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New to Afib, blood thinners and beta blocker
Hello - I'm an otherwise healthy 55 year old female, diagnosed with afib 1.5 years ago. The dr. that diagnosed it immediately prescribed warfarin and metoprolol. My regular dr. was away at the time, and when she returned 3 months later, she said "I probably would have only put you on aspirin" - because I am otherwise healthy. No other risk of stroke, my bp is fine, blood sugar is fine, no history of heart attack, etc. But she decided to run the tests and try to determine my afib trigger, so I have since had an echo to check my heart's mechanical health (its good), sleep apnea test (I have mild, and am now on a device that treats it), and I've quite drinking alcohol. I saw an internist that decided I had alcohol induced afib. However, I suspect that my afib may also be triggered by hormone fluctuations caused by the peri-menopause I'm going through, but every dr. I've suggested it to says probably not, hard to prove. Ever since I was put on the 2 meds, I have been asking to get off them. "My" dr. wanted me to go through all the tests, and then decide. I live in a small remote town, and "my" dr. only works half time, so I am constantly seeing a new dr. The last new dr. I had basically said I have no choice but to stay on the drugs. She actually said the words "why do you want to get off the meds". I'm still flabbergasted. I've refused to go back and see that one. I have an appt. this week with yet another dr. to review my sleep apnea results, and maybe since it's under control, I will be able to get off the warfarin. But what about the beta blocker? Has anyone every been on warfarin and a beta blocker, and then been able to get off both of them?
I HATE being on these meds. But obviously I don't want a stroke either.
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@debbee,hello!
please read the following link: http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/Treatment-Guidelines-of-Atrial-Fibrillation-AFib-or-AF_UCM_423779_Article.jsp
the need for anticoagulation depends of your CHA2DS2–VASc risk.. after reading you will be entirely informed ,and you are able to discuss your treatment better with the doctors.
Special thanks @yoanne for the reference to the Heart Association's guidelines on A-fib diagnosis and treatment and the Internet link to bring them up to read. On that page is another link that takes us to an online tool for calculating your risk of a stroke from A-fib and the need for anticoagulation therapy. Here's that link to that page: http://www.heartinteractives.org/afib5/activities/MAE-CHA2DS2VASc/Interactive2-MAE.html. As @yoanne advises, print those two pages and take them with you to discuss them with your cardiologist(s).
The tool recommends that I take a "blood thinner," although my risk of a stroke is based only on my age (over 65) and my hypertension. I need an anticoagulant even though I am not experiencing congestive heart failure, diabetes, prior stroke, or vascular disease and am not a woman.
I take a medium dose of Coumadin daily and stop by the lab for 15 minutes once a month. Staying in tune with the coagulation index is no problem for me or for my 83-year-old friend, who has been on Coumadin for 10 years and tracks his index at home with a special device. I also take a beta blocker (Carvedilol), mainly for my hypertension, but also as a prophylactic for my A-fib. My medication regimen is a joint therapy of my cardiologist (who knows the heart) and my nephrologist (an expert on hypertension).
Hi @debbee, I also add my welcome.
You may also be interested in reading and joining this discussion on Connect called "AFib questions" http://mayocl.in/29iD8aJ There's a lot of information shared amongst members there.
I certainly sympathize. I'm on metoprolol and Eliquis and i resisted both. All my doctors say they're low dose amounts, that i am at risk because of heart disease ( i had bypass surgery), and of course they believe meds are downright good for you. I finally went on metoprolol but at half dose. And i'm continuing to study, thru diet or lifestyle changes, how i can safely eliminate them. Your situation sounds better than mine so i'm sure there's a solution for you. But it will require a change in doctors.
Visit the websites for the doctors wolfson and dr sinatra (Google them). They present alternatives. Jack Juraco
Thank you @yoanne. I wasn't clear in my post, my CHA2DS2-VASc risk is 1. And after my dr.s appt. today, I am now OFF warfarin, and on a baby aspirin. I'm thrilled. The beta blocker though is another story. I have to be monitored as I ween off it, but am going to be out of the country off and on for the next 7 months, so have to wait on that one.
Thanks @colleenyoung. Yes I scrolled through there, and it was helpful!
Thank you @predictable. Yes, I wasn't clear in my post, I've done that risk assessment, I'm a one. This was why I was frustrated with being on the warfarin. And, as I said in my reply above, as of today, I am now off it, thank goodness. Baby aspirin now.
Thank you @jackj, I will google them.
As of today I'm off the warfarin, but still on the metoprolol, for now. Have you heard of the Australian Legacy study, Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation ? It's more evidence of lifestyle changes that could influence afib.
http://content.onlinejacc.org/data/Journals/JAC/934063/03002.pdf
Thank you @yoanne. I wasn't clear in my post, I know my CHA2DS2-VASc risk, it's one.
And as of today, I'm off the warfarin!! Yayay! But still on the metoprolol, I have to be monitored to get off that, but will be in and out of the country for the next few months so have to wait till I'm back to do that. 1 down, 1 to go.
@debbee, hello!
I can imagine that you are relieved. it is according to the guidelines.I started with 100 mg aspirin as well, because I was younger than 65 and had no other risks. metoprolol is meant to keep the heart rate within certain limits it does not prevent A-Fib's, ,but it makes the A-Fib. more bearable.(less dizziness for example).