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question about no treatment for LAF

My husband who is 49 has had two episodes of afib that lasted about 8 hours. These two espisodes were ten years apart. He has occasional bouts of irregular beats that last less than a minute. These short bursts usually happen less than every six months but sometimes happen twice in a day. When he had the longer episodes his heart rate went up to 135 bpm for several hours and then calmed down to 95 for the remainder of the 8 hour episode. My husband has always been healthy and is not on any regular medications. He feels that since his episodes self convert and are so infrequent that he would rather not be on medication for this.   While his CHADS2VaSC score is zero do you believe taking 81mg of aspirin would be called for?  His doctor seems okay with no treatment considering his episodes have all converted on their own in less than 24 hours.  I wanted to get you opinion on this decision.  I know there are many factors that play into choosing the correct treatment and many different points of view on this.   Thanks in advance for your reply.
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Avatar universal
Without being able to review the entire history it will not be possible to give an exact answer, but generally speaking your husband would fulfill the criteria of "lone" atrial fibrillation, if his heart is structurally normal and has no risk factors. The ACC guideline recommend using aspirin (81 mg or more) in that group of patients, but the same guideline disclose that In patients younger than 60 y with lone Afib the risk of stroke or embolism is low without treatment and the effectiveness of aspirin for primary prevention of stroke relative to the risk of bleeding has not been established. So even that is not the recommendation the ACC guidelines, choosing not to use aspirin is a possible approach in lone AFib as there is no evidence to support chronic aspirin in this group of patients.
Good luck.
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