Eliquis: Transforming Lives with Atrial Fibrillation Treatment

Mahshid Moghei, PhD Medically reviewed by Mahshid M. on | Written by Philip Lindeman MD-PhD

Man with severe chest pain due to heart failure

Author’s note: This is a personal story in the sense that someone close to me (let us call him ‘Dan’) had atrial fibrillation. To honor his memory and protect my family’s privacy, I have altered details sufficiently to mask his identity. One detail remains, which is quite true: Eliquis (apixaban) extended his life and improved its quality so that he could enjoy watching his grandchildren grow up.

Dan had atrial fibrillation (AF) for as long as I could remember. Although I was a physician, I kept family and profession strictly separated. Dan never asked me for medical advice, and I never gave it. I watched Dan’s AF journey from afar. I was impressed with how medications significantly improved his quality of life. Here is Dan’s story.

Dan’s life with AF

AF is a common heart rhythm disorder characterized by irregular and often rapid heartbeats caused by chaotic electrical signals in the atria and the heart's upper chambers. This disruption in the heart's normal rhythm can lead to poor blood flow, increasing the risk of stroke, heart failure, and other heart-related complications. Symptoms of AF can include palpitations, fatigue, shortness of breath, and dizziness, though some individuals may be asymptomatic.

Dan began feeling palpitations when he was 35 years old. He was an attorney and attributed his symptoms to stress and too much caffeine. He called his doctor when he began to feel shortness of breath associated with the palpitations. His past medical history was unremarkable. Dan drank socially and smoked cigarettes in his 20s.

Dan’s doctor ordered an electrocardiogram, which revealed irregular R-R intervals and the absence of distinct P waves, confirming the presence of AF. An echocardiogram assessed the heart's structure and function, showing no significant structural abnormalities but confirming the irregular atrial contractions. Blood tests were carried out to rule out potential secondary causes such as hyperthyroidism and electrolyte imbalances; all results were within normal ranges. He also wore a Holter monitor to record his heart rhythm over 24 hours, capturing episodes of irregular heartbeats consistent with AF. These diagnostic findings collectively confirmed the diagnosis of AF.

Dan is treated for his AF

Dan's treatment for AF involved a comprehensive approach to manage his symptoms and reduce the risk of complications. Initially, he was prescribed rate control medications, including beta-blockers, to slow his heart rate and alleviate palpitations. Antiarrhythmic drugs were introduced for rhythm control to help maintain a regular heart rhythm. Given the increased risk of stroke associated with AF, Dan was also prescribed Eliquis, an anticoagulant, to prevent blood clots from forming. Periodically, when medications alone were insufficient, Dan underwent electrical cardioversion procedures to restore normal sinus rhythm. Throughout his treatment, Dan's response to the drugs and procedures was closely monitored, with adjustments made as necessary to optimize his heart function and minimize side effects.

Cardioversion for AF

Cardioversion is a procedure to restore a normal heart rhythm in patients with AF and other conditions. In Dan's case, the indication for cardioversion was the persistence of symptomatic AF despite optimal medication management. The procedure involves delivering a controlled electric shock to the heart through electrodes placed on the chest to reset the heart's electrical system and revert it to a normal rhythm. Dan underwent a total of three cardioversion attempts. The first attempt restored normal sinus rhythm successfully, but the AF recurred after a few months. Subsequent cardioversion attempts also resulted in temporary success, with normal rhythm maintained for progressively more extended periods. The cardioversion procedures temporarily restored normal heart rhythm, relieved symptoms, and improved Dan's quality of life. However, ongoing management was necessary to address recurrent episodes of AF.

Dan's response to treatment for AF was generally positive over time. Initially, the combination of medications and cardioversion procedures effectively restored and maintained normal sinus rhythm, significantly reducing his symptoms and improving his overall quality of life. However, Dan experienced intermittent recurrences.

Things to know about Eliquis

When taking Eliquis, a patient must know several important considerations to ensure safe and effective use. Eliquis is an anticoagulant that helps prevent blood clots and increases the risk of bleeding. Patients should take the medication exactly as prescribed and avoid missing doses. It is crucial to inform all healthcare providers, including dentists, about taking Eliquis, especially before any surgical or dental procedures, as adjustments may be needed. Patients should be cautious about activities that increase the risk of injury or bleeding and avoid taking other medications or supplements that could interact with Eliquis without consulting their healthcare provider. Signs of severe bleeding, such as unusual bruising, prolonged bleeding from cuts, blood in urine or stool, or coughing up blood, require immediate medical attention.

Patients should seek urgent medical help if they experience symptoms of an allergic reaction, such as difficulty breathing, swelling of the face or throat, or hives. Regular follow-up appointments are essential to monitor the patient's response to Eliquis and adjust the dosage if necessary. These were managed with additional cardioversion sessions and adjustments to his medication regimen. The use of Eliquis successfully prevented the formation of blood clots, mitigating the risk of stroke. While Dan tolerated the medications well, he occasionally experienced mild side effects, such as dizziness and fatigue, which were monitored and managed by his healthcare team. Overall, the treatment plan, including diet modifications, proved effective in controlling Dan's AF, allowing him to lead a more active and symptom-free life.

Consult a qualified medical professional if you or a loved one have AF or any questions regarding symptoms or treatment.

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