AFIB meds (anticoagulants) + wet macular degeneration

Posted by realitytest @realitytest, Nov 11, 2021

I have been taking Xarelto for several years for paroxysmal atrial fibrillation and so far so good.
A few days ago I got the devastating diagnosis of wet macular degeneration in my right eye. (dry too in both it seems). I didn't have a clue. All the worse since I am an artist by profession.
I'm beginning the vitreous injections (Lucentis, he started with) and doing much thinking and reading.
My gut feeling about the Xarelto was that it must be dangerous for my wet macular degeneration and of course, reading and my retinal doc confirm that as seems obvious. It looks like a choice between blindness and a cardiac "event" – at least, in terms of the odds.
But perhaps it's worth the risks of trying ablation to control the AFIB so I can discontinue the Xarelto. I couldn't be the only senior with both problems. What is current thinking about how to deal with this conundrum? Research shows the combination does indeed much increase my WAMD risks – of greater likelihood of bleeding in the one eye and more risk of its involving the "dry" eye (certainly sooner than otherwise).

Interested in more discussions like this? Go to the Heart Rhythm Conditions group.

Added here as the site doesn't allow me to extend my post above. I realize I need expert evaluation by both a retinal specialist and a cardiologist to know more about my particular situation re the ablation. I. would much welcome, however, input from others about how to handle this bind. My retina doc just says to continue the Xarelto – do I want a stroke? I see the decision as more nuanced. I'd rather continue to minimize my cardiac risks from the arrhythmia (somehow) at the same time, I maximize my chances of protecting my eyes to the extent I can. I see my chances of maintaining my vision are indeed much worse because of taking an anticoagulant.

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Would the Watchman device be an option- I don't know anything about it but might be worth asking your cardiologist. 🤔

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I am sorry you are having issues with your eyes. My Electrophysiologist, Dr. John Day, wrote a book called the AFib Cure with Jared Bunch. It is packed with information specifically on AFib that is all scientifically based and referenced. I have found this book to to be invaluable because it focuses on lifestyle changes, yet it also provides honest, accurate information on medications procedures and bio marker monitoring. I bought the book on Amazon. The book is well written, motivating, and it has practical advice. In addition, Dr. Day has a podcast I listen to full of tips.

Perhaps this book will provide you with some ideas. It has helped me. I have multiple other cardiac issues I am dealing with, and having my heart rhythm in control with lifestyle changes has enabled me focus on my other cardiac issues. Take care.

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@detom

Would the Watchman device be an option- I don't know anything about it but might be worth asking your cardiologist. 🤔

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Thank you, will look into it.

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@janet23

I am sorry you are having issues with your eyes. My Electrophysiologist, Dr. John Day, wrote a book called the AFib Cure with Jared Bunch. It is packed with information specifically on AFib that is all scientifically based and referenced. I have found this book to to be invaluable because it focuses on lifestyle changes, yet it also provides honest, accurate information on medications procedures and bio marker monitoring. I bought the book on Amazon. The book is well written, motivating, and it has practical advice. In addition, Dr. Day has a podcast I listen to full of tips.

Perhaps this book will provide you with some ideas. It has helped me. I have multiple other cardiac issues I am dealing with, and having my heart rhythm in control with lifestyle changes has enabled me focus on my other cardiac issues. Take care.

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Thank you very much, Janet. Sounds promising!

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@realitytest

Added here as the site doesn't allow me to extend my post above. I realize I need expert evaluation by both a retinal specialist and a cardiologist to know more about my particular situation re the ablation. I. would much welcome, however, input from others about how to handle this bind. My retina doc just says to continue the Xarelto – do I want a stroke? I see the decision as more nuanced. I'd rather continue to minimize my cardiac risks from the arrhythmia (somehow) at the same time, I maximize my chances of protecting my eyes to the extent I can. I see my chances of maintaining my vision are indeed much worse because of taking an anticoagulant.

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I have dry AMD in my left eye and wet AMD in my right eye, diagnosed 6 years ago. My AFib diagnosis ca. 10 years ago. I have a injections in my right eye every 3 months, have had them for 6 years and my AMD is stable – I do not have the meds name handy, but expect it is what you are receiving. I have taken Coumadin and now Eliquis for 10 years. Either of my doc’s has cautioned me of a potential problem. Perhaps a second opinion

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@downeaster

I have dry AMD in my left eye and wet AMD in my right eye, diagnosed 6 years ago. My AFib diagnosis ca. 10 years ago. I have a injections in my right eye every 3 months, have had them for 6 years and my AMD is stable – I do not have the meds name handy, but expect it is what you are receiving. I have taken Coumadin and now Eliquis for 10 years. Either of my doc’s has cautioned me of a potential problem. Perhaps a second opinion

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Dear downeaster, thanks very much for your encouraging reply. It certainly seems to the "naked eye" like our situations are much alike.
I'd love to know more about your eye history – whether your AMD handicaps you in your function, at what stage you were diagnosed and where you are. being treated (both for your AMD, wet and dry, and AFIB).

I've definitely noted that the quality of ones physicians make a significant difference in outcomes. For example: my mother who is totally blind now from wet macular degeneration – not even any peripheral vision – was most fortunate in landing after her diagnosis decades ago in the practice of an expert retinalogist in Sarasota, FL (Florida with all its seniors is blessed with many of the best practitioners in all geriatric fields).

He was unique at the time in being aware of the off-label use of Avastin for AMD, wet and dry – I believe he imported it from overseas. Thanks to his acumen, her vision was preserved at least ten years longer than friends diagnosed at the same time she was.

Might I write you to compare notes? Not sure how to go about it through this very useful "Connect" site, but there must be a way. A similar site dealing with complex spinal surgery helped me immensely six years ago, in navigating choices – surgeon, hospitals, pointers about how to prepare, etc.). What my options were, and above all, the pros and cons of daring to proceed with that very dangerous surgery – nine hours for me (all too often leading to paralysis, increased pain and other irreversible negative consequences even many years after the initial surgery). Patient to patient outreach in such medical decisions can be life-saving/sight saving – not to replace the guidance of an MD but to supplement it. There are many controversial aspects about which patients are rarely adequately informed.

Before signing off, though, please clarify what I suppose is a confusing typo. You wrote of your physicians, "Either of my docs has cautioned me…" and I suspect you meant "Neither…" Which is it?

Many thanks again!

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