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New to Afib, blood thinners and beta blocker
Heart Rhythm Conditions | Last Active: Aug 13, 2023 | Replies (66)Comment receiving replies
I'm a 78-year-old male in excellent health (132 lbs, 5'8"). I've been running 3 to 4 miles most days for 45+ years without difficulty and am continuing to do so. My resting heart rate is in the 40's or 50's, which my doctors have always said is normal and healthy, given my daily exercise routine.
Recently, I had an episode of atrial fibrillation that lasted about 90 minutes and went away. My doctor had me wear a Zio heart monitor for 14 days. It showed an "AF Burden" of "1%." I also had a transthoracic echo that appears to be normal and a nuclear stress test that also appears normal, with an "Exercise Duke Score" of "10+." The report states that I have "good exercise tolerance."
QUESTION: How much a-fib can a person have before a blood thinner is necessary? I don't want to take a blood thinner unless it is essential to do so. With my running regimen, there is always the potential for a tumble that can cause bleeding (and I have tripped twice while running and opened a bloody cut on my knee).
SECOND QUESTION: Should I avoid anti-arrhythmic meds, in view of my low resting heart rate? The Mayo Clinic website states that "[b]ecause they tend to have more side effects than drugs that control the heart rate, anti-arrythmics tend to be used more sparingly."
Thank you.
Replies to "I'm a 78-year-old male in excellent health (132 lbs, 5'8"). I've been running 3 to 4..."
I have afib for 2-7 hours about once a year. I have consistently declined anticoagulants and do not take any other meds for afib other than the "pill in a pocket" approach meaning I taked diltiazem only when I have an episode. My pulse goes up to 180 so I end up on a drip of diltiazem in the ER anyway, due to low bp.
Anyway, each time this happens, I ask about short term anticoagulation. To me, this makes sense more than continual anticoagulation which carries risk of bleeding i brain and elsewhere.
So I just read a study that supports exactly that: for episodes longer than 5.5 hours, short term anticoagulation.
Doctors overprescribe. My cardiologist finally, after 6 years, told me I was probably right and they are overmedicating. Think about it. It is safer legally for MD's to follow a protocol strictly. Then, if a bleed happens, they were following established guidelines. On the other hand, if they do not prescribe and a stroke happens, they are liable. Liability drives decisions and pushed medication over no treatment.
I have one cardiologist who is brave enough to say "Go home and forget this happened."
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Hi @parkgp. Interested in your single experience with atrial fibrillation which, as you describe it, demands an additional focus of your medical treatment. The "blood thinners" that you question are better known as "anticoagulants" -- more to delay or prevent clots formulating than to thin the blood. For example, I've been diagnosed with a-fib regularly for several years, and I had a blood clot form in the atrium of my heart and lodge in a small artery in my brain. In response, my medical team prescribed Coumadin (active ingredient Warfarin). Two important points are required to manage my condition: First, irregular rhythm in my heart and, second, the degree of coagulation of my blood as shown by regular INR blood tests that show my prothrombin time (PT) -- how long it takes for a clot to form. For me, "how much a-fib" is not the issue. I want to know 1) if a-fib shows up on any EKG; 2) since it does, what is my prothrombin time and whether it is stable in every blood test, 3) whether my medical team's a-fib therapy keeps me safe from clots and/or serious rhythm problems in my heart. Finally, I don't believe my anticoagulant provides any significant treatment for a-fib; it only guards against the side effect of clotting. I hope my experience provides some points that you can discuss in detail with your medical team. Martin