Choosing the right blood thinner for patients with AFib

Individuals with atrial fibrillation, a type of arrhythmia that occurs in the top chambers of the heart, have a higher risk of stroke than the average population. While AFib on its own is not generally life threatening and can be treated through medication or ablation, most AFib patients will be prescribed a blood thinner to reduce the risk of stroke. There are several options for blood thinners that an Oklahoma Heart Hospital physician may prescribe, depending on the patient’s unique medical history and lifestyle factors.

The most common blood thinner prescribed for AFib patients is warfarin, also known by the brand name Coumadin. Warfarin has been on the market for years, so its effectiveness is well documented, and it’s a relatively affordable treatment option. However, it does require regular blood work to monitor the therapeutic level of the drug in each patient’s bloodstream. For most patients, they will have blood drawn once a week for the first month on the medication, and then less regularly over time. There are also food interactions that patients must be aware of, such as keeping a consistent intake of green leafy vegetables or other foods high in vitamin K, which can lower warfarin levels in the blood. Warfarin also takes time to build up and dissipate in the blood, meaning that a patient may need to stop taking the medication farther in advance of a medical procedure.

Some of the newer drugs for reducing stroke risk in AFib patients are Eliquis, Xarelto, Savaysa, and Pradaxa. These medications start working and stop working faster when compared to warfarin, meaning that a patient’s stroke risk is reduced quickly and that less time is needed off the drug before or after a surgical procedure. As newer medications on the market, these options may be more expensive for some patients, but they do offer an alternative for patients for whom warfarin is not a good fit.

It's important to note that these medications do not treat atrial fibrillation, but rather help reduce the risk of stroke associated with AFib. Once you begin taking a blood thinner, you should continue taking it daily unless otherwise directed by a doctor. Patients who will undergo certain medical or surgical procedures may need to stop taking their blood thinner before the procedure, but the number of days in advance will vary depending on the procedure and the doctor.

Your Oklahoma Heart Hospital physician can discuss these medications options with you and ensure that your prescribed medication is the best option for your specific needs. When discussing medications with your doctor, be sure to bring a list of all other medications you are taking, including any vitamins or over-the-counter supplements.