An increasing number of atrial fibrillation patients are being prescribed one of the new oral anticoagulants (dabigatran, rivaroxaban, or apixaban) for stroke prevention either after diagnosis or to replace warfarin. Warfarin (Coumadin) has been in routine use for over 30 years and a wealth of information is available concerning its benefits and potential for harm. Such is not the case for the new anticoagulants (NOACs). In a bid to correct this situation, the European Heart Rhythm Association recently published a set of guidelines for their use. Some highlights of these guidelines are – NOACs do not require monitoring like warfarin and INR testing is not applicable to establish the degree of anticoagulation; there are numerous known interactions with other pharmaceutical drugs including antiarrhythmics; there are currently no effective and readily available antidotes to deal with major NOAC-related bleeding; thrombolytic therapy (to deal with an ischemic stroke) is not safe for patients on NOACs and, at this time, NOACs are not recommended for cancer patients.

Also in this issue we report that a combination of vitamins C and E and fish oil is effective in preventing post-operative atrial fibrillation associated with heart surgery, that pre-existing inflammation worsens the outcome of catheter ablation, that the risk of suffering a stroke is similar in paroxysmal and persistent afibbers, that major bleeding associated with warfarin therapy is more common than originally thought and is further increased if aspirin is also prescribed and finally, that age is no barrier to having a successful catheter ablation.

If you have not yet visited the afibbers.com website I would urge you to do so. The database has just been updated and now includes the abstracts published in the 2012 issues of “The AFIB Report”. You can search the entire database using the Google on-site search feature. Please give it a try! I am sure you’ll like it! http://afibbers.com/atrial_fibrillation/index.htm

Last but not least, if you need to restock your supplements, please remember that by ordering through my on-line vitamin store you will be helping to defray the cost of maintaining the web site and bulletin board. You can find the store at http://www.afibbers.org/vitamins.htm - your continuing support is greatly appreciated.

Wishing you good health and lots of NSR,