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New to Afib, blood thinners and beta blocker
Hello - I'm an otherwise healthy 55 year old female, diagnosed with afib 1.5 years ago. The dr. that diagnosed it immediately prescribed warfarin and metoprolol. My regular dr. was away at the time, and when she returned 3 months later, she said "I probably would have only put you on aspirin" - because I am otherwise healthy. No other risk of stroke, my bp is fine, blood sugar is fine, no history of heart attack, etc. But she decided to run the tests and try to determine my afib trigger, so I have since had an echo to check my heart's mechanical health (its good), sleep apnea test (I have mild, and am now on a device that treats it), and I've quite drinking alcohol. I saw an internist that decided I had alcohol induced afib. However, I suspect that my afib may also be triggered by hormone fluctuations caused by the peri-menopause I'm going through, but every dr. I've suggested it to says probably not, hard to prove. Ever since I was put on the 2 meds, I have been asking to get off them. "My" dr. wanted me to go through all the tests, and then decide. I live in a small remote town, and "my" dr. only works half time, so I am constantly seeing a new dr. The last new dr. I had basically said I have no choice but to stay on the drugs. She actually said the words "why do you want to get off the meds". I'm still flabbergasted. I've refused to go back and see that one. I have an appt. this week with yet another dr. to review my sleep apnea results, and maybe since it's under control, I will be able to get off the warfarin. But what about the beta blocker? Has anyone every been on warfarin and a beta blocker, and then been able to get off both of them?
I HATE being on these meds. But obviously I don't want a stroke either.
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My docs say aspirin is not effective for clots from afib, and the experts recently announced we should not be taking the daily low dose to prevent heart attacks either.
Thanks for this info.
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.
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
Your right, no questions for me!
Hi Martin:
Thank you for replying to my post with helpful information from your experiences. I will incorporate this into my discussion with my doctors.
Happy Holidays,
George
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1 ReactionMy empathy is with you regarding taking Warfarin. I have a clinical work history and can’t tell you how many times I’ve heard providers say that fatigue isn’t related to taking Warfarin. I’m now on Eliquis. There are no dietary restrictions, no “Coumadin clinic” blood tests, no fatigue. If you can take a different anticoagulant you may not feel so bad. I do wonder about stroke risk due to bleeding (vs clotting) on Eliquis. I’m also wondering if you could get an ablation.
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."
Thanks for your reply. This is helpful. I will take it up with my cardiologist if she recommends prescribe a blood thinner. Happy holidays.
What do people taking a blood thinner do to stop the bleeding from a small scratch or scrape that breaks the skin? Now that summer is here and my legs are exposed, I’ve already banged up my knees and shins. Even a small scrape wants to keep on bleeding, even through a band aid. Does “second skin” work?