16 months on

16 months ago, i was rushed into hospital for as heart stopped for 45 seconds - with no real prior warning

After 24 hours they said pacemaker and it was major Afib

After another 24 hours had passed, Afib had stopped and the I was put on warfrine for the rest of my life with a pacemaker

The pacemaker has a high rate of 70bpm to try and stop the afib

As far as I know the Afib only ever lasted about 4 hours and that was 16 months ago, after a very stressy week - very stressy.


So now I am thinking, what I should be speaking to the doc about, as I have a routing apointment next week

Should I try and come off of the warfrine now as nothing happened for 16 months and the paceing rate is now about 20% all at night when the heart rate drops to below 70

Should I wait another 6 months to see if Afib did not come back after 24 months, they say my stroke risk is less than 1, so I could come off, but I dont wan to risk my health by coming off if it is not good idea

Any ideas about what I should do, I did have major Afib for 4 hours and my heart did stop for nealy a min, but it was a single very very short event, and now 16 months later - nothing has happened since

Can this can be caused by major stress, or by some kind of bad food or to much caffine - I dont understand how this happened and not happene again in 16 months

G

4 Comments

Warfarin

by Alma Annie - 2015-04-03 06:04:15

There are other blood thinners, not so strong as Wafarin. Ask your cardiologist about them. My husband is on 100 mg aspirin a day, much easier than managing INR and the like.
Alma Annie

I know what I would do !

by IAN MC - 2015-04-03 06:04:20

With your medical history I would definitely come off warfarin, purely because taking it, and having INR measurements , is quite an inconvenience.

Cardiologists vary a lot as to how risk-averse they are when it comes to blood thinners ( as do patients ! ) . I would imagine that your stroke-risk is pretty low , as you now seem to have normal sinus rhythm,so why take warfarin ?

. Ask your cardiologist if it is possible that you had a one-off fibrillation caused by your cardiac pause. If he says it IS possible then I would push him very hard to stop your warfarin.

I stopped warfarin immediately after having a successful ablation for atrial flutter , but I have a friend who had an identical medical situation, with an equally successful ablation and his cardiologist insisted that he remain on the warfarin. Doctor advice does vary and I guess it is your decision.

Best of luck

Ian

Afib is tricky

by Theknotguy - 2015-04-03 09:04:24

Afib is tricky. Once you've had it, there is a very good chance of getting it again. Problem being you don't know what triggers it and when it will happen. Along with afib is the risk of stroke or heart attack. If you haven't had an afib session for 16 months, you're probably at low risk for it. However, you can get it again.

I was on rat poison - er, ah - I mean warfarin/coumadin. Very dangerous stuff. I had so much trouble with it I ended up on aspirin. But aspirin causes side effects too. Namely when you take it in enough strength to help with blood clots it can cause stomach bleeding. I'd start bleeding in the stomach and lose so much blood that I'd end up in the hospital.

Currently I'm on apixaban (Elequis) and get along fine with it. Other than bleeding a little more when cut it doesn't seem to bother me.

Your PM should be keeping track and should be able to tell you if you are having afib sessions. If you are, then the blood thinner is mandatory. If you haven't had any afib sessions then you could argue for no blood thinners or minimal blood thinners.

Unfortunately if the heart stopped once, it could again. Problem being it happens with no warning and it could stop permanently. Fortunately you have the PM to take care of the heart stopping.

As for what triggers the afib and heart stoppage, that's mostly due to genetics. While some things could trigger the events the underlying cause is the genetic problem. We have members on the forum who have said their afib events were triggered by alcohol, chocolate, and other things. For some people that may be true however, my afib events are random and they don't know what triggers them.

I was with a cardiologist who's thinking was, "Same old disease, same old treatment." He insisted on Warfarin/Coumadin. After ending up in the hospital several times, I had to get a new cardiologist. My new cardiologist let me go to aspirin. After my heart stoppage they put me on Apixaban (Elequis). So while you can have your discussion with your cardiologist he may be reluctant to change. If so, you might ask for a second opinion.

It appears your PM has helped with the heart stoppage.
I hope things continue to go well for you.

Chances are ??

by IAN MC - 2015-04-04 11:04:48

As Theknotguy so clearly summarises in his post, a fib is certainly "tricky" and what makes it more tricky is the fact that it is not easy to get hold of accurate statistics.

I often think that hospitals should have a resident Consultant Statistician as well as all the cardiologists, E.Ps, surgeons etc. We , the patients should be able to visit a resident statistics expert who is part of the health team and be given the most up-to-date figures on the " What are the chances ? " questions :-

- what are the chances of getting another attack of a fib if we last had one 16 months ago

- are the chances of having a stroke increased if I had one attack of a fib 16 months ago and if so, by how much ?

- what are the chances of warfarin preventing a stroke or heart attack

- what are the chances of warfarin causing a haemorrhagic stroke or a significant bleeding episode ?

- do the risks of taking a blood-thinner outweigh the benefits for a patient who had one a fib attack 16 months ago

It is impossible for us to make a rational decision about how to manage OUR health unless all available data is at our disposal .Eventually all data will be collected and, at the touch of a computer button, some sort of rational statistical verdict will be available.

When I have asked cardiologists for statistics I seem to be given brief sound-bites which probably reflect their prejudices as much as anything else.

Ian




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So, my advice is to go about your daily routine and forget that you have a pacemaker implanted in your body.