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Had Atrial fibrillation, taking diltizem, digoxin and aspirin. Was put on xarelta. Have controlled high BP. Suggest?

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I"ve had Afibb for 2 years. I"m taking 360mg of diltizem and 250mcg of digoxin and 324mg of aspirin daily.
My doctor wants to put me on Xarelta 20mg once a day. I"m wondering if I can take Xarelta only during an episode?
I don"t want to be on blood thinners on permanent bases.
Sometimes I go for 4 months without episodes. When I have an episode it lasts up to 9 hours. i"m 59 years old.
I"m a female. I have controlled high bloodpressure. I'm a smoker and I will never quit!!!! I walk and swimm every day and I do yoga 3 times a week.
Posted Sun, 22 Sep 2013 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 7 minutes later
Brief Answer:
It is not feasible. see details......

Detailed Answer:
Respected Ma'm
I am sorry to say that it will not be feasible. A blood thinner has to be given on long term basis. It can not be taken on SOS basis or on episode basis. The reason for same is that "not all episodes of AF (atrial fibrillation) will be recognized by you, like one in sleep". Moreover the chances of thrombus formation are more during the episode or just after it but it may go to your body even days after the AF episode, if it has formed once. The effect of blood thinners also take some time to start; so a drug started after the initiation of episode may not be that effective.
Hence you have to take your blood thinner on long term basis irrespective of type of AF you have (episodic or permanent).
Hope this helps. Feel free to discuss further.
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