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Are there some tips on taking warfarin for atrial fibrillation?

Anthony L. Komaroff, MD
Internal Medicine
The decision to start taking warfarin (generic, Coumadin, Jantoven) for lone atrial fibrillation (atrial fibrillation not caused by underlying heart disease) or any other type of this heart rhythm disorder depends on several factors, not just age. Most cardiologists use the CHADS2 score (it stands for Cardiac failure, Hypertension, Age, Diabetes, and Stroke [doubled]) to help make the decision. As you can see in the table below, age does not accrue any points until 75 years and older. If your CHADS2 score is zero, and you truly have lone atrial fibrillation, then it should be fine to hold off on taking warfarin. Some doctors recommend anticoagulation for people who are often or always in atrial fibrillation even though they have a CHADS2 score of zero, but this approach is not part of current guidelines for treating atrial fibrillation.

CHADS2 Score

Risk factor:
  • Heart failure: 1
  • High blood pressure: 1
  • Age 75 or older: 1
  • Diabetes: 1
  • Prior stroke or transient ischemic attack or blood clot: 2
Scoring: Circle any risk factor that applies to you and add up the circled points.
0: Anticoagulation with warfarin generally isn't needed.
1: Take aspirin or warfarin (although warfarin is preferred).
2 or higher: Take warfarin.
Douglas E. Severance, MD
Family Medicine

Warfarin (Coumadin) is a common blood thinner that's prescribed for people with atrial fibrillation. Because of the increased chance of blood clots and stroke with atrial fibrillation, keeping your blood thin is an important preventive measure. If you take warfarin or another anti-coagulant, be aware of activities and situations to avoid that can cause bleeding, including:

-Avoid recreational activities such as football, soccer, or other sports that may result in a cut, injury, or open wound.
-Use a soft toothbrush to brush your teeth to avoid cutting or injuring your gums.
-Use an electric razor to avoid cutting your skin when shaving.
-Prevent falling at home by removing objects out of the halls and pathways and having good lighting.
-Don't climb on stools or ladders.
-Don't walk on wet surfaces or icy ground.

Also, check for signs of bleeding, including your gums bleeding, blood in the urine, bloody or black stools, vomiting blood, or heavy bleeding during a woman's period or between periods.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.