AFib questions

Posted by peggyd @peggyd, Mar 23, 2016

Good morning! I’m almost 66 years old, with infrequent AFib and on Eliquis. Sunday evening I had a spectacular nosebleed and went to the ER, where the attending physician inserted an epistaxis nasal pack (the kind with the inflatable balloon). I’m getting it removed tomorrow. What can I expect when it comes out–besides my own reaction of dancing gleefully around the office? Blood? Clots? Scabs? A genie? Thanks for your help!

Hello, I have taken Xarelto for 3 years and have no side effects. I don’t know if the number of lawsuits against the company filed in the US is an accurate barometer for determining the efficacy of the drug. I live in Canada where there isn’t a culture of suing. Litigation is far less frequent here for that type of case. I rely on the NEJM as one of my sources when I am investigating drugs etc… There is an excellent article about the comparison of Xarelto to Warfarin. (http://www.nejm.org/doi/full/10.1056/NEJMoa1009638#t=articleTop)
They completed a double blind trial on 14,000 patients and the results were favourable for Xarelto.

CONCLUSIONS

In patients with atrial fibrillation, rivaroxaban was noninferior to warfarin for the prevention of stroke or systemic embolism. There was no significant between-group difference in the risk of major bleeding, although intracranial and fatal bleeding occurred less frequently in the rivaroxaban group.”
There is a greater chance of a brain bleed with warfarin and a greater chance for an intestinal bleed with Xarelto. Although both statistics are quite low. I opt for the intestinal bleed! 1.7% of the patients had a stroke with Xarelto over a 4 year period and 2.2% had a stroke using warfarin.
BTW, I have not heard of an antidote for a bleed with Xarelto. Please let me know what it is and the source.
Good luck! martishka

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Thank you for this info @martishka. I really appreciate the level of information and questioning that you and @gonefishinmt bring to this discussion and other discussions in the Heart Health group.

@donnelson @frank4848 @zenk @irishblueileen @murryone Any information on an antidote for a bleed with Xarelto?

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@jhoffmanj

Hello, new to group. I am 80. Four years ago had afib to point that I need catheter ablation. OK for two years, another ablation procedure. No current afib. However I have been diagnosed with enlarged heart. I have been active all my life. High school and college sports, infantry officer for seven years and marathon runner. My problem now is fluid developing in my one leg and ankle. I have water pills which my cardiologist told me to take only as needed. My latest LVEF is 50%. I am concerned about this fluid issue. Comments please. PS I guess I have CHF, which is hard for me to realize.

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You’re welcome. It’s an amazing and knowledgeable discussion.

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@colleenyoung

Welcome to Connect @prescott. I moved your message to this discussion thread about called Questions about AFib where you’ll meet @twptrustrek @irishblueileen @billmichalski @martishka @peggyd @nadine66 who have also been talking about afib and ablations. I’d also like to introduce you to @predictable and @cynaburst who will join me in welcoming you.

Many here in the Heart & Blood group have similar questions and concerns as you have expressed here. You may also be interested in reading and posting to these threads:
– How does a person develop skipped heart beats? http://mayocl.in/28U8QNs
– Should I consider ablation? http://mayocl.in/28ReaNr

Prescott, what medication are you taking at the moment? What lifestyle changes have you had to make?

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I had to jump in regarding the discussion of Anxiety Attacks. Mine started well over 20 years ago and I tried to deal with them on my own and I was to the point I had enough episodes that I was crossing things off my list of fun things I liked doing and no longer could do. I finally went & saw a Psychiatrist who prescribed 1 mg of Klonopin and that has got me over the hump that I am now able to drive over brides or on freeways, fly on planes and generally have a peace of mind. I now take the generic form called Clonaspam. Other than a headache like I missed a cup of coffee if I miss, it has been a miracle drug for me.

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@colleenyoung

Welcome to Connect @prescott. I moved your message to this discussion thread about called Questions about AFib where you’ll meet @twptrustrek @irishblueileen @billmichalski @martishka @peggyd @nadine66 who have also been talking about afib and ablations. I’d also like to introduce you to @predictable and @cynaburst who will join me in welcoming you.

Many here in the Heart & Blood group have similar questions and concerns as you have expressed here. You may also be interested in reading and posting to these threads:
– How does a person develop skipped heart beats? http://mayocl.in/28U8QNs
– Should I consider ablation? http://mayocl.in/28ReaNr

Prescott, what medication are you taking at the moment? What lifestyle changes have you had to make?

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Hi @thankful. I’m so glad you jumped in here with your experience and successful management of your anxiety. So many people are reluctant to share that they manage anxiety with medication. What a huge turn-around for you from being “grounded” by fear to being able to fly again – both in terms of going on airplanes to enjoying life.

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Did your cardiologist explain the cardioversion procedure? I was an emergency Afib patient on July 24, 2015 and was cared for by an emergency doctor. He had me on cardizem 360 and lasix 160 and coumadin. I was miserable with hugely swollen legs (plus 3) and still in Afib. That doctor told me to go through the scheduled hip replacement surgery in Afib and then get a cardioversion later. When I saw my own cardiologist one month later (August 27th) in a different hospital and city he told me no surgeon would perform on a patient in Afib and I’d have the cardioversion immediately (September 11, 2015.) It was successful, heart back in rhythm, and I then had surgery October 19, 2015. I was 86 years old then and did not flip back into Afib during the surgery. You may want to ask your cardiologist if you are a candidate for cardioversion. If not, why not?

I got off the coumadin after 10 months because it was not compatible with my food requirements and I now take Pradaxa since May 10, 2016. Pradaxa has an excellent antidote and I have seen no side effects from taking it except it costs much more than coumadin. Report is that they are backing off of coumadin now because it can take up to 72 hours to stop bleeding. Much too long for safety.

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Forgot to tell you that I am taking 20 mg.lasix twice a day, 12.5 mg. metoprolol twice a day and 150 mg. Pradaxa twice a day and am normal now. I also have ITP (low platelets – 51) and if the platelet count goes down near 30 I’ll have to take only 75 mg. Pradaxa twice a day, according to my latest visit with the hematologist whom I see for the platelet problem.

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I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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@colleenyoung

Welcome to Connect @prescott. I moved your message to this discussion thread about called Questions about AFib where you’ll meet @twptrustrek @irishblueileen @billmichalski @martishka @peggyd @nadine66 who have also been talking about afib and ablations. I’d also like to introduce you to @predictable and @cynaburst who will join me in welcoming you.

Many here in the Heart & Blood group have similar questions and concerns as you have expressed here. You may also be interested in reading and posting to these threads:
– How does a person develop skipped heart beats? http://mayocl.in/28U8QNs
– Should I consider ablation? http://mayocl.in/28ReaNr

Prescott, what medication are you taking at the moment? What lifestyle changes have you had to make?

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Thank you Colleen! I have dealt with Anxiety for many years and I am amazed how much more prevalent this deliberating thing is with many folks. I have found that not a lot of people are willing to talk about it, but I am very open about what it did to me robbing me of many things for years until I got the help I needed. I find the more I talk about it, the more people open up and it also helps me in a healthy way express that you don’t have to become a shut-in and live in fear.

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@grandmajan

I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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Welcome back, @grandmajan. Sorry to hear about the new issue with A-fib. My experience may clarify some of your concerns and help you chart a path. I’m almost 81, treated for hypertension for 25 years, survivor of epithelial bladder cancer, victim of benign prostate growth and surgery, and for the last two years, atrial fibrillation. Everything is under control! It helped to have an 83-year-old friend who has been on Coumadin blood thinner since he was 70 and has encouraged me regularly since my a-fib diagnosis. Another friend has had cardioversion, and while he doesn’t wish for others to have it, he says it’s been good for him so far and wasn’t an intolerable surgical intrusion.

My friends and my cardiologist agree that I probably will be taking Coumadin the rest of my life. Switching to Xeralto or Pradaxa won’t change that prospect, I am told. With Coumadin, I have regular laboratory tests of my blood’s clottiness, with minimal inconvenience and lots of good new friends who are phlebotomists at the lab. As to blood pressure medication, I’ll always have that also after 25 years of it, but there is nothing I can tell you about your BP situation without all of the information that your doctors have developed about you. The same is applicable on cardioversion, I think; trust your best doctors on whether that is necessary and when!

In my HMO agreement, there are specific provisions for changing doctors and/or getting second opinions. In my case, I changed both my nephrologist and my cardiologist in search of doctors who were devoted to exploring basic causes as much as treating symptoms. To do that, in both cases I asked my then-current specialist to help arrange a second opinion with another specialist. They did so as a matter of HMO policy. In both specialties, I have received second opinions twice and am now well satisfied with the third nephrologist and third cardiologist. Check the fine print of your HMO agreement and assert your rights under it. Let us know if you find any impediments that we can help remove.

Martin

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@grandmajan

I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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Hello grandmajan,
I had paroxysmal atrial fibrillation which means intermittent. My heart would convert into sinus rhythm after 2-4 hours with additional meds sometimes in the hospital, sometimes on my own. I couldn’t tolerate afib because it was accompanied by SVT which is a very rapid heart rate. The importance of taking care of afib and getting your heart into a normal sinus rhythm is that over time it can migrate to persistent afib and then continue on into permanent afib. Persistent afib doesn’t convert without medication and sometimes electric conversion is necessary (paddles to the chest). Chronic or permanent aFib cannot be converted back into a normal rhythm. It sounds like you are in persistent aFib and if it were me I would rush to get cardio converted. You are in a better situation if you can take care of the problem before it becomes permanent. Once you are in sinus rhythm sometimes the fib can be controlled by meds and sometimes an ablation is the answer. Regarding your question about HMO’s- I can’t help. I live in Canada and I see whatever specialist I want to. I also asked for a second opinion and my cardiologist recommended some doctors to me. Once you are referred to a specialist here you are under their care and need no more referrals. I do wish you the best of luck, it would make sense that you get a second opinion- but I would move on it, The less time your heart is in afib, the better.
martishka

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@grandmajan

I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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Hello predictable,
I just wanted to comment on the BP question. My sister lives in NY, is 73 and a few months ago she had an ablation for aFib and at the same time she had an ablation for uncontrollable high BP. This procedure is in the “testing” stage. Since then her BP has been 120/70 on an average. At the time of the ablation they inserted some little mechanism into her heart that records all “rogue” signals from the heart. Its all very high tech (I don’t understand most of it!) She has another device that she holds to her chest and it records the information which is then transferred to NYU Langone Centre. Some of the people discussing this issue along with aFib might be interested in this.
All the best,
martishka

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@grandmajan

I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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I agree with you. The conversion was done and I am on Warfarin. I have regular check-ups and am taking Solitol. My cardiologist is vey good (I switched from another who was pretty uncommunicative.

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@grandmajan

I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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Happy to hear that!

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@grandmajan

I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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Excellent points, @martishka. Medical advances are outpacing our ability to keep track of them and benefit from them. Both of your contributions here before lunch are very helpful and encouraging.

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