Stopping Warfarin - any advice please !

I had a successful Pulmonary Vein Ablation in February of this year. Other than two or three episodes of ectopic beats I have been fine. I had my six monthly check with my EP today and after some discussion he said he was surprised I was still on Warfarin and felt I could, if I so wished come off it immediately which at first I was really pleased about. But when I got home I started wondering whether that would not be such a good decision. My CHAD2 score is 2 as I am aged 65 and take hypertension medication ( although it is managed very well ). Any thoughts would be gratefully appreciated.

7 Replies

  • More and more EPs are starting to recommend that you remain on warfarin for life. There is actually no evidence that successful ablation removes the stroke risk as changes to the internal structure of the atria (including the ablation scarring) could still allow eddying of blood with subsequent risk of clotting. MY own EP told me six years ago I could come off it but I declined. It causes me no problems but a stroke jolly well would! One does of course also have to look up HASBLED to check that you are not likely to have a major bleed but I think most of us here stay on it out of choice.


  • Unless taking warfarin has serious side issues for you Ken, why take a chance? Ablation is not a cure for AF and as Bob says the procedure probably hasn't changed your stroke risk. Stick with it if you can - or consider one of the newer alternatives.

  • I came of the medication with the consultants blessing, I was happy to take the risk which is small anyhow, no regrets

  • I specifically checked with my EP, Prof Schilling, and he recommended I remain on warfarin. My CHADS score is also 2. There is insufficient medical evidence that an ablation on its own reduces stroke risk sufficiently to risk coming off warfarin unless your score is zero.

  • I had an ablation in April and had my final check up with my heart specialist and was told that it was now working perfectly so I asked when I could come off the walfarin. He said after 6 months but I woud need to check my pulse daily as there is a chance of stroke!!!

    I'm not sure what to advise you as there would appear to be disagreement in the medical profession as to what you should or should not do.


  • If you have no problems with warfarin personally I would stay on it

  • Thanks for those replies my friends. After visiting my GP this morning she too agrees that I would be better off staying on Warfarin. As I mentioned my CHAD2 score was 2 , she did the HASBLED check and I scored 1 which means my risk of a major bleed is pretty low. So the decision was easy for me to accept. It is heart warming to know that there so many good people on this site who have been good enough to offer advice when someone is unsure of which way he or she should go. Many thanks to all. Stay well everyone.

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