(BPT) – Being diagnosed with a chronic medical condition can be overwhelming. Patients and their doctors face a delicate balancing act to weigh the risks of a disease against the potential side effects and inconveniences of treatment. This is certainly true for patients with atrial fibrillation, better known as AFib, who have a significantly increased risk for stroke due to a blood clot.
Experts suggest and historic data confirms that without treatment, AFib patients are five times more likely to have a stroke than people without AFib. Commonly prescribed treatments such as oral anticoagulants or "blood thinners" have been shown to reduce the risk of an AFib-related stroke, but carry a risk of bleeding. Also some blood thinners may require lifestyle changes that could impact your daily routine. So what should patients know so that, in partnership with their doctors, they can make important AFib treatment decisions?
"There is a lot of information available online and in television advertisements, and trying to understand all of your options and their risks can be overwhelming," says Dr. Rajat Deo, MD, MTR, assistant professor of cardiovascular medicine at the University of Pennsylvania. "There are forms of treatment that may not be as good a fit for you. That's why it is important to work together with your doctor to understand your risks in the broader context of stroke prevention to determine what works best for you."
AFib is the most common type of arrhythmia, occurring when one or both of the upper chambers of the heart (the atria) don't beat the way they should. Approximately 2.7 million people in the United States have AFib not caused by a heart valve problem (also known as NVAF), and this number is expected to increase as our population ages. AFib-related strokes often cause long-term or permanent damage and some can be fatal. Stroke survivors may require help with daily tasks, such as eating and bathing, if they have lost the ability to move their arms or legs. Some stroke survivors also experience vision problems, memory loss or have difficulty speaking.
Physicians often prescribe oral anticoagulants to AFib patients to help interrupt the body's process involved in forming clots in the blood, consequently reducing their risk of having a stroke. However, sometimes there are circumstances that require the anticoagulant effect to be reversed. When choosing an appropriate anticoagulant, doctors assess several factors, including blood pressure, liver function and previous stroke and bleeding history to determine the recommended treatment approach. When patients are considering different options, knowledge of the efficacy, side effects, and whether or not a reversal agent is available for their treatment option in case of an accident or rare emergency may be an important factor in helping them feel comfortable in starting treatment.
"Everyone arrives at their treatment decision in a different way," Dr. Deo says. "It is important to be honest with your doctor when discussing lifestyle considerations and potential inconveniences to certain treatments. Balancing the risks and benefits is all about getting the facts. It is important to speak up, ask questions and feel comfortable talking to your doctor."
Your lifestyle and preferences are essential in choosing a treatment. Having open conversations with your doctors, so you can understand your condition and they can understand your lifestyle and priorities, can be empowering.
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