AF Association

Change from NOAC's to Warfarin before ablation?

I have a GP appointment next week to start anticoagulants ready for an ablation at Papworth. If I take Warfarin I cannot go on the list until I am 'in range' so for that, and several other lifestyle reasons, I was all set to argue my case if necessary for a NOAC (Rivaroxaban being my EP's recommendation).

I have seen several different posts recently which, as an aside to the main topic, lead me to believe that those on NOAC's have to change to Warfarin just prior to the ablation itself?

Can anyone tell me if that is always the case (my EP made no mention of it when discussing with me which anticoagulant I should take) and if so would one still have to become 'in range' before the ablation, which would surely mean many scheduled procedures being postponed?

Many thanks


9 Replies

I think EPs have their own ways of working. If you have to be on warfarin it can be OK to get in range - but not so easy to stay there for four weeks. Yes, there are postponements as a result, but one person's pain will be someone else's gain.



I changed a while ago from warfarin to Rivaroxaban and was only asked to stop taking it for 24 hours before my ablation with no problems.



I take Rivaroxoban and before my ablation I was told to stop taking it

for 24 hours before. No problem and no bleeding after ablation.


Angie, every EP has their own way of doing things so ignore what anybody tells you other than your man. NOACs have a very short half life so can be stopped close to the date fixed. Ask at your pre assessment appointment. If your EP says Rivaroxaban then that is what your should take.



Thank you for posting. I had been wondering the same thing. Having to go back to Warfarin after moving to Rivaroxaban would certainly be a point against having an ablation should that procedure be suggested.


Thank you for your replies. It is becoming more and more obvious to me that there are as many ways to 'manage' and 'treat' this condition as there are variations of AF itself. I think I have to do as Bob suggests and go along with what my EP says, although that in itself is a leap of faith as I didn't actually research and choose him- I was referred to him by my local hospital Cardiology Dept! Pick a card, any


Would just like to qualify that last statement as I can't remove it- it seems a little glib now I re-read it!

I do have every faith in, and respect for, my EP's knowledge and skill. And although it has been a bit of a battle to get to this stage I am extremely grateful for the care I am now getting from the NHS.


I asked if I could change to a NOAC but my EP said that he wanted me to stay on Warfarin because, at the time, I was due to another ablation. But that was 18+ months ago. He also increased my target range prior to the ablation to 3 - 4. I didn't manage to get that high but they went ahead anyhow with my INR at 2.5 'ish.

As Bob says I think it's personal, and my EP seems to prefer Warfarin whether you're having an ablation or not, at least with me he does.



I too changed from Pradaxa to Warfarin prior to my ablation nearly 3weeks ago now. My EP told me it was because on Warfarin if Id had a bleed during the procedure they could give me Vit K to help stop bleeding. With all the other drugs I was lead to believe there is no antidote yet.

As it happened the ablation went well with no bleeding.....not even a bruise! We have to go with their advise I suppose. Good luck

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