Just a hypothetical question, but I am curious as to whether one can have an operation as normal while medicated with rate control and anticoagulent only? I.e. not had ablation to control AF.
What if you suffer an episode during the op? Would it matter?
Depending on circumstances. I have had short procedures under anaesthetic, and I am in permanent AF. Hospitals always do a pre assessment before any kind of surgery, and so will take into account your history, specially the anaesthetists. May adjust the anti coagulants, but as I say each case would be different. Hope this helps
That is really up to the surgeon and anaesthetist at the time. Also the duration of the operation would be taken into account. For example they told me that had I not been AF free thanks to my ablations then they would not have attempted the four hour cancer op I had. Lucky me!
Everyone is different, and I suspect the answer will very much depend on the risk profile of the patient.
I am in persistent AF, and had an op last week (just over an hour under I am told) without any problems whatsoever.
Be well
Ian
How's the knee.
I'm in hospital at the moment having had an hour and a half operation. Had a long chat with the anaesthetist beforehand (who had been forewarned and asked for a bed in the high dependency unit for me after the op) - they have the drugs in theatre to manage any episodes.
My AF actually kicked in a few hours after coming round. At that point they got a Medical doctor (as opposed to??!!) to advise, who basically asked me how I normally control my episodes. Learning point for me - if you are allowed to vary your medicine dose according to how you feel, get that added to your notes from the word go!
So to summarise, as Bob says, depends on your surgeon but particularly your anaesthetist.
Caroline
Depends on the hospital / consultant / anaesthetist. However it is very important that you also speak to you EP / cardiologist as well. As my cardiac specialist (I am seeing an EP as well) said the old rules of stopping Anticoagulation or other medicines 5 days before hand no longer apply and many outside of heart specialists are not up to date with practice and thoughts. For instance when I had my catheter ablation 16 months ago I was told NOT to stop any of the medications and took warfarin on the night before as usual. Also on the morning only difference was to take Bisoprolol a couple of hours earlier. At that time it was less common to do this but much more common now.
Training and knowledge has changed and will continue to change.
Hi scottishmuppet,
I can only say my experience ... I'm on Bisoprolol and 5.5 mg Warfarin daily and these are prescribed meds for paroxysmal AF. I am also on Ramipril and Felodopine for high blood pressure and Simvastatin (all prescribed prior to AF). I've not had an ablation.
I have undergone 2 procedures, one a CT scan when my Warfarin was cut out according to specific guidelines I was given and the other (some years later) was a partial knee replacement ( about 2 to 2 and half hours on the slab) - when again my warfarin was cut out according to the same guidelines however, it was replaced by a bridging anticoagulant (Fragmin) during surgery. In all cases other meds remained in placed and doses were not changed. At 8 pm the same day following knee surgery I was given the all clear to return to Warfarin. (For the record, I was operated on at around 11 am ).
At no time did my Orthopaedic Surgeon or Anaesthetist seem particularly phased by the AF issue. I survived, my knee survived and my AF remained quite unchanged, i.e. no AF event during or following surgery, and obviously no stroke either.
John
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