Apixaban

[Lindabob]

How long should I be on Apuxaban to be fully anticoagulation before an ablation?

[MarkS]

Only a matter of days as I understand it as it acts so rapidly. The EP might want longer to help dissolve any clots that had previously formed. However the key thing is to remain on apixaban throughout the ablation as the ablation procedure itself can generate a lot of micro-emboli which cause problems later in life.

[Lindabob in reply to MarkS]

Thanks MarkS quite quick!!

[BobD Volunteer]

My understanding is that you are protected almost immediately.

[Lindabob in reply to BobD]

Thanks...😊

[Perrylees]

My EP wanted me to be on it for a month and then did a TOE anyway.  He also told me to miss a dose on the morning of the ablation.  Afterwards I developed a couple of tiny pulmonary embolisms ( discovered accidentally ) so he now thinks that I should have stayed on it throughout (as per the comment above). 

Best to speak to your EP - he/she will have a view.  The bottom line is that nobody quite agrees about AF / NOACS  and what is the best route because it's still so new.

By the way - I don't believe that pulmonary embolisms will necessarily cause any issues later in life?  Mine are small yes, but are being treated and I'm not even due to have another scan - I certainly haven't been told this.  In fact I was told that they would never have been noticed by me  if I hadn't had a ct scan for something else and that they would almost certainly have dissolved naturally... 

Ruth 

[Lindabob in reply to Perrylees]

Gosh, so much information, thanks😊

[Perrylees in reply to Lindabob]

Sorry - was just trying to give you a real life example - didn't mean to go on about the PE - but it is probably worth knowing 

[Hidden]

Courtesy of The University of Washington Medical Dept......

How long does it take for apixaban to work?

Apixaban begins to reduce blood clotting within a few hours after taking the first dose. If you stop taking apixaban, its effects on clotting begin to wear off within 24 hours for most people.

[AnticoagulateNow]

After no more than a couple of hours, it begins to inhibit clotting.    It stops doing so just as quickly if you miss a dose of course.     To correct an earlier comment, NOACs cannot "dissolve clots" that have already formed - they simply stop new clots forming.

[MarkS in reply to AnticoagulateNow]

Well in this article it mentions "Patients who entered the study with either a deep vein thrombosis or a pulmonary embolism had the same chance of reduced bleeding with the drug, while maintaining its ability to thin the blood and dissolve blood clots."

medicaldaily.com/new-clot-b...

 However technically you are correct in that Apixaban, like warfarin and other NOACs, stop clots getting bigger and then your body can dissolve them naturally over time. So your EP might want you on it a few weeks beforehand to get rid of any clots that were already there.

[KipperJohn]

Had my first ablation last year within about 3 weeks of first seeing the EP and was put on Apixaban immediately. I seem to recall I had to miss the morning dose on the day of the procedure. 

Waiting to hear about the second ablation which is due in a fortnight. 

[KipperJohn]

Just heard from the hospital concerning appointments for tests and ablation.

Confirmed that I have to omit Apixaban on the morning of the ablation.