I was recently diagnosed with atrial fibrillation and was told preventing blood clots is a primary goal of my treatment. What steps should I take?
Answers from Martha Grogan, M.D.
Atrial fibrillation is a common heart rhythm disorder. Many people who have atrial fibrillation or are undergoing certain treatments for it are at high risk of blood clots. Blood clots can lead to stroke or can block blood flow to other organs (ischemia). To reduce this risk, your doctor may prescribe blood-thinning medications (anticoagulants), such as:
Warfarin may be prescribed to prevent blood clots. If you're prescribed warfarin, carefully follow your doctor's instructions. Warfarin is a powerful medication that may cause dangerous bleeding. You'll need to have regular blood tests to monitor warfarin's effects.
Several newer blood-thinning medications (anticoagulants) are available. These medications are shorter acting than warfarin and don't require monitoring. It's very important to take these medications exactly as prescribed. You shouldn't take the newer anticoagulants if you have a mechanical heart valve.
- Dabigatran (Pradaxa) is as effective as warfarin at preventing blood clots that can lead to strokes, and it doesn't require blood tests to make sure you're getting the proper dose.
- Rivaroxaban (Xarelto) also is as effective as warfarin at preventing strokes. Rivaroxaban is a once-daily medication.
- Apixaban (Eliquis) also is as effective as warfarin at preventing strokes.
Talk to your doctor about taking one of these newer anticoagulants as an alternative to warfarin if you're concerned about your risk of stroke. Follow your doctor's dosing instructions carefully and don't stop taking any of these medications without talking to your doctor first.
Jul. 18, 2014
- Atrial fibrillation (Afib). Heart Rhythm Society. http://www.hrsonline.org/Patient-Resources/Heart-Diseases-Disorders/Atrial-Fibrillation-AFib. Accessed Feb. 17, 2014.
- What is atrial fibrillation? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/af/. Accessed Feb. 17, 2014.
- Cheng A, et al. Overview of atrial fibrillation. http://www.uptodate.com/home. Accessed Feb. 17, 2014.
- Furie KL, et al. Oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation: A science advisory for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43:3442.
- Phang R, et al. Anticoagulation prior to and after restoration of sinus rhythm in atrial fibrillation. http://www.uptodate.com/home. Accessed Feb. 19, 2014.
- Manning WJ. Antithrombotic therapy to prevent embolization in atrial fibrillation. http://www.uptodate.com/home. Accessed Feb. 13, 2014.
- Xarelto (prescribing information). Titusville, N.J.: Janssen Pharmaceuticals; 2011. http://www.xareltorems.com/sites/default/files/pdf/xarelto_0.pdf#zoom=100. Accessed Feb. 20, 2014.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. April 7, 2014.