Anyone with occasional Afib NOT on a blood thinner?

There is a lot of difference of opinion on how long an afib episode should be to require anticoagulation (minutes to over 5 hours to 48 hours) and how long that anticoagulation should last (hours, days, weeks, a month).

The question was asked about "Is there anyone with afib not on anticoagulants". In fact, the need to use a "blood thinner" is dictated in large part by the CHADS score of the patient. This system gives points for a variety of things including age, diabetes, hypertension, alcohol use etc. A 75 year old will get two points and put on anticoagulants just on the basis of age, but a younger person without any other compounding factors may not be, or may just be put on aspirin. The problem with someone who has infrequent episodes is that we may not feel symptomatic and therefore unaware of the fact that fibrillation is present (and potentially forming clots that could cause stroke). This and other subjects are discussed in an article in the New England Journal of Medicine in 2021 entitled "Atrial Fibrillation". Unfortunated they won't let me post a link here

@roba7 my CHADS score is 2 (age over 65 and female) but since I have no other factors like hypertension, diabetes, overweight, alcohol etc. my electrophysiologist does not think I need anticoagulation. I always feel my afib and monitoring has shown that to be true. I have episodes roughly one a year. I am really happy this EP gave me Eliquis to take short term after an episode that lasts over 5 hours, which mine rarely do. I have flexibility in how I use it so if an episode were , say, 3 hours I might consider a few days or a week on it. One hospital did an echocardiogram after an episode to check for clots and I was unmedicated.

If monitoring shows more afib than a person is aware of, then the CHADS may be a good indicator of need for meds.

Makes sense to me. But your situation is quite uncommon

@roba7 in what way is my situation uncommon? Frequency of afib or ability to know when it is happening? The original post asked about blood thinners for "occasional" (paroxysmal) afib, by someone who had gone a year without any afib.

A doctor using the CHADS score alone prescribed an anticoagulant for me 10 years ago and I declined. Another doctor told me to "just go home and forget it happened." I was happy to find an individualized approach and understand it does not apply to everyone.

Anticoagulants bring risks of bleeding. I believe my mother's vascular dementia was worsened by Coumadin. Afib brings risk of stroke. It is a matter of risk vs benefit and which brings the higher risk. The CHADS score simplifies what is actually a quite complicated decision.

Surely doctors face less liability when following the CHADS protocol than when they don't prescribe. For me, that is a problem. For many, it is not.

My brother was on blood thinners for 10 years. They did an ablation and AFIB disappeared. Now he takes 1 baby aspirin a day and no dizziness or side effects. Take with food.

My doctor told me studies show that bleeding risk from aspirin is the same as anticoagulants. Other doctors have told me that aspirin is not effective in preventing stroke from afib. And I read a report that aspirin is no longer recommended daily due to bleeding risk.

@roba7, welcome. I noticed that you wished to post a link with your post. You will be able to add URLs to your posts in a few days. There is a brief period where new members can't post links. We do this to deter spammers and keep the community safe.

Obviously the link you wished to include is not spam. Allow me to post the information for you:
- Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMcp2023658

Access to the article requires a subscription.

When people tell me that a health problem runs in the family, by listening to them, I usually find that the HEALTH and DIET habits are passed down. I am also very reactive to meds, so I take none. I investigate the causes and ways to get rid of the problem naturally. Dr Google does not cost me a bit and does not get me on meds that are more dangerous for me than the original problem.

@kildlaren96 it seems you must have high blood pressure, from the meds you are taking. That raises your CHAD score. It sounds like your cardiologist is taking a reasonable course of action balancing risks, and if you have more afib, that course may change. Two episodes in 11 years is not cause for alarm, from what my EP has said about once/two years or even once/year, and I hope that pace continues!

@lindy9 on many of these health forums, whether for bones or heart or lupus, there are people who are following a "natural" or "holistic" approach (including diet, exercise, supplements). Everyone is different. Many of us do require medications and for some health conditions, we may even be in danger without medication.

That said, finding doctors who listen, and are cautious and flexible in whether and what they prescribe, seems key in my experience.