Rivaroxaban

[Buffafly]

I take Rivaroxaban even though I have had a successful ablation. A couple of days ago I had a fall in the evening and banged my face hard on the pavement. I felt very anxious and went to A&E as I was convinced I must have broken something and I was worried about the banged head. I am covered in bruises down my right side and after reading the 'head injury' leaflet given to me I decided not to take my dose of Rivaroxaban on the evening of the fall although the doctor didn't mention it. The dose from the previous day would have worn off, luckily.

My fear of being a 'cabbage' is much greater than my fear of dying from any cause so I don't regularly worry about taking an anticoagulant, as I feel the balance of risk is on the side of the Rivaroxaban.

[pip_pip]

It's not unusual to be on anti coags after a successful ablation for a short or long time.

However I feel that you should continue the Rivaroxaban as prescribed. If any bleeding was going to happen you prob would have known by now. Unless you were told to stop the R , just continue with it as usual. 

Be well

Phil 

 

[BobD Volunteer]

Successful ablation does not remove stroke risk according to the EPs I trust. That is why many of us stay on anticoagulants for life, regardless of the outcome. There are technical reasons for this as I have written countless times elsewhere.

I confess that I was expecting to stop but having studied all the evidence I actully requested to stay on warfarin which I have been for nearly eleven years.

[Buffafly in reply to BobD]

I was told I might be able to stop but until there is a good reason to do so I am happy to carry on.

[PeterWh in reply to Buffafly]

Sorry to hear about your fall and hope that you recover quickly.

I certainly am not going to stop when I am back in NSR all the time.

[jeff1257 in reply to BobD]

Bob, would you share the technical reasons that anti coagulation is still needed after a successful ablation?  Isn't it the irregular beating that creates the stroke risk?  And isn't that risk resolved by a successful ablation?  Thanks.

[BobD Volunteer in reply to jeff1257]

My understanding of the mechanics is that AF causes the internal surface of the atrium  to change. Ablation also causes changes to the surface by creating the scars which stop the rogue impulses. The irregular surface thus created by both can allow blood to eddy and pool which can then allow clots to form. It is not just the irregular beating which allows pooling of the blood. It is  thought that most clots form in the left atrial appendage, hence the idea of closing this in some cases but as you can see this is not fool proof. As I said I couldn't wait to stop warfarin until this was explained.

[jeff1257 in reply to BobD]

Ah, that makes some sense.  I so hate the anticoagulant that I was looking into the watchman device, but I see that involves lifelong aspirin therapy, which seems just as risky.  I am a CHADS-VASc 1 (at least until I get to age 65) and my only checked box is hypertension, which I no longer have (without the use of meds). I know that any history of of hypertension keeps the box checked, but some doctors think that if you have resolved the hypertension, say with weight loss, you can uncheck the box.  I may just drop the apixaban, as the risk/benefit seems like a coin toss, even if I consider myself a CHADS-VASc 1.  Not easy having this condition, that's for sure.

Thanks for your reply!

[Buffafly in reply to jeff1257]

As Bob has not replied yet I'll have a go, though it won't be very technical. My reason for continuing is that a 'successful ablation' is not the same as '100% cured AF'. You may have runs of AF you are unaware of or the healing process may allow AF to return at some time. 

I see now Bob has added the tech bit 🤓

[jan-ran]

Just want to say how awful for you, to fall and hurt yourself. I have a real fear of falling, hence my manic desire to exercise through dance all the time. (Helps with balance) I have had falls, and can sympathise with your concerns. Get well soon. JanR

[Buffafly in reply to jan-ran]

Thank you Jan, it has certainly knocked my confidence. I have a tendency to fall for reasons I won't bore you with but this one was very bad, my daughter asked me to send a selfie and then wished she hadn't. I only went out on an errand 🤕, clearly walking as exercise is not for me! What kind of dance do you do? I started swimming but after my ablation I took a break, trying to persuade myself gardening is good enough exercise but probably not.

[jan-ran]

I go line dancing twice a week, and I do one class of movement to music. I try to do 20 mins cycling (recumbent) the other days. I too have a history of falling since the mid nineties when I got Dermatomyositis. Terrifying! It would be good if you could get back to swimming. Be well. JanR 

[Dodie117]

I have about 20 of my favourite fast dance tunes on my phone. I put in my ear plugs and dance to them around the house or in my room for 30/40 mins most days.  Its the most pleasurable form if exercise I know (??) and often have to tell myself to stop as I want to listen to just one more tune!

The phone measures steps and 30mins gives roughly 3,000 steps which is the same as 30 mins of walking.

[Buffafly in reply to Dodie117]

I like that idea! Several exercise classes a week wouldn't really be practical for me as I rely on the husband taxi and have to ration myself. One of our local sports centres has  machines and a programme specially for people with disabilities so I might look into that.

[Buffafly]

Update, my bruises are growing and coming out in places there weren't any visible before. I guess this is the price I pay for peace of mind. My husband is rather anxious that people might think he did it!

[Hidden]

I recently started xarelto. All the a fibbers advice I get is try not to let a fib rule your life. Well one of my loves is riding my horse. Now that Im older and arthritic, my riding is mostly in our arena or our own field, very controlled environment. I wear a helmet and ride an older "safe" horse, wouldnot want to quit but a part of me questions my wisdom. Any thoughts re continue or hang it up?

[Buffafly in reply to Hidden]

Well I would say continue as it is something you love and you are aware of the risk. You could give up riding and have an accident doing something everyday like going to the corner shop to buy teabags ......

[souljacs4]

Can I ask who did your ablation

[Buffafly in reply to souljacs4]

Dr David Jones at Harefield. Very impressed!

[souljacs4 in reply to Buffafly]

Thank you