Ken: Great to hear from you. I apologize for being so slow to respond. For those who don't know, Ken is a world known exercise physiologist who ran the US Olympic sports science laboratory at Lake Placid for years. He made major contributions in many areas and especially in lung function in athletes and indoor air pollution.
The rule about the new anticoagulants and valves is: Be careful and discuss with your doctor. In general, if you do not need warfarin (coumadin) for your heart valve replacement and you develop afib, you can use a novel agent. But if you need coumadin for your valve, you should not switch to a novel agent. Also, if you have mitral stenosis, without valve replacement, and get afib, you should use warfarin. But PLEASE discuss this with someone who knows your personal story better.
Bob: Thank you. The reference that Bob refers us to is worth the read. It discusses a computer simulated approach to the risk of treating afib discovered by patient self-monitoring. it concludes as Bob notes below that there is very little benefit in treating these patients regardless of their risk score. As you can see from my post, I take the other side. I fear strokes far more than I fear bleeding.
Dr. Coyle - That is a great question and I should have been clearer. Whenever someone has aifb they have afib. Even paroxysmal afib can cause an embolus possibly because folks don't even know how often they are in it. So, yes. I do consider anticoagulation in all afibbers even when it is paroxysmal. I may not do it, depending on the patient and other factors, but I always think about it. I fear strokes. Paul
Good morning, I would like to ask if you also consider anticoagulation in patients with paroxysmal atrial fibrillation and CHA²DS²VAS²c de 1. Thank you for the perfect review
Question concerning the newer anticoagulants: how does this apply to those with a prosthetic valve?
Ken: Great to hear from you. I apologize for being so slow to respond. For those who don't know, Ken is a world known exercise physiologist who ran the US Olympic sports science laboratory at Lake Placid for years. He made major contributions in many areas and especially in lung function in athletes and indoor air pollution.
The rule about the new anticoagulants and valves is: Be careful and discuss with your doctor. In general, if you do not need warfarin (coumadin) for your heart valve replacement and you develop afib, you can use a novel agent. But if you need coumadin for your valve, you should not switch to a novel agent. Also, if you have mitral stenosis, without valve replacement, and get afib, you should use warfarin. But PLEASE discuss this with someone who knows your personal story better.
Treat AFib diagnosed by smart watch? by F Perry Wilson of Yale
https://www.medscape.com/viewarticle/treat-afib-diagnosed-smartwatch-2025a1000avp?ecd=WNL_trdalrt_pos1_250506_etid7407755&uac=216046BG&impID=7407755
Bob: Thank you. The reference that Bob refers us to is worth the read. It discusses a computer simulated approach to the risk of treating afib discovered by patient self-monitoring. it concludes as Bob notes below that there is very little benefit in treating these patients regardless of their risk score. As you can see from my post, I take the other side. I fear strokes far more than I fear bleeding.
Very well done. Device detected AFib gains very little wi anticoagulation (9-11 days).
Dr. Coyle - That is a great question and I should have been clearer. Whenever someone has aifb they have afib. Even paroxysmal afib can cause an embolus possibly because folks don't even know how often they are in it. So, yes. I do consider anticoagulation in all afibbers even when it is paroxysmal. I may not do it, depending on the patient and other factors, but I always think about it. I fear strokes. Paul
Good morning, I would like to ask if you also consider anticoagulation in patients with paroxysmal atrial fibrillation and CHA²DS²VAS²c de 1. Thank you for the perfect review