New to AFIB

Had my pacemaker implanted in 2014 with no problems to date.  Within the past year during interrogation, they have noted a concerning amount of AFIB lasting very short periods.  My last interrogation they found over 1300 incidents of AFIB.  Approx.800 or so were again for very short periods of time,  another 200 were lasting up to 10 minutes, and the one which concerned them the most was one lasting 45 minutes.  Since I'm not up to all the terminology used the best I can descibe is my upper chamber was almost 400 while my lower ran over 120.  They did note that the lower switch was not turned on, and they plan on doing that in a few weeks.  The main reason I'm asking is they want to put me on both beta blockers and blood thinners.  Being 76 next month and not taking any meds whatsoever, receiving this info has me concerned.  Has anyone info on the effects of taking one over the other....or both...I would appreciate your feedback.  Thanks all.!!


5 Comments

AFIB and your pacemaker.

by Jediscuba - 2023-12-21 19:46:36

I'm curious, why in heck wold they wait a few weeks to turn on the Ventricle sensor if they recognize a problem and their medical expertise tells them that it needs to be done?

I don't have AFIB, to the best of my knowledge. I do have a right bundle branch block which causes the lower chamber, as you call it, to suddenly just stop.  On December 11th of 2023 I got my Medtronics Micra AV2. This is implanted in the heart. This unit has very few restrictions as to life style. I scuba dive, race sports cars, do welding and more. This is a leadless pacemaker that only activates if the atrium ( upper ) area pumps and is not followed by the Ventricle.

 

As for blood thiners, my own personal life style says NO. The possibility of bleeding out is just too great and as far as I know, at this time there is NO REVERSAL. Vitamin K will not stop the bleed. Ask your doctor if 325mg coated aspirin might be enough of a tinning agent for you. This is what my doctor and I agreed to, though he was very reluctant. I even presented him with documentation for my decision and he just up up his hand and said, I don't have time to read journal reports. This is the same doctor who didn't want to fit me with a halter loop monitor a year ago.

 

I wish we could find doctors who are not just practicing and KNOW what they are doing.

AFIB

by wescoot2 - 2023-12-21 21:13:22

Thanks for the input about the Asprin I'll ask about that when I see them in a few weeks to have my Ventricle sensor  turned on.  The reason it takes a while is because at this point in my life I'm dealing with the VA.

My current battery looks like it will need attention in approx. 22 months and at that point, it will be interesting to see what Pacemaker they will approve for me.

Atrial Fibrillation (AF)

by Gemita - 2023-12-22 01:48:17

Westcoot, I am sorry to hear about your many episodes of Atrial Fibrillation (AF).  I was officially diagnosed with AF in 2016.  At that time I was told the two most important treatments would be a rate control medication (like a beta blocker) to control a high heart rate if present, and if we have risk factors for an AF stroke, anticoagulation.  With both these meds on board, if they are "both" required and providing our AF can be controlled and we are not symptomatic, doctors are usually not too concerned. 

Unfortunately AF is a very common arrhythmia as we age.  (I am 75 now).  The lower switch they were probably talking about is something called Mode Switch.  This switches to a non tracking atrial pacing mode until the arrhythmia is over.  As you can imagine, it would be dangerous if high atrial rates of 400 bpm which you mentioned, were tracked and transmitted to your ventricles pushing them so fast, so Mode Switch would protect you from this and help you to feel less symptomatic during an AF episode.

I have had up to several thousand Mode Switches for AF annually in the past, but I am glad to say with a beta blocker, my episodes are better controlled now.  I am also taking Edoxaban, an anticoagulant, but at a lower dose for body weight (under 60 kgs) and so is my husband and we have had absolutely no problems at all.  Aspirin (an antiplatelet med) is not as effective for AF Stroke protection as is a direct oral anticoagulant like Apixaban, Rivaroxaban, Edoxaban and others. Aspirin is no longer recommended for stroke prevention in people with AF, and should not be prescribed unless there is another indication for its use.

I can understand your concern about taking an anticoagulant for the first time, especially as you appear to take no medication at the moment.  I felt just the same.  I have to say though that the prospect of having a stroke was an even greater fear with uncontrolled AF.

So if both meds are required, both meds should be taken to keep you safe, but do spend time with your medical team to find the best medication for you.  With AF, it can be trial and error with our meds until we find something that suits. 

Good luck Westcoot and have confidence.  Fortunately most good doctors do know what they are doing and want the best for their patients.

The link below will help you to assess your stroke risk.  It should be copied and pasted into your general browser to open if you wish to read further:-

https://en.wikipedia.org/wiki/CHA2DS2%E2%80%93VASc_score

blood thinners and beta blockers

by Julros - 2023-12-22 01:52:26

I take both of these pills. I've already had 1 stroke that left me with partial vision loss, and I don't care to have another. I take Eliquis and have had no problems, other than taking a little long to stop bleeding, and having a bigger bruise after a bump. I ride a bike, and have had a tumble or two, and I don't get on the roof anymore. I take 2 beta blockers, metoprolol and sotalol, to prevent atrial fib/flutter and nonsustained ventricular tachycardia. I've not had any problems with them either. 

I believe Elquis has been shown to decrease the incidence of stroke and is safer than coumadin in regards to serious bleeding. I don't think aspirin has been shown to be effective for stroke prevention in atrial fibrillation, but that is a good discussion to have with your doc. 

RISK IN ATRIAL FIBRILLATION

by Selwyn - 2023-12-23 14:19:05

I have had atrial flutter and fibrillation for years. There is a real risk of stroke associated with embolus from the stasis induced by the arrhythmia.

Risk can be calculated.

https://www.mdcalc.com/calc/801/cha2ds2-vasc-score-atrial-fibrillation-stroke-risk

https://clincalc.com/cardiology/anticoagulation/hasbled.aspx

The choice for atrial fibrillation treatment is between rate or rhythm management.  See https://www.ccjm.org/content/89/10/567

It is not individual experience you require, rather medical science and choice. I have had numerous meds, cardioversions, and ablations. I still get a little atrial fibrillation. Atrial fibrillation is  both dangerous ( Who wants to be paralysed with a stroke ?) and exercise limiting.  I continue to take anticoagulation. I think I prefer to be treated for a bleed rather than a hemiplegia.

 

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