Well how do you feel about having a stroke? You can calculate your own risk by clicking on this link:
I input two common risk factors, hypertension and diabetes. The calculator shows that if you had these two risk factors alone, you would have a 4% risk of stroke PER YEAR without Coumadin. That means if you started with one hundred 45 year olds with hypertension and diabetes, 40 of the 100 would have a stroke by the time they hit 55! Of the lucky 60 still walking around with all their faculties at age 55, by the time they hit 65; another 24 of the 60 would suffer a stroke. That leaves just 36 fully intact 65 year olds who by the time they hit 75, another 14 of the 36 would have stroked. In summary, of the original one hundred 45 year olds, 78 of 100 would suffer a stroke by the time they hit 75! Of course these scary numbers are all predicated on the condition that your doctor didn’t put you on Coumadin. Coumadin does reduce your risk of a stroke significantly so you should follow your doctor’s recommendations in case he orders it for you. But is Coumadin risk free?
What is Coumadin?
Wikipedia states that Coumadin was initially introduced in 1948 as a pesticide against rats and mice and is still used for this purpose. Properly titrated with usually monthly blood tests, it can be a very effective and safe anticoagulant used commonly for atrial fibrillation and after mechanical heart valve replacement.
Unfortunately, as used in pesticides, when taken in excess Coumadin can be deadly. You can literally bleed to death if you take too much.
What is your risk of a major bleeding episode from Coumadin?
You can calculate your own bleeding risk by clicking on this link:
For this analysis, I input the three most common risk factors I thought most people would have, hypertension, taking an aspirin a day, and drinking alcohol. I myself was shocked to find out that the risk of suffering a major bleed with just these 3 very common risk factors was 5.8% PER YEAR. Again starting with a population of 100 people placed on Coumadin, with simply the risk factors of high blood pressure, taking an aspirin a day and liking to drink a glass or two of wine at night, almost 60 of these 100 people would suffer a major life threatening bleed in the next 10 years!
Due to the relatively low efficacy and side effects of anti-arrhythmic drugs, most patients with atrial fibrillation are relegated to a lifelong regimen of rate control and anticoagulation. That usually means being placed on lifelong beta blockers (to slow your heart rate) and lifelong Coumadin (or newer drugs like Xarelto (www.xarelto.com), Pradaxa (www.pradaxa.com), or Eliquis (www.eliquis.com). As we have seen, since the risk of stroke (with hypertension and diabetes) without anticoagulation over 30 years can be as high as 78%, you should be on an anticoagulant if your doctor orders it for you. Unfortunately like most things in life, the risk of this lifelong treatment approach is not zero and the chances of you suffering a major life threatening bleed over the next 10 years (with hypertension, aspirin, and alcohol) can be as high as 58%.
Is there a solution? We believe the solution dwells in a robust hybrid treatment approach, combining the best efforts of minimally invasive cardiac surgery and cardiology, both working together for you. In this article which you can download here, 36 patients with long standing persistent (n = 28) or persistent (n = 8) atrial fibrillation underwent minimally invasive cardiac ablation followed by, in 30 days, “touch up ablation”. At 30 months, 91.6% of the patients were in normal sinus rhythm, 77.7% were off antiarrhythmic drugs and 88.8% were completely free of Coumadin! This is the exciting protocol we modeled our own Robotic Hybrid Cardiac Ablation and Left Atrial Appendage Ligation program after.
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