My EP took me off eliquis. But I’m petrified. I’ll have a stroke now.

Most doctors are very eager to prescribe blood thinners so if your
doctor says you are outside of the recommendation range I think you can believe him.

Do you take any nutritional supplements? A very common combination, fish oil for the omega-3 DHA and EPA and curcumin as a general anti-inflammatory, are good for healthy people too and may have much the same effect as blood thinners when it comes to avoiding clotting issues. Others take the route of a baby aspirin per day, but that's rather less popular now than some years ago.

Other nutritionals offer additional and alternate approaches, too, you can have a new hobby good for years just researching them. What I've never seen, however, is a comparison to prescription approaches!

@marybird
Thanks, really helps. When I get my ICD/Pacemaker reports sent to me they are quite medical sounding and hard to understand if problem or not. Your history with your ICD/pacemaker sounds like mine.

So I wait for Pace Clinic to call me or portal message me about an issue. I just had them call me as had 8 seconds of VTAC that my ICD/Pacemaker paced me out of thus no shock. They asked me what I felt and quite frankly I don't think I felt the VTAC just the pacemaker speeding me up.

My AFIB as just you posted is short lived and random. Great information. How long have you had a pacemaker? I have had one since 2006 and on my 3rd. Battery is at 2.5 years so coming up for another soon. The % you mentioned made the number I see understandable, thanks again.

@carbcounter
My EP also suggest magnesium OTC.

@jc76 I guess I'm a pacemaker newbie compared to you, I received my pacemaker in June of 2019. I just have a pacemaker, not a defibrillator as so far I've had no issues with ventricular tachycardia. I got the pacemaker for bradycardia- I had tachycardia issues as well but most often these were what the EP identified as atrial tachycardia. The A-fib showed up once in 2015, ( a-flutter, actually) and the A-fib started showing up in short episodes around early 2021, I think it was. I've never gotten my pacemaker reports, I guess if I asked for them I would get them, but I haven't. But I've been notified by telephone by my cardiologist's office when there was an "actionable event"- this would be an incident in which the provider needs to take action for a patient, ie, a change in medication, further testing or something like that. I got the notification to come into the office and see the cardiologist after a pacemaker report of a couple A-fib episodes lasting several hours each, that's when he started me on Eliquis. Sounds as though your clinic was concerned about your V-tach enough to call and inquire about it- thank goodness your ICD/pacemaker was there to stop it.

I think my last pacer check showed around 3 years battery time.

@jc76 said, "My EP also suggest magnesium OTC."

Hey, that's new to me, but Google agrees:

"Yes, magnesium can influence blood clotting, generally acting to reduce excessive clotting by relaxing blood vessels, preventing platelet stickiness, and balancing calcium's role in coagulation, effectively working as a mild natural anti-coagulant or anti-thrombotic agent, though it's not a potent blood thinner like medication"

Often many other good reasons for supplementing with a little Mg, add this to the list!

@carbcounter
Yes got it recommended several years ago for the purpose of helping heart's electrical function (recommended by my EP Mayo Jacksonville).

I have read, like you, many advantages of magnesium and have been taking for several years now. I would though as a caveat to those on MCC to always check with your cardiologist about taking any supplements.

Several years ago on MCC was reading about potassium and it's benefits with heart function and electrical. I thought wow should try that. But I do follow my doctors instructions and contacted my EP about taking potassium OTC. He sent me an immediate message via Mayo portal system to not take any additional potassium. My blood test showed I was already at the maximum acceptable level of potassium and not to take a supplement.

If you read about potassium it is a great supplement for heart but too much can be dangerous to heart function.

@sandw40 As we age and sit more/move less, and if we want to live well for another few years, I think anti-coagulation makes abundant sense. It's just that there are perhaps better options, at least at first, in the early days of aging, say from 60-80 for many of us with 'long genes'. One better option would be to clean up the diet. Another might be to haul our coats out and move our carcasses just a bit more often....and more than just once around the block and nip back indoors to the digital devices and their siren calls.

@gloaming Far as I know they don't give out pacemakers or ICD defibrillators just for the purpose of controlling or eliminating A-fib or any other arrthymias, with the exception, as I understand it, when a person is in permanent A-fib and is symptomatic to the point where the A-fib affects the quality of life, and/or is associated with a rapid ventricular response which drives the heart rate up to unsustainable rates. At this point a kind of "last resort option" is to ablate the A-V node so it can no longer function and the electrical signals from the atrium can no longer be transmitted via the A-V node to the ventricles. A pacemaker is implanted to send the electrical signals in a controlled fashion to the ventricles. As I understand it, the person still has the A-fib but may not feel it as badly.

A defibrillator is generally implanted when a person has had episodes, or is at risk for ventricular tachycardias which may be life-threatening, or is at risk or has had cardiac pauses, arrests. A defibrillator is implanted to shock the person's heart in the event of ventricular tachycardias or sudden cardiac arrests, to restore the heart to a normal sinus rhythm. As I understand it, most cardiac defibrillators currently come with pacemaker functions as well, whether or not the pacemaker function is activated depends on the patient's needs.

Far as I know, having A-fib alone does not meet the American Heart Association, European Cardiac Society, or the Heart Rhythm Society guidelines for the placement of a pacemaker or ICD. These guidelines address symptomatic bradycardia as primary reasons for pacemakers. Although one of their criteria does include the necessity of taking medication that causes bradycardia to control a condition in which there is no substitute for this medication. That's actually an A1 classification, meaning that all experts agree that pacemaker placement would be expedient and helpful for such a patient.

And that said, I've learned that pacemakers, once implanted in a patient, can be used to suppress A-fib episodes by using "overdrive" pacing. The pacemaker would be programmed to raise the pacing rate to a higher rate, ( I think mine is set at 75) when an A-fib episode is detected, this is intended to stop the A-fib and it seems to work pretty well, at least I've found. This is most helpful for paroxysmal A-fib, but pacemaker placement would not be indicated for this reason in a person who just has A-fib.

Pacemaker monitor readings/reports have to do with the status and functions of the pacemaker and cardiac functions and responses to the pacing over the period of time covered by the report. The reports include the remaining voltage in the battery and time estimated to the end of service, voltage applied for each paced beat, information about the leads, average percentage of atrial/ventricular pacing, total number, times and length of time that arrhythmias such as A-Fib ( these are classified as "Atrial High Rate Episodes" ) have occurred. The cardiac activity is also graphed ( called EGMs) so an EP/cardiologist/pacer tech can see the type of arrhythmia may be occurring, can see if it's A-fib or a non-afib atrial event, which they refer to as SVT. The reports will also show the number of times, dates and times and other details when the pacemaker made adjustments in its pacing to accomodate particular issues such as arrhythmias, lead issues ( some of those are referred to as "mode switching") and much other data that I can't even begin to understand or explain!

The CHAD2S2-VASc score has nothing to do with pacemaker readings. Looking at the link in your post, you can see the points listed there are for the risk factors in an individual's medical history, including history of hypertension, diabetes, strokes, TIAs, thromboembolism, cardiovascular disease, age and gender.

I hope this helps!

@jc76 yes, as you say. In general you can get most nutrients just by having a good diet, with vitamin D being perhaps the most difficult these days. And some vitamins are very safe, like vitamin C, the body happily passes excess right back out.

Even Mg can be a little tricky since different supplements absorb better or worse so the blanket recommendation of 400mg isn't enough. I take a little Mg at night to help with sleep, but 100 mg of magnesium glycinate is as effective as 400 mg of magnesium oxide. A handful of almonds after lunch or dinner is a natural way to get Mg, too.

You don't want to be short of K (potassium) but in general eating some fresh fruit and vegetables daily is the right way to do that, and too many in supplements can be dangerous. Also the general advice is not to take calcium supplements, again dairy products also dark green leafy vegetables, are easy ways to get it naturally.

Overall diet can facilitate health and a simple, balanced diet is far more important than we've generally appreciated. Did you know that vitamins weren't even discovered and named until the 20th century? And even then they weren't considered medicine. Doctors are taught very little about it, and it is not considered a standard topic of discussion, is outside of standards of practice so discourages mention of what doctors may have picked up even outside of medical school. You really want an MD who also has nutritionist training but that is fairly rare. A nutritionist who is not an MD and so can't even see your records is already working at a disadvantage in both education and information.

@carbcounter
Good information, thank you.

On the magnesium my EP recommended Citrate formula. He said was highly absorbable. He also said some find it to much for digestive system and said if that occurred use the Glycinate you mentioned. EP said take to help with PVCS and recommended 400 mg.

What I find is my EP is pro supplements and my Heart Failure doctor is anti supplements. My PCP is open to hearing what I want to take and give a thumbs up or down.