Dear Dr. Roach: I’m a male, 71, with a bovine aortic valve that was installed 11 years ago.
I went into atrial fibrillation six years ago and had an electric shock to stop it.
That lasted a week, and was followed by an ablation, which kept me out of atrial fibrillation for five years.
I went into atrial fibrillation again last year, and the shock I got is still working.
I am now on Xarelto as before, but my cardiologist will not allow me to quit this time, even with electronic surveillance equipment. His only explanation is that the risk of stroke as a result of going back into unrecognized AFib is too great.
Is he just being old-fashioned?
I can buy the monitor app and still have money leftover compared with the monthly cost of Xarelto, not to mention the side effects and risks.
— B.K.
Answer: I think I agree with your old-fashioned cardiologist.
Since you have gone back into atrial fibrillation — a lack of rhythm of the heart that predisposes to clot formation — despite an ablation procedure, it is likely you will do so again.
People who go in and out of atrial fibrillation are at similar risk for stroke as those who are in atrial fibrillation all the time.
The risk for stroke is a few percent per year.
Strokes can be devastating: The expense of Xarelto, and its attendant (small) risks, are outweighed by the reduction in stroke risk.
