Progression of Treatment and Aspirin

Happy Holidays and many thanks for your responses to this forum!

53 old male with afib taking metoprolol and aspirin.

The bouts with afib seem to be increasing in duration and frequency. What would be the next treatment possibilities?

Also, had my first dental work - nothing major, since afib and the teeth area kept on having minor bleeding for hours afterwards because probably due to the aspirin. The next time I want to stop the aspirin before going in but how soon should I stop? And what's the chances of a clotting problem during that interim?

[CCF-M.D.-KE]

Dear Rossi,

Sorry to hear about your episodes of atrial fibrillation.
People with atrial fibrillation  are at increased risk for the development of stroke because the top chambers of the heart do not contract effectively. The stroke risk can be more easily quantified. If the person has had a previous stroke, then their annual stroke risk is at least 5%. If they have risk factors for stroke with afib, such as hypertension, diabetes, advanced age, or heart failure, then the stroke risk is between 3-5% per year.
You should discuss with your doctor whether or not you need to be on coumadin.

You may be a candidate for antiarrhythmic medication to control your atrial fibrillation. Lastly, if antiarrhythmic medication fails, it may be possible to treat your atrial fibrillation using a catheter based approach. You need to discuss these options with your doctor. If you have not already done so, I would suggest seeing a cardiologist who specializes in treating atrial fibrillation (EP doctor).

The bleeding you experienced is likely related to your aspirin. Typically we do not suggest that patients stop their aspirin prior to a dental procedure. However, if you do stop your aspirin  for a few days the risk of stroke during that period is very low.  


Thanks for your question,


CCF-MD-KE