I have very occasionally afib and no other symptoms, my new cardiologist seems concerned I could have a stroke and wants to place me on blood thinners or beta blockers. I feel good, excercise regularly and don't get light headed etc. Getting a holter soon to check it all out. I am almost 19 years post of for a MV repair and the echo looks stable. I suspect he is being vigilant as my previous cardiologist was very unconcerned and thought I was generally doing very well. At any rate I am trying not to overreact and get anxious over this... anyone else been placed on thinners as a stroke deterrent?
AFIB
- Thread starter JohnnyD
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Anti-coagulants are used for patients having A-Fib to minimize stroke risk. I developed periodic A-Fib several years ago. Since I was already on Warfarin for my mechanical valve no additional treatment for the A-Fib was needed. My A-Fib is now chronic and my treatment is still the Warfarin I take for the valve.
It is my understanding that some of the newer blood thinners are used for A-Fib if a mechanical valve is not involved.
It is my understanding that some of the newer blood thinners are used for A-Fib if a mechanical valve is not involved.
pellicle
Professional Dingbat, Guru and Merkintologist
Some reading
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515763/
emphasis mine
Atrial fibrillation (AF) is a leading preventable cause of ischemic stroke for which early detection and treatment are critical. The risk of stroke in people with AF can be stratified by the use of such validated prediction instruments such as CHADS2 or CHA2 DS2–VASc.
...The prevention of stroke related to AF is a global public health priority. Strokes due to AF are common and associated with very poor outcome (70%–80% of patients die or become disabled)
...The associated risk of embolic events, particularly embolic cerebrovascular accidents, is its most serious complication. Careful risk stratification and estimation of the risk of stroke using CHADS2 or CHA2 DS2–VASc can help to identify the high-risk patients who will benefit from OAC. The NOACs are preferable for stroke prevention in nonvalvular AF while warfarin is still the best option in valvular AF. The risk of bleeding should be assessed in every patient with AF prior to initiating anticoagulation to help guide the appropriate determination of the method of stroke prevention and avoid bleeding complications.
and before you jump on the "I don't wanna have warfarin" bandwagon the incidence of bleeds is lower on well managed warfarin than on the "novel Xa anticoagulants"HTH
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It's very common to be diagnosed with Afib and put on anticoagulants until they investigated and fixed the Afib. Ask your cardio why now and not earlier.
Just a quick question. Have you been positively diagnosed with Afib? Atrial flutter can mimic Afib, and both can be corrected via meds and/or ablation. The Holter should help narrow things down a bit.
Regarding the anti-coagulants, in the US it is also common to place a person on apixaban (Eloquis) or some type of direct oral anticoagulants. Sometimes for only a short period of time if you obtain control of the AFib/Aflutter.
I must place a caveat that with MV repair this may be different plus I am not an MD. My personal experience is with BAV and a bout of atrial flutter.
Good luck, you will have options!
Regarding the anti-coagulants, in the US it is also common to place a person on apixaban (Eloquis) or some type of direct oral anticoagulants. Sometimes for only a short period of time if you obtain control of the AFib/Aflutter.
I must place a caveat that with MV repair this may be different plus I am not an MD. My personal experience is with BAV and a bout of atrial flutter.
Good luck, you will have options!
I have very minor and infrequent afib, and no other symptoms like light headedness... that is why I am wondering why my cardiologist seems concerned. He tells me that patients with persistent afib call him about it. I made should not have mentioned it.. 
pellicle
Professional Dingbat, Guru and Merkintologist
actually he has been suggesting I get a holter for some time, I had one last year and the techs were confusing my workouts with having a high heart rate. I know it was my workout because my app records the time, the accelerated heart rate the techs were concerned about coincided with my workouts, so I was a bit annoyed about having to do this again...
I've had to repeat a test more than once due to the "techs" not getting it right. Humans make mistakes. However, not due to mistakes, but I've had a friend who has done holter tests more than once to get sufficient data to base a decision on. If the mistakes make you question the techs competency, get a different firm to do the test.
Your doctor says "patients with persistent afib call him about it". That could be her telling you that afib is a problem that concerns others and should concern you.
My metric for having a test is "will the results determine treatment?" If yes, get the test. If no, question why have the test? If it's yes and a very expensive test, there may be a cheaper route.
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A-Fib is diagnosed when the heart beats are irregular (no rhythm)! Heart rate can be within accepted high limits (or lower) but still in atrial fibrillation So, your workouts had elevated your heart rate, but the beats may have been irregular (just guessing).
Keep us posted.
Accelerated heart rate alone is not an indication of A-Fib!
A-Fib is diagnosed when the heart beats are irregular (no rhythm)! Heart rate can be within accepted high limits (or lower) but still in atrial fibrillation So, your workouts had elevated your heart rate, but the beats may have been irregular (just guessing).
Keep us posted.
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I occasionally have an irregular heart beat, but rarely... and it lasts for 15- 20 seconds. I am guessing...
pellicle
Professional Dingbat, Guru and Merkintologist
Probably ectopic beats. This is quite common and can remain like that for decades and never be an issue. I have had them most of my life, usually brief appearance.
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Yeah. I get those as well. They may come out of the blue, last for a few days (or at least I'm aware of them for a few days) and then disappear for weeks or months.
uncle_boko
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I have been put on apixaban following mitral and tricuspid valve repair.
ejc61
Well-known member
I had MV repair 14 years ago. I had a few episodes of AFib last year. My cardio said that AFib is something that can develop after valve surgery especially after 60 years of age which ironically was the time it developed. Anyway he did put me on a beta blocker metoprolol tartrate 10 mg daily as a way to prevent stroke by reducing my heartrate as well as for my controlled high BP. He put me on Eliquis at the same time as an anticoagulant temporarily in place of my low dose aspirin but after 3 months, he put me back on low dose aspirin 162mg and off Eliquis. In short, he is indeed, concerned about stroke.
well they are prescribing Amiadrone which is a scary drug... I was on baby aspirin years ago but suffered chronic noes bleeds so they took me off,
I don’t have afib but I have been on 325 mg aspirin daily since my mitral repair, due to enhanced risk of a clot and stroke.
pellicle
Professional Dingbat, Guru and Merkintologist
it is, but there was more to that article than that point. I'm not sure why you focused on amiadrone which has valid uses if its not used in a long term manner.
Lots of things are scary if you think about them. Driving a car in traffic on the motorway among people like this for instance.
ATHENS1964
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This is an anticoagulant drug aw warfarin, it is not related to antiarrhythmic drugs, i.e. it does not contain any medicinal substance that interferes with the heart rhythm .
