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@gloaming I suggested to the cardiologist that the three criteria for reducing the dose of Eliquis by 1/2 were 1) age over 80 (I'm 79.5) and weight lower than 130 lbs (I am 135) and 3) decreased kidney function (mine is fine). He practically had smoke coming out of his ears at the suggestion. I have no history of stroke in my family. My B/P is well controlled. My brother also has had A-fib for years with multiple cardioversions and one ablation and his cardiologist has never had him on anything except ASA. However, he was on an anti-arrhythmic med for years (amiodarone) known for potential to damage the lungs. New cardiologist for him was shocked he'd been taking it for 10 years and took him off! Now he is having recurrent episodes of A-fib. Go figure. He lives in the midwest; can there be a regional difference? This is what surprises me about talking to others on this site--how different and sometimes how "flippant" some doctors are about this condition. Shouldn't there be some standard treatment approaches with all the studies that have been done and all the people out there that suffer from this condition. I feel like it is more like every man (or woman) for themselves in terms of what approach to take.
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@sjm46 It's a head-shaker, to be sure. Some of us in this and on other AF boards have make it a point to try to convince newcomers to the disorder that there are EPs in business, and then there are the better EPs. As Dr. Scott Lee says in his YouTube channel videos, some EPs feel most secure, and are most successful, in doing the basics. It pays their bills, and they probably get lots of positive feedback if they've succeeded in stemming a patient's AF. Dr. Lee feels that some patients will not do well by them. They need more skilled care, more expert care, from EPs who have confidence in tackling the more complex arrhythmia patients.
The other partner in this dance is the patient. Some need hand-holding and have little motivation or interest to learn about their condition and what they can do for themselves. Others, like myself, almost present as a nuisance to EPs because we ask intelligent and challenging questions (which tends to make meetings longer). We have begun to read, or are already well-read, and we know what to do to advocate for ourselves. Personally, I can't see a patient on amiodarone longer than two or three years, although each patient is different in both tolerance and in their ability to profit from the drug and to stay alive reasonably well.
One other factor is Ye Olde Underwriter. They call the shots when it comes to approving procedures, drugs, and what they will insure any one individual for doing....or failing to do.