What is it about ?
The atrial fibrillation (AF) is a heart rhythm disorder, causing the rhythm to be irregular and usually faster than normal. This is the most common heart defect after palpitations. The electrical signals that cause the heart to pump are disrupted and occur without coordination. Because of this, blood can remain in the atria, forming clots which are carried with the bloodstream in the body and block a blood vessel elsewhere (pulmonary embolism, TVP, etc.). If this clot rises in the brain, then we are talking about a stroke.
To prevent these complications, anticoagulant drugs are given in some cases. Blood clots occur just as often in people with or without a heart rhythm disorder.
What is its frequency?
AF is the most common heart rhythm disorder in humans. Up to 1 in 5 strokes are linked to AF. Without anticoagulant therapy, a person with AF has about a 5% risk of developing a complication from a blood clot each year.
How to recognize it?
Most often, the patient with AF experiences palpitations, increased heart rate while resting, or has fainting (syncope). In this case, it is always an irregular heartbeat. In some cases, nothing is felt, and the diagnosis is made quite by chance during auscultation of the heart.
How is the diagnosis made?
The doctor can detect an irregular rhythm by auscultating the heart or taking your pulse. A heart rhythm test or an electrocardiogram (ECG) will confirm the diagnosis. Sometimes the heart rate is recorded for 24 hours using a portable heart rate monitor (Holter monitoring) in order to be able to make the diagnosis.
What can you do ?
Treatment with anticoagulants requires discipline. Take your medication rigorously every day. This is a fundamental condition for the success of the treatment. Limit alcohol consumption. It is very important not to smoke or to quit smoking. Get enough exercise, but within limits. If you are prescribed a new medicine, each time explain to the doctor that you are taking blood thinners. This can be important because some medicines (such as anti-inflammatory drugs) influence the effect of blood thinners. The same goes for herbal products like herbal remedies, vitamins, etc. If you take it, always discuss it with the doctor.
Note that the bleeding will last longer if you take blood thinners. Take this into account in the event of an injury or fall, and ensure that the wound is sufficiently compressed. Contact the doctor in case of persistent or chronic bleeding. If you have to have an operation or procedure, it is sometimes necessary to stop the anticoagulant medicines and replace them with other treatment. Stopping and resuming treatment with anticoagulants is always done in consultation with the attending physician.
What can your doctor do?
In deciding to initiate anticoagulants, the doctor will always weigh the risk of blood clots (and stroke) against that of bleeding. There are also tables that will facilitate this decision making. The determining factors in this case are ao age, history of stroke, diabetes, high blood pressure or other heart problems as well as any known bleeding problems.
When deciding to start anticoagulant therapy, the doctor will check a number of parameters: blood pressure and kidney and liver function on the basis of a blood test. This assessment gives him a general idea of your state of health.
With certain anticoagulants (coumarin derivatives), a routine blood test is essential. Initially, these checks are frequent. After a good adjustment of the treatment, the controls are generally done once a month.
There are new drugs (direct anticoagulants) equivalent to coumarin derivatives that do not require monthly monitoring. These drugs are used more and more, but are not suitable for everyone (for example, with artificial valves or poor kidney function). The doctor will decide which medicine is best for you, taking into account its risks and benefits.
There is a third category of anticoagulants: antiplatelet drugs, better known as aspirin. These agents are not as strong as other anticoagulants and are generally not indicated for AF, except in exceptional circumstances.
In the event of an acute episode of AF, the doctor will sometimes initiate anticoagulant therapy and at the same time restore the heart rate to normal (cardioversion). He will check if this applies to you.
Want to know more?
www.mongeneraliste.be/maladies/fibrillation-auriculaire-quand-le-coeur-s-emballe
www.mongeneraliste.be/maladies/arythmie-quand-le-coeur-a-des-rates
www.mongeneraliste.be/veiller-a-sa-sante/soins-et-medicaments/traitement-anticoagulant-rigueur-et-pr …
Sources