AFIB

[imoldernu]

Without going in to detail here, it might be well to understand atrial fibrillation as a potential health concern... not just on the basis of of what we know today, but on the projections for a potential doubling of the number of persons affected... in just the coming 12 years.

Atrial fibrillation is the most common sustained cardiac tachyarrhythmia encountered by clinicians worldwide. An estimated 2.7 to 6.1 million people in the United States have Atrial fibrillation with projections to reach nearly 12.1 million in 2030.

Atrial Fibrillation

Whether the warning is valid or not, the article is quite complete, as to the what's , where's and why's.

In my own case, it was first diagnosed in my late 70's, with no warning before, and more importantly, with no discernible symptoms at the time, and still, except for being able to hear the abnormal heartbeats with a stethoscope, otherwise, totally asymptomatic.

Attention to this health risk, has only grown slowly over the past years, but based on the projections, it might be well to understand, and be aware.

 

[marko]

+1
I've often mentioned on this forum about my elite level athlete brother.
He had been diagnosed with mild/intermittent AFIB in August of '16. His doctor suggested 'keeping an eye on it' for a few months.

Four weeks later he had a massive stroke which has left him fully disabled and unable to speak. It not only has changed his life but the entire family's as well.

 

[Dawg52]

+1
I've often mentioned on this forum about my elite level athlete brother.
He had been diagnosed with mild/intermittent AFIB in August of '16. His doctor suggested 'keeping an eye on it' for a few months.

Four weeks later he had a massive stroke which has left him fully disabled and unable to speak. It not only has changed his life but the entire family's as well.

That is sad. It can be tough to even get diagnosed when its intermittent. Alan said it took 2 years to finally have his captured on an EKG and doctors won't do much until they do. My GP Dr said the same. You would have thought they would have started some meds for your brother even if was considered mild.

 

[marko]

That is sad. It can be tough to even get diagnosed when its intermittent. Alan said it took 2 years to finally have his captured on an EKG and doctors won't do much until they do. My GP Dr said the same. You would have thought they would have started some meds for your brother even if was considered mild.

Yeah. I don't know the details of what decisions were being made at that time; he was doing his own thing back then.

But thanks to his athleticism and athlete's mentality he's been able to recover considerably more than what they originally thought he would.

His journey has been quite amazing and inspiring.

 

[Dtail]

Yeah. I don't know the details of what decisions were being made at that time; he was doing his own thing back then.

But thanks to his athleticism and athlete's mentality he's been able to recover considerably more than what they originally thought he would.

His journey has been quite amazing and inspiring.

From your other posts, it sounds like you are providing support on some level. We wish the best for your brother.

 

[marko]

From your other posts, it sounds like you are providing support on some level. We wish the best for your brother.

Thanks for the kind words. He's doing well and sloooowly improving.

He just instantly went from 63 years old to being a semi independent 84 year old (who can only communicate with gestures). He doesn't need a lot of help but needs a driver and someone to speak for him at doctors etc. (that's my job). I'm also now his guardian and manage his finances. Fortunately he lives just a block away.

He gets out every day for breakfast, lunch or dinner; he even hits golf balls 80 yards one handed. He walks with a cane and his biggest disability now is his inability to speak even though he's 99% cognizant (similar to an 84 year old)

 

[Souschef]

i am really sorry to hear about your brother. DW was diagnosed the AFIB, underwent cardio-version, which (thank the Lord) was successful.
She is on Xarelto to minimize the possibility of stroke.

 

[Bamaman]

Our daughter had rheumatic fever as a child. As an adult, she didn't take care of herself and had an AFiB problem. After one fatal arrhythmia and no oxygen for 9 minutes, she had open heart surgery. She later didn't take her medicine as directed, she died of AFIB at age 50.

 

[Teacher Terry]

Marko, when a friend of mine couldn’t talk due to cancer surgery he carried around a tablet that he would type into and it talked for him. That would work if your brother can physically type. B, that’s sad about your daughter.

 

[aaronc879]

There is a wide range or severity with Afib. My Aunt has a minor case and rarely has it impact her life in any noticeable way. She takes one script and has never needed a procedure. My Dad on the other hand had a severe case. He would have his heart race near or even over 200 bpm without even doing any physcial activity. He tried meds which didn't do much. He tried cardioversion where they stop your heart and 'reset' it. The first two times they did it it only worked for a few weeks then a few months. The third time they had a hard time getting his heart restarted so they decided that would be the last time they tried that procedure. Next they did cardio ablation where they burn parts of your heart hoping it will correct the rythme. That didn't work either. The next option was a pacemaker and that has finally helped a lot. He was 65 when it started and 68 when he had the pacemaker procedure.

 

[imoldernu]

Xarelto ... a good reason to hate the pharmaceutical industry.

That and Eliquis are the two drugs that are recommended for AFIB. Not to fix or cure, or even improve the problem... simply to avoid blood clots.

FYI... the average price is $525.00 for 30 tablets. That's about $6,300.00. per year. If you thought your plan D would reduce the price, better check it. The lowest price for most plans is about $5,000. Both drugs are about the same price.

When you start doing the numbers... 6,000,000 persons with AFIB... you can do the math. The patent for Xarelto doesn't expire until 2021, so no help for a while.

A side note for anyone who is facing these prices. The warnings about clots that could form without the preferred drugs are real, but diving into the medical risk for death from afib, tells a story that you won't hear from the industry. It come in the "risk percentage" part. I won't pretend to give medical advice, but you or a loved one is at risk, and the price would cause hardship, you might want to spend an hour or so becoming familiar with the subject.

 

[Souschef]

Xarelto ... a good reason to hate the pharmaceutical industry.

That and Eliquis are the two drugs that are recommended for AFIB. Not to fix or cure, or even improve the problem... simply to avoid blood clots.

FYI... the average price is $525.00 for 30 tablets. That's about $6,300.00. per year. If you thought your plan D would reduce the price, better check it. The lowest price for most plans is about $5,000. Both drugs are about the same price.

We have plan D, and it costs about $ 45 for a 30 day supply. After falling into the doughnut hole, it went up to $150

 

[imoldernu]

We have plan D, and it costs about $ 45 for a 30 day supply. After falling into the doughnut hole, it went up to $150

I'll go back and check. I stopped taking it because of the high price...
Thanks for the fact check...

 

[imoldernu]

Okay... here's where i got the info...

https://www.goodrx.com/xarelto/medicare-coverage

Xarelto
Rivaroxaban

Rivaroxaban (Xarelto) is an expensive drug used to treat blood clots in the lungs or in the veins. It is also used after knee or hip surgeries to prevent blood clots. It is also used to lower the chance of stroke in people with a medical condition called atrial fibrillation. There are currently no generic alternatives for Xarelto. It is covered by most Medicare and insurance plans, but some pharmacy coupons or cash prices may be lower. The lowest GoodRx price for the most common version of Xarelto is around $422.78, 18% off the average retail price of $521.76. Compare anticoagulants.

But then this.??

Average Co-Pay for 30 tablets of Xarelto 20mg
Medicare Plan Name Average Co-Pay
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) $95
MedicareBlue Rx Standard (PDP) $72
SilverScript Plus (PDP) $36
Symphonix Value Rx (PDP) $31

Hmmm..I have United Healthcare... gotta go back... I stopped taking the Xarelto about 2 years ago, and went to baby aspirin, because of the high price.

so far, so good. AFIB has never bothered me at all. Just a scare from the doctor.

 

[Murf2]

The maker of Xarelto, Jansen,I believe has a program for us poor folk who can’t afford it. You can also use warfarin. It is cheap but more work to use.
Anyway,I wouldn’t recommend taking the blood clot threat lightly. There are affordable options.
I have had around 6 or 8 cardio versions & 2 ablations so far. Rhythm drugs & Xarleto currently. It is a pain in the butt. This could always be worse.

Merry Christmas
Murf

 

[Murf2]

I use the coupon until I’ve met my deductible then it’s around $30 a month on my ACA policy. A person needs to explore all available options.

 

[aja8888]

I am in the process of dealing with SVT (which includes Afib as a subset). I have an ablation scheduled for 12/21. No meds for me as a choice as I am not a fan of them.

 

[imoldernu]

The maker of Xarelto, Jansen,I believe has a program for us poor folk who can’t afford it. You can also use warfarin. It is cheap but more work to use.
Anyway,I wouldn’t recommend taking the blood clot threat lightly. There are affordable options.
I have had around 6 or 8 cardio versions & 2 ablations so far. Rhythm drugs & Xarleto currently. It is a pain in the butt. This could always be worse.

Merry Christmas
Murf

Thanks... I'm going to back off what I was trying to say. Thing is, that the studies (and there are many in progress) offer different results, based of the patient's history. It takes some digging in to the medical acronyms to see how the these different kinds of AFIB determine the risk factors. Most of the studies involve 2 to 5 thousand patients, and the end results of some of the studies are vastly different.

In short, a medical study in progress. The ones that I was referring to were many, many pages long and involved much reference to the patient's history as opposed to those that were geared to the outcomes.

Sometimes, we're better off, not knowing.

The doctor (small letter) has left the building.

 

[Murf2]

Thanks... I'm going to back off what I was trying to say. Thing is, that the studies (and there are many in progress) offer different results, based of the patient's history. It takes some digging in to the medical acronyms to see how the these different kinds of AFIB determine the risk factors. Most of the studies involve 2 to 5 thousand patients, and the end results of some of the studies are vastly different.



In short, a medical study in progress. The ones that I was referring to were many, many pages long and involved much reference to the patient's history as opposed to those that were geared to the outcomes.



Sometimes, we're better off, not knowing.



The doctor (small letter) has left the building.

I hope you don’t think I’m disagreeing with you. I am not. It’s just that a clot kicked loose by AFIB is very dangerous as you know.
Merry Christmas
Murf

 

[Scusan]

Hi- My first post. I know I need to fill out a profile/intro and will do so soon.

IMO, if you have A Fib, it's better to know about it and manage/treat it than not (and just hope it doesn't lead to a stroke). One of the issues here is that A Fib may be intermittent. Also, how does one know that little flutter feeling was A Fib? Do you make a Dr appointment, show up and say "two weeks ago, I felt something funny in my chest"? The doc needs to actually observe it to diagnose.

My Mom (88) has A Fib. She's had a (successful, so far) cardioversion. Using this little gizmo (and an Ipad or smart phone), she can take her own EKG at home. She does so every morning before and after coffee as well as times she doesn't feel right. It's unfortunate she wasn't doing this over the past couple years-- she had a stroke last year and they can be caused by A Fib.

The software/app seems to give you 3 possible outcomes after the 30 second reading.
1. Possible A Fib-
2. Unclassified
3. Normal

I have zero personal interest in this company and I believe there are now other outfits making similar contraptions. I'll try to post a link, if not you can google "KARDIA".

https://www.alivecor.com/

You can get them through Amazon for around 100 bucks. Also, you don't have to buy the monitoring service. You will need a smartphone, ipad or something to receive the signal from the device. My Dad emails each EKG to their inbox after it's taken with a descriptive comment in the title. (ex...Morning Before Coffee Unclassified). If you keep the labeling consistent you can then search for a specific reading later.

I realize that a first post that mentions a product could raise some eyebrows. Here are a few articles I found on another website that's run by a cardiologist (of course everyone is a 6 ft 4, 190 lb cardiologist on the internet or something like that!!)

https://theskepticalcardiologist.co...fibrillation-potential-for-stroke-prevention/

https://theskepticalcardiologist.co...ng-atrial-fibrillation-at-home-and-in-office/

I hope that is of some assistance and look forward to participating more on this board in the future.

 

[Alan]

Marko,

Sorry to hear of your brother’s story. With intermittent AFib and being very fit at age 63 I expect he was not put on blood thinners because his Chads 2 score will have been 0.

https://emedicine.medscape.com/article/2172597-overview

Both my cardiologist in the USA and the one in the UK also declined to put me on blood thinners under similar circumstances because the initial going onto blood thinners increases the risk of a stroke so it is a difficult call to make.

I was put on blood thinners 4 weeks before I had Ablation surgery and will be on them for another month or 2 until I’m hopefully given the all clear next month.

 

[imoldernu]

Alan... keep us up to date..
Marko... We recently 6 months ago, had a younger (60 yr. old) in the Bounceback facility in our CCRC. He had been felled by a stroke, and was working to recover... mobility, as well as speech. In a way, a long haul, but just recently moved into assisted living, and is expected to fully recover within just the next few months. Physical as well as speech therapy.
I always wondered about this kind of recovery, and was so pleased to see the progress. Hopefully back to his family.

.....................................................................
Side note... Alan mentioned the CHADS2 score. there are many websites that show the chart, which starts the 'Risk Score" @ 1.... Being in my 80's That's an opening risk factor that I can't change. My score is now 1. ...as I have none of the other factors in the scoring table.

So... I mentioned in a previous post that understanding the level of risk, means getting into the weeds to understand just what "Risk" means. Most sites don' t discuss risk level in any detail. Here's one that does, and what made me take the chance of going off the more expensive or time consuming drugs.

When you get down to the end, my score of 1 places my risk of having a heart attack @ 2.4 percent more than if I didn't have AFIB.

Not to say that this doesn't matter, but checking on other risk factors at my age, it's at the lower end of concern. More likely are my increasing memory/dementia problems.

Here are the top causes of death for adults over the age of 65 starting with the number one cause:
Heart disease.
Cancer. ...
Chronic Obstructive Pulmonary Disease (COPD) ...
Cerebrovascular Disease (Stroke) ...
Alzheimers. ...
Diabetes. ...
Pneumonia and Influenza. ...
Accidents.

 

[calmloki]

Progress progress in the medical world - MIL lived with Afib and coumadin for 24 years. I have Vfib and had a pacing unit installed, then was diagnosed with Afib and have had several cardioversions and an ablation to try and get my heart to keep proper time. Also eat my daily rat poison and a drug meant to act as a governor. Now I read of a new procedure designed to reduce stroke risk by sealing off a "closet" in an upper chamber of the heart that tends to have blood pool and clot. This for those who can't tolerate Coumadin.
https://www.desertsun.com/story/spo...tives-blood-thinners-two-fixes-afib/37583587/

 

[braumeister]

I'll try to post a link, if not you can google "KARDIA".

https://www.alivecor.com/

You can get them through Amazon for around 100 bucks. Also, you don't have to buy the monitoring service. You will need a smartphone, ipad or something to receive the signal from the device.

Welcome to the forum, ramjet.

Yes, the Kardia gadget is amazing. My doctor thinks it's the greatest thing since sliced bread, and has quite a few patients who use it.

You can also, AFAIK, just use their monitoring service on a one time basis whenever you want, instead of a subscription. The first analysis was free when I bought one.

 

[34rlsa]

Anyone using the new Apple Watch 4 to track AFIB episodes?

https://support.apple.com/en-us/HT208955