Atrial Fibrillation (AFib) Support Group
Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.
Last Monday, while running on my treadmill, I felt a flutter in my heart. I stopped running and my heart rate shot up to 200 bpm.
Amazingly I did not panic but took some deep breaths as I told myself I was okay and this will come to an end. After about 10 minutes my heart rate was down to 64 and I was still in afib. This is the third time this has happened while running in the last 6 months.
Coincidentally, I had my 6 month follow-up with my cardiologist the next day. At that time I was still in afib although symptom free. My cardiologist using my eps recommendation has now put me on xarelto; previously I was on low dose aspirin as chads2vasc was 0.
In addition, the cardiologist is now recommending an ablation. In the past he was against ablation as I was always asymptomatic.
Based on my last 7 day Holter, I am in afib about 30% of the time, with hr ranging from 39 to 140 (when running) and longest episode over 8 hrs. My hr has always been low since I am a long time runner.
Since being diagnosed with afib I have significantly reduced my running duration and speed. I am thinking that my afib is progressing so anticoagulation and ablation makes more sense to me now than when I was initially diagnosed 17 months ago.
In addition, the diltiazem has caused some fatigue. When initially diagnosed I tried beta blockers and they did not work for me. Due to my low hr, rhythm control was contraindicated.
I have a consultation with my ep next month and will get his insights.
I found in my research that some eps like mine use afib burden in addition to chads2vasc in determining if one should be on anticoagulation.
A particular interesting study was the Trends study that showed af burden exceeding 5.5 hrs in a 30 day period doubles the risk of a stroke. Of course the challenges in studies like these are that you have to have implantable cardiac devices in patients to measure time in afib as well as account for silent afib so it is not surprising that burden was never part of the factors in chads2vasc.
For those interested in af burden and stroke risk you can download the presentation (it takes a while) at:
http://spo.escardio.org/eslides/view.aspx?eevtid=48&fp=1045
As many have said on this forum, aspirin has little value in stroke prevention. While taking aspirin I also ate foods that I felt had anticoagulant and blood thinning effects such as natto, green tea, ginger, turmeric.
Does anyone know if natto is contraindicated with xarelto. I ate it daily and have temporarily stopped. My cardiologist never heard of natto which is not surprising.
opsyn
Amazingly I did not panic but took some deep breaths as I told myself I was okay and this will come to an end. After about 10 minutes my heart rate was down to 64 and I was still in afib. This is the third time this has happened while running in the last 6 months.
Coincidentally, I had my 6 month follow-up with my cardiologist the next day. At that time I was still in afib although symptom free. My cardiologist using my eps recommendation has now put me on xarelto; previously I was on low dose aspirin as chads2vasc was 0.
In addition, the cardiologist is now recommending an ablation. In the past he was against ablation as I was always asymptomatic.
Based on my last 7 day Holter, I am in afib about 30% of the time, with hr ranging from 39 to 140 (when running) and longest episode over 8 hrs. My hr has always been low since I am a long time runner.
Since being diagnosed with afib I have significantly reduced my running duration and speed. I am thinking that my afib is progressing so anticoagulation and ablation makes more sense to me now than when I was initially diagnosed 17 months ago.
In addition, the diltiazem has caused some fatigue. When initially diagnosed I tried beta blockers and they did not work for me. Due to my low hr, rhythm control was contraindicated.
I have a consultation with my ep next month and will get his insights.
I found in my research that some eps like mine use afib burden in addition to chads2vasc in determining if one should be on anticoagulation.
A particular interesting study was the Trends study that showed af burden exceeding 5.5 hrs in a 30 day period doubles the risk of a stroke. Of course the challenges in studies like these are that you have to have implantable cardiac devices in patients to measure time in afib as well as account for silent afib so it is not surprising that burden was never part of the factors in chads2vasc.
For those interested in af burden and stroke risk you can download the presentation (it takes a while) at:
http://spo.escardio.org/eslides/view.aspx?eevtid=48&fp=1045
As many have said on this forum, aspirin has little value in stroke prevention. While taking aspirin I also ate foods that I felt had anticoagulant and blood thinning effects such as natto, green tea, ginger, turmeric.
Does anyone know if natto is contraindicated with xarelto. I ate it daily and have temporarily stopped. My cardiologist never heard of natto which is not surprising.
opsyn
but everyone is different.
Good luck
FDAs assessment of Nattokinase
As noted above, the FDA has warned that unsubstantiated and illegal claims are being published about the effectiveness of NSK-SD Nattokinase and that Nattokinase products are not generally recognized as safe and effective to prevent blood clots [ref 2,3]. Other health care professionals have also concluded that there is an absence of data at this time that Nattokinase has clinical efficacy [ref 12].
Personal comment
I think it is fair to conclude at present that Nattokinase MAY have some potential to protect from blood clots. However, it has not been appropriately studied in humans.
Nattokinase is not a substitute for warfarin! If a patient takes Nattokinase he/she should not count on it having any clinically useful effect.
Comments made that Nattokinase is effective in preventing blood clots in humans are, at present, speculation, and any claim that one should consider using warfarin and Nattokinase together and titrate the warfarin downward to decrease the harmful effects of warfarin while maintaining a safer level of anticoagulation with the positive effects of nattokinase [ref 13] are scientifically and clinically unsound, inappropriate and irresponsible.
If a patient would benefit from staying on warfarin (or Pradaxa), I think it is negligent /dangerous/inappropriate for the patient to (a) replace warfarin with Nattokinase or (b) take less warfarin, aiming at an INR below 2.0, but add Nattokinase instead.
However, if a patient is not on warfarin (or Pradaxa) any more due to a low risk of recurrent VTE, it may be o.k. for him/her to take Nattokinase, with the argument that it MAY have some protective effect. However, Nattokinase has also not been studied regarding its safety profile, particularly when taken together with aspirin or warfarin.
http://professionalsblog.clotconnect.org/2011/09/18/nattokinase/#more-737
petey
What was counter-intuitive was the chart that showed that paroxysmal patients had higher stroke risk rates at ages up to 80 than permanent afibbers.
If you are on an anticoagulant, the different factors matter less as the stroke risk range becomes smaller.
petey
I say this all the time... it seems eliminating all the other preventable stroke risk factors would be prudent if you have afib. Multiple problems means more risk.
petey