What are the treatment options for atrial fibrillation? Part 2
Anticoagulation
Anticoagulation means that you take a drug to reduce the chance of forming a blood clot. Therefore, anticoagulation helps to prevent a stroke from occurring. Some people call anticoagulation 'thinning the blood' although the blood is not actually made any thinner. The most commonly used anticoagulant drug is called warfarin. Warfarin interferes with certain chemicals in the blood to prevent blood clots forming so easily.
As with all treatments, there is a small risk if you take warfarin. The main risk is that a bleeding problem may develop as the blood will not clot so well. Over a period of one year of treatment, about nine in a thousand people who take warfarin for AF are likely to have a serious bleeding problem. For example, some people develop a serious bleeding ulcer in the gut. If you have a serious bleed you are likely to need to be admitted to hospital, often needing a blood transfusion, and it can even result in death.
Most people with AF who have a high or medium risk of having a stroke are advised to take warfarin. However, some people with a moderate risk may be treated with aspirin rather than warfarin (see below), particularly if the risks of taking warfarin are higher than average. People with a low risk of having a stroke are not usually advised to take warfarin. This is because the benefit does not usually outweigh the risk of serious bleeding problems with taking warfarin. In short, the decision to take warfarin is a joint decision between you and your doctor. It involves weighing up the risk of having a stroke against the small risk of a complication from taking warfarin.
If you take warfarin you will need regular blood tests to check on how quickly your blood clots. Blood tests may be needed quite often at first, but should become less often quite quickly. The aim is to get the dose of warfarin just right so your blood does not clot as easily as normal, but not so much as to cause bleeding problems.
Aspirin is another drug that helps to prevent blood clots forming. It is not as effective as warfarin, but is less likely to cause problems. It is usually advised if you only have a low risk of stroke, or if you cannot take warfarin.
Other treatments
Other treatments may be advised, depending on the need to treat any underlying problems such as angina, heart valve problems, high blood pressure, overactive thyroid, etc.
Further help and information
British Heart Foundation
14 Fitzhardinge Street, London, W1H 6DH
Tel - Heart Information Line: 08450 70 80 70 (local call rate)
Web: www.bhf.org.uk.
© EMIS and PIP 2006 Updated: November 2006 PRODIGY Validated
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