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.
Dear All,
I was diagnosed about a year ago with Afib. I am 63 years old. I am on flecainide 2X100 mg and aspirin. As for anticoagulant my cardiologist claims that my risk without it is 2.5 % and with anticoagulant it is 1.5%; a very modest benefit as compared to the downside (i.e., bleeding).
I read some of the discussions on this site and was very impressed with the knowledge of the group ("the wisdom of the crowd") ; will be glad to hear some of your opinions.
Stay in sinus,
pandor.
I was diagnosed about a year ago with Afib. I am 63 years old. I am on flecainide 2X100 mg and aspirin. As for anticoagulant my cardiologist claims that my risk without it is 2.5 % and with anticoagulant it is 1.5%; a very modest benefit as compared to the downside (i.e., bleeding).
I read some of the discussions on this site and was very impressed with the knowledge of the group ("the wisdom of the crowd") ; will be glad to hear some of your opinions.
Stay in sinus,
pandor.
I am also taking flecainide, 75mg twice a day. It keeps me in NSR about 99% of the time. I am currently taking aspirin but my EP does want me to start eliquis. I am 62 and feel I could wait a few more years, but he has been trying to convince me. So...I filled the prescription and I have just about run out of excuses to put off starting it.
Welcome to the group. I am 64 and was diagnosed with afib 1.5 years ago. I was prescribed a calcium channel blocker for rate control along with aspirin.
Most dr's use risk factors known to determine if you need anticoagulants. You can read about these risk factors at http://en.wikipedia.org/wiki/CHADS2_score
I found a useful tool at http://www.sparctool.com/
that you can plug in your risk factors to determine stroke risk among aspirin and other anticoagulants.
Although I do not have any risk factors my ep and cardiologist put me on an xarelto about 6 weeks ago based on afib burden which is the amount of time I am in afib.
opsyn
The stroke risk numbers are ANNUAL risk numbers. I understand what you are saying about absolute numbers and the negligible absolute risk change that occurs with anticoagulants if your stroke risk is 1 or maybe even 2. Your doctor's numbers don't match up with the new system or the old CHADS2 system. They are actually 1.3% for a score of 1 and 2.2 for a score of 2.
Bleed risk is very small in absolute numbers also. You need to look at your lifestyle to weigh bleed risk. If your hobby is boxing, stock car driving, or skydiving, I guess anticoagulants would be bad.
There are other factors that could affect stroke risk not included in CHA2DS2Vasc. Atrial appendage shape and left atrial size (large presenting more risk) are examples.
Another thing to consider is the extent you have been tested for other heart problems. Many doctors will say you have no heart issues if they haven't found anything and you are asymptomatic. That doesn't mean you don't have genetic risk factors or coronary calcium numbers that are high. If you don't get tested, you could have stroke risk issues. Is there heart disease in your family? What about your cholesterol and diet?
Not to complicate things more... I just wanted to lay out some other things that could change stroke management. I've seen enough afibbers with a 0 or 1 CHA2DS2Vasc score have a TIA or stroke.
petey
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After you look at the CHA2DS2Vasc risk URL that opsyn provided, you might want to addin some other factors to decide what you want to do about anticoagulants.
(Opsyn, may I ask what the threshold is for "afib burden" before they suggest anticoagulants? Or if you don't mind sharing, what your typical length is?)
My ep recommended xarelto based on my 30% burden with longest episode 10 or 12 hours (cannot recall).
I never asked him what the threshold that he used to determine burden was. I spoke to another ep who did not feel anticoagulants were necessary so clearly the use of afib burden is not universally accepted.
opsyn
When you are in a reading mood, here is another article that also explains anticoagulation...http://heartdisease.about.com/od/atrialfibrillation/a/Preventing-Stroke-In-Atrial-Fibrillation.htm......
I take Pradaxa. It is a huge nuisance for me!!! It also puts me in the donut hole with Medicare by Autumn. I would have 2 pts. with the Chads score, one for being 71 and one for being Female. I no longer have hypertension.
My Dad had a pace maker and 2 strokes. One that paralyzed him and the other fatal. It is because of this, that I accept the nuisance and expense.
You and your Dr. will come to an effective choice for your well being!
You can sign up for his newsletter on the above link. Sorry the first one didn't work.
I like his newsletter a lot. It only comes once a week, is simple and up to date.
Hope you are having a Good Day!!!
Welcome to the group. Bear in mind that I had a Chad score of ZERO, exercised regularly, did not have any cholesterol or heart issues other than afib, took aspirin, and had stroke and will get my ablation in four weeks.
Needless to say, I'm not a big fan of aspirin. Now I take Coumadin. You will find several discussions here on the NOAC's. These revolve around antidotes, side effects, cost, convenience and bleed risk. It's a very personal decision.
petey
I was diagnosed a year ago. Always been so healthy and thought I was having a panic attack with heart so fast. I started with an intestinal infection and was getting frustrated because I didn't seem to be getting better. My h.r.was 140 beats/ min and h.b totally erratic. They tried Diltiazem drip at e.r. didn't work so kept me in hospital. I had it for 3 days and they had me ready for cardiaversion, even gave me the light Anesthesia ("Michael Jackson drug')!!!! When I opened my eyes, they were all laughing when. I asked if it wilorked - said they didn't have to do it that it just went back into NSR. I went home on Diltiazem and Warfarin. After a month the Warfarin was switched to 1 baby aspirin. Long story short @ had a second one exactly same in Sept. I am now on Sotalol 80mg. Twice daily and back on Warfarin.I havehad every heart test done and everything is good A fib is so c. This s why I viisit this site. Hope u are doing well:) Wish you NSR!
Christine
Welcome this is a great site. I have a fib for 1 year now but was diagnoses in June 2013. I am taking Xarelto Tiazac xl 240 Coversyl
and Apo Hydro. I have episodes every 14 to 24 days. I just self converted 20minutes ago after 14 hours. The good thing is , that so far ,
it always started in the afternoon or early evening and I just rest till it's over.
Most of what I know about a fib is from this group. So thanks to all of you, and especially Pete
I also learned most of what I know about A Fib from this site.
Have you been able to consult with an EP cardiologist yet?
D.
EP1: It is your decision; you can go the medication route or ablation; up to your personal preference.
EP2: "it is no brainer; you should take medication because you respond well to flecainide".
Next mont will see EP3 as a "tie breaker" :)