American Heart Association and American College of Cardiology said on Monday that anti-clotting drug warfarin, commonly called Coumadin, cannot be used anymore to treat all patients suffering from atrial fibrillation. The drug can now only be used on certain patients and other patients will have to be treated with NOACs, approved by US FDA in the past decade. Other treatment updates include weight reduction, lifestyle changes and starting anticoagulants when the disease is at its lower stages.
3 to 6 million Americans suffer from some kind of Afib. The CDC reports that 2% and 9% of people below and above 65-years-of-age experience symptoms of Afib, making it the most wide-spread form of heart arrhythmia. Dr. Craig, the lead guidelines writer for both 2014 and 2019, said that things get more difficult when individuals enter the ages between 70 and 80.Afib feels like a fluttering chest, as if one’s heart is not beating but quivering. It might even feel like the heart is doing an uncomfortable flip-flop or that it is skipping a beat and then racing for a very long time. These sensations occur due to upper heart chambers shuddering from receiving disordered electrical signals, leading to lower heart chambers beating rapidly and not syncing with rest of the heart as it is bombarded with impulses. While a normal heart beats for 60 to 100 times in one minute, a person having a heart attack will have a heart rate of 100 to 175 beats per minute. Also, due to the rapid beating, there is no proper contraction, leaving blood to pool in left atrial appendage.
The 2019 guidelines state that people with acute or moderate mitral stenosis and mechanical valves should continue to take warfarin. Others should use NOACs- edoxaban, apixaban, rivaroxaban and dabigatran—as side effects are fewer, management is easier and stroke prevention is better than warfarin, which was initially used as rat poison. Factors like one’s weight gain or loss, illnesses, infections and level of alcohol intake affect impact of warfarin, making NOACs a better choice for treatment of Afib.
Afib can be caused by obesity, diabetes, genetic defects, abnormal heart valves, malfunctioning pacemakers, high BP, viral infections, lung disease, over-active thyroid, certain medications, exposure to alcohol, tobacco and caffeine, sleep apnea, heart surgery or heart attacks.