Hi @elegantgem. Glad to have you join us here on Mayo Connect where we do just that because so many members want to help us think through our options for health improvements. I will give you a direct answer about Eliquis. I won't touch it. I've been in A-fib for 6 years -- maybe 30 years, since I've had an irregular pulse at least that long. When A-fib was diagnosed by my Primary Care Physician -- an internist not a cardiologist -- she let me check around. At the time, I had a half-dozen friends on Warfarin, so I followed their experience and joined the Coumadin crowd.

I've never regretted that choice, even though I had a small stroke two years ago from a blood clot that cut off oxygenated blood to a small section of my brain. It was the result of an unexpected rise in my INR followed by a reduction in my Warfarin dose which left me without enough protection from clotting in my left atrium. Even so, I plan to stay on Warfarin 37.5mg per week (spread over 7 days), and one of the reasons is that my regular lab tests every month or two keep me posted on how long it takes my blood to clot. I just had my August test and, as a result of a small rise in that time, we cut my dose by 1.0mg per week -- a tiny adjustment.

My main problem with Eliquis and Xarelto and Plavix is the uncertainty about whether the clinic or hospital I wind up in has an antidote. An antidote for the first two got FDA approval in 2018, but a year later -- a year after my stroke -- the antidote still wasn't available on the general market. There was a problem about the process for manufacturing it.

Availability of an antidote bears special importance to me. Three years ago, I found a neighbor on his garage floor with a head injury from falling off a ladder. I called 911 and got him to the hospital 2 miles away, but they didn't have the easy-to-acquire Vitamin K antidote for Warfarin, so they called for a helicopter to take him to a regional hospital but he didn't make it. I sang at his funeral. Antidote for Warfarin is readily available in a variety of forms, but for Eliquis and Xarelto, the Andexxa antidote is more difficult to find on the shelf of fewer emergency rooms.

My main concern though is that there are dozens of different A-fib heart problems, a half-dozen main groups of physicians who deal with it, and a variety of ways that A-fib presents itself to diagnosis. As such, it needs to be diagnosed and treated as a unique problem for an individual patient. There should be no "customary" or "typical" symptoms or remedies, because they are based on generalizations about a large population of patients. In your case, I hope you'll have the opportunity for a second opinion from a recognized expert in heart arrhythmia problems, followed by a team of medical professionals who can be counted on to advise you what's best in your personal situation. With that kind of advice, you may not need a lot of treatment in the years ahead. Let me know if I have left something out that bothers you a lot, and I'll respond quickly -- as will our other members on Mayo Connect. Martin