embolic events as persistent and permanent AF. This observation strengthens the guideline recommendation not to consider the clinical AF subtype when deciding on anticoagulation.



http://www.medpagetoday.com/resource-center/atrial-fibrillation/Paroxysmal-Atrial-Fibrillation-Diagnosis-Progression-Stroke-Risk/a/32419

What about stroke rates in PAF? Though theoretically when PAF patients are in sinus rhythm their stroke risk should be lower, it is postulated that this benefit is offset by an increased risk of stroke during the period when AF converts to sinus rhythm.


petey

It's a miracle that I didn't have a stroke sooner than I did. 17 years of Afib and converting to NSR multiple times daily and dozens weekly. I never had a cardioversion in all those years, just toughed it out. I'll never know for sure but I'll always wonder if I would have avoided the stroke had I chose to have an ablation one year earlier than I did. I think about that every time I take a Pradaxa.

EDIT. . . I'll never know for sure but I'll always wonder if I would have avoided the stroke had I chose to have an ablation [ OR BEEN ON AN ANTICOAGULANT ] one year earlier than I did. I think about that every time I take a Pradaxa.

One other factoid:


http://www.uptodate.com/contents/paroxysmal-atrial-fibrillation

The frequency of paroxysmal AF (PAF) is uncertain, because up to 90 percent of episodes are asymptomatic, including some that last more than 48 hours


petey

Hi rplas64,

Outstanding documentary. Like yourself I was concerned that I was not on anticoagulants, just 1 baby aspirin per day. Then I reminded myself that based on CHA2DS2-VASc score it was not warranted. I had previously discussed this with my cardiologist and ep and was told that they would put me on anticoagulants at 65.

In the meantime I think Scott makes some excellent points on blood testing and nattokinase. Having been diagnosed with prostate cancer several years ago I looked at dietary changes I could make and discovered the benefits of soy and in particular fermented soy in slowing down cancer progression. I started eating natto about 3-4 times a week (cancer has not progressed , last biopsy showed no cancer). I am not sure if this is due to the natto but along with the use of turmeric powder (which induces apoptosis of prostate cancer cells) were the only dietary changes I made.

I did not realize natto had clotting benefits as well.I have been doing some research on this and their are lots of info out there although not the kind of data that we have on anticoagulants. I found great information at the afibbers.net bulletin board and links such as

http://cnmwellness.com/wp-content/uploads/2008/12/art_nattokinase_2.pdf

http://www.doctoroz.com/videos/8-alternative-health-secrets-japan

http://www.jafra.gr.jp/eng/sumi.html

opsyn

Tumeric reduces inflammation... very good for afibbers. I eat Gulden's mustard for tumeric.

petey

My percentage rate of asymptomatic episodes of paroxysmal Afib was more like 30%. The rest of the time I was definitely feelin' it.

Petey, does tumeric have sufficient anti-inflammatory properties to be used in the place of aspirin for heart benefit? My regular cardiologist recently suggested that I take a baby aspirin every other day while on Pradaxa, instead of every day as I was previously. If there are no interactions with Pradaxa and a sufficient amount of tumeric can be added to diet it sounds like it could be a healthy alternative to aspirin. Is their solid data on tumeric and does anyone know how much has to be ingested to gain effective benefit? Thanks.

Steve

I am doing the baby aspirin with Pradaxa also. Aspirin is prescribed for its antiplatelet properties.

I read that aspirin irreversibly and permanently inhibits platelets for their lifespans (8 10 days). So, you may be more prone to unstopped bleeding after taking Aspirin!

It is also has inflammatory properties. But I would favor tumeric and mustard for that purpose. Aspirin doesn't taste good on a hot dog either.

I eat mustard alot. Previous to afib, I took tumeric on my former doctor's advice (at the baseball field as her son and mine were on the same team) for inflammation because I was complaining about stiffness and pain. It worked within hours (the powder is yellow and messy, so I just started using more mustard).

Read this:

Mustard is cheap. To begin with, mustard is extremely low in calories and high in flavor. This makes it a useful option if you are trying to cook flavorful meals without tons of extra calories. For cooking, you can buy either dry powdered mustard or bottled mustard which has vinegar, a small amount of salt, and some spices like paprika and tumeric added for color. I personally prefer cooking with bottled mustard because I think the vinegar helps enhance the flavor of the plain mustard, making it stronger and more tangy.

Mustard is also a good source of phytonutrients that can actually help prevent cancer, especially gastrointestinal and colorectal cancers. The phytonutrients contained in mustard are called isothiocyanates and can inhibit the growth of existing cancer cells in the intestines as well as prevent the growth of new cancer cells.

Mustard also has strong anti-inflammatory properties due to the presence of minerals such as magnesium and selenium as well as small amounts of omega 3 fatty acids. While some spices such as ginger and tumeric may be very well known for their anti-inflammatory properties, mustard, unfortunately, is often overlooked. Fortunately, mustard has a more accessible taste than ginger and tumeric and, therefore, might be a lot easier for you to incorporate into your diet.

Note: Tumeric and vinegar are the ingredients in mustard.

petey

Thanks for the info Petey. I eat quite a bit of Chinese Mustard, I like the burn. :-) I'm going to try the Gulden's, might help my stiff back from sitting so much at work.

I finally got a chance to watch most of it. I think I have about 7 more minutes. I gotta say it was disconcerting!! There wasn't a lot of new info, but the way it was presented was scary to me.

It is a well presented documentary the only drawback is they did not discuss catheter ablation as a treatment.