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Photo courtesy of the CDC
SAN FRANCISCO—New research suggests patients with atrial fibrillation (AF) may benefit from receiving novel oral anticoagulants on an “as-needed” basis.
The study indicated that anticoagulant therapy guided by diligent pulse monitoring can be a safe and effective alternative to long-term anticoagulant therapy for lowering the overall risk of stroke in AF patients.
This finding was presented at the Heart Rhythm Society’s 37th Annual Scientific Session (abstract AB21-06).
The researchers studied 100 AF patients, ages 45 to 78, who had significant stroke risk. All patients had no AF recurrences during an extended period of telemetry monitoring before the study began.
Eighty-four patients had been ablated, 16 were being treated with drug therapy, and 3 had implanted devices that served as a quality control check.
Each patient was instructed to monitor his or her pulse—manually or by using a smartphone—twice a day and take an anticoagulant as needed. The patients were provided with novel oral anticoagulants and were instructed to start taking the medication if they suspected or detected an AF episode lasting longer than 1 hour.
“This kind of approach to anticoagulation therapy requires an open line of communication between the patient and the care team and calls for a specific type of patient,” said Monica Pammer, a physician assistant at the Hospital of the University of Pennsylvania in Philadelphia.
“We call them ‘highly motivated patients.’ These are patients who were actively seeking, preparing for, and are committed to the alternate treatment method, and who are informed about how to diligently and effectively monitor their pulse throughout the day.”
The researchers followed the patients for approximately 23 months.
During this time, 28 patients started taking an anticoagulant at least once for a suspected or detected AF episode, and 10 patients transitioned back to chronic oral anticoagulation therapy for recurrent AF.
None of the patients experienced a stroke or transient ischemic attack, but there was 1 mild bleeding incident that required medical attention.
“It is extremely common for patients with AF to seek treatment that does not involve the use of chronic oral anticoagulants therapy, as there are other risks associated with their long-term use,” said Francis E. Marchlinski, MD, of the University of Pennsylvania Health System.
“The goal of this study was to find a safe and effective treatment option, and our initial results support ‘as-needed’ blood thinners and pulse monitoring as the alternative.”
“While this is an observational study with a relatively small patient sample, further research is certainly needed to better understand alternate treatment options,” Pammer said. “And we stress that ‘as-needed’ blood thinners should not be considered unless the patient qualifies as highly motivated.” 
Photo courtesy of the CDC
SAN FRANCISCO—New research suggests patients with atrial fibrillation (AF) may benefit from receiving novel oral anticoagulants on an “as-needed” basis.
The study indicated that anticoagulant therapy guided by diligent pulse monitoring can be a safe and effective alternative to long-term anticoagulant therapy for lowering the overall risk of stroke in AF patients.
This finding was presented at the Heart Rhythm Society’s 37th Annual Scientific Session (abstract AB21-06).
The researchers studied 100 AF patients, ages 45 to 78, who had significant stroke risk. All patients had no AF recurrences during an extended period of telemetry monitoring before the study began.
Eighty-four patients had been ablated, 16 were being treated with drug therapy, and 3 had implanted devices that served as a quality control check.
Each patient was instructed to monitor his or her pulse—manually or by using a smartphone—twice a day and take an anticoagulant as needed. The patients were provided with novel oral anticoagulants and were instructed to start taking the medication if they suspected or detected an AF episode lasting longer than 1 hour.
“This kind of approach to anticoagulation therapy requires an open line of communication between the patient and the care team and calls for a specific type of patient,” said Monica Pammer, a physician assistant at the Hospital of the University of Pennsylvania in Philadelphia.
“We call them ‘highly motivated patients.’ These are patients who were actively seeking, preparing for, and are committed to the alternate treatment method, and who are informed about how to diligently and effectively monitor their pulse throughout the day.”
The researchers followed the patients for approximately 23 months.
During this time, 28 patients started taking an anticoagulant at least once for a suspected or detected AF episode, and 10 patients transitioned back to chronic oral anticoagulation therapy for recurrent AF.
None of the patients experienced a stroke or transient ischemic attack, but there was 1 mild bleeding incident that required medical attention.
“It is extremely common for patients with AF to seek treatment that does not involve the use of chronic oral anticoagulants therapy, as there are other risks associated with their long-term use,” said Francis E. Marchlinski, MD, of the University of Pennsylvania Health System.
“The goal of this study was to find a safe and effective treatment option, and our initial results support ‘as-needed’ blood thinners and pulse monitoring as the alternative.”
“While this is an observational study with a relatively small patient sample, further research is certainly needed to better understand alternate treatment options,” Pammer said. “And we stress that ‘as-needed’ blood thinners should not be considered unless the patient qualifies as highly motivated.”
Photo courtesy of the CDC
SAN FRANCISCO—New research suggests patients with atrial fibrillation (AF) may benefit from receiving novel oral anticoagulants on an “as-needed” basis.
The study indicated that anticoagulant therapy guided by diligent pulse monitoring can be a safe and effective alternative to long-term anticoagulant therapy for lowering the overall risk of stroke in AF patients.
This finding was presented at the Heart Rhythm Society’s 37th Annual Scientific Session (abstract AB21-06).
The researchers studied 100 AF patients, ages 45 to 78, who had significant stroke risk. All patients had no AF recurrences during an extended period of telemetry monitoring before the study began.
Eighty-four patients had been ablated, 16 were being treated with drug therapy, and 3 had implanted devices that served as a quality control check.
Each patient was instructed to monitor his or her pulse—manually or by using a smartphone—twice a day and take an anticoagulant as needed. The patients were provided with novel oral anticoagulants and were instructed to start taking the medication if they suspected or detected an AF episode lasting longer than 1 hour.
“This kind of approach to anticoagulation therapy requires an open line of communication between the patient and the care team and calls for a specific type of patient,” said Monica Pammer, a physician assistant at the Hospital of the University of Pennsylvania in Philadelphia.
“We call them ‘highly motivated patients.’ These are patients who were actively seeking, preparing for, and are committed to the alternate treatment method, and who are informed about how to diligently and effectively monitor their pulse throughout the day.”
The researchers followed the patients for approximately 23 months.
During this time, 28 patients started taking an anticoagulant at least once for a suspected or detected AF episode, and 10 patients transitioned back to chronic oral anticoagulation therapy for recurrent AF.
None of the patients experienced a stroke or transient ischemic attack, but there was 1 mild bleeding incident that required medical attention.
“It is extremely common for patients with AF to seek treatment that does not involve the use of chronic oral anticoagulants therapy, as there are other risks associated with their long-term use,” said Francis E. Marchlinski, MD, of the University of Pennsylvania Health System.
“The goal of this study was to find a safe and effective treatment option, and our initial results support ‘as-needed’ blood thinners and pulse monitoring as the alternative.”
“While this is an observational study with a relatively small patient sample, further research is certainly needed to better understand alternate treatment options,” Pammer said. “And we stress that ‘as-needed’ blood thinners should not be considered unless the patient qualifies as highly motivated.”