Anticoagulation 'as needed' may be safe, effective in A-fib

(HealthDay)—A smartphone app might offer an alternative for certain patients with atrial fibrillation who are on chronic anticoagulation medication, according to research presented at the annual meeting of the Heart Rhythm Society, held from May 4 to 7 in San Francisco.

Francis Marchlinski, M.D., director of cardiac electrophysiology at the University of Pennsylvania Health System in Philadelphia, and colleagues focused on 100 patients, aged 56 to 72, previously on a daily regimen of novel anticoagulants (NOACs). When the study was launched, none had atrial fibrillation recurrences during an extended period of electrocardiogram monitoring. All checked their pulse twice daily, including nine who monitored their heart rhythm using a smartphone-enabled device. The study participants were told to avoid taking their NOAC unless they suspected or were sure they were experiencing an atrial fibrillation-related event lasting between one to two hours.

Over the following 18 months, about one-quarter of the patients had to take their NOAC medication at least once. Only six patients ultimately ended up returning to a daily regimen of NOAC. Also, none of the patients experienced either a stroke or transient ischemic attack. And only one experienced a minor bleeding event.

Still, the researchers cautioned that the current study is an investigational "pilot study," and said more research will be needed to confirm the findings. "This potential strategy for intermittent use is only intended for patients with electrocardiogram-demonstrated control of atrial fibrillation, who have undergone an extended period of monitoring, and who are avid pulse-takers that can recognize their atrial fibrillation if it occurs," Marchlinski told HealthDay. "In other words, it's a very select group of highly motivated patients."

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