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Atrial fibrillation is a major risk factor of stroke. The top heart chambers (atria) fibrillate and stagnation of blood predisposes to clotting; the blood clot can then get dislodged into circulation and finally wedged in one of the arteries in brain cutting off blood supply and causing a stroke. Rivaroxaban is one of anticoagulants ('blood thinning' drugs) which reduce the risk of excessive clotting and so the risk of stroke. So, the answer is yes - a previous stroke automatically places your mother in the high risk category - but she seems to be on a good treatment to reduce this risk as much as possible.

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Dr. Petr Ruzicka PhD FRCP Premium Profile Has a more complete profile



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There are two approaches to the management of AF. 1. Controlling the heart rate or converting the rhythm back to normal sinus rhythm. To control or reduce the heart rate beta blockers are useful such as bisoprolol. Sometimes converting the rhythm back to sinus rhythm may involve a procedure called a DC cardioversion. Then the patient may be on a beta blocker or other medication like flecainide or possibly amiodarone to maintain the patient in sinus rhythm. 2. The other important thing to consider is blood thinners such as warfarin or apixiban. This in some patients is important to consider taking to reduce the risk of stroke.

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Dr. Alamgir Kabir



It may be worth trying another cardio specific beta blocker such as Bisoprolol or Nebivolol.If the nightmares continue to be a problem then Verapamil is a choice that won't cause nightmares although not as great in controlling palpitations. Simple measures such as avoiding stimulants such as Caffein and Alcohol also help reduce palpitations. Good luck !

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Dr. Abdullah Mohammed

Cardiologist, Internist


Isolated ventricular ectopic beats are very common and usually benign. Although 206 beats sound a lot, your burden of ectopic beats is low during this period of recording. If you only feel the intermittent skipped beats, have had no black outs and you have no other significant cardiac symptoms, it is unlikely these are of significance although they can be quite intrusive. in some cases (dependent on characteristics of your 12 lead ECG and the pattern of ectopics) an echocardiogram may be helpful.

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Dr. Michael Hickman MD FRCP



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