Just wondered if anyone has been kept on medications after a successful Ablation?
My GP doesn't seem to agree with the EP- who wants me to carry on with Bisoprolol and Rivaroxaban as a precaution, in case AF returns.
It may be because mum died of a stroke and my brother has recently had a minor one!
Thanks a lot .
Linc2u, how would you define a successful ablation? AF for me returned 15 months after my first ablation , very much to my surprise as I felt so well
It is quite normal to be kept on anticoagulants for some time after an ablation. Many of us are on them for life.The stroke risk will still be there, maybe reduced but even then there doesn't appear to be universal agreement on this.
Personally I wouldn't ever want to stop taking an anticoagulant, in my case warfarin. You never know when or if AF will return.
Sandra
Hello, I have also been kept on medication and warfarin post all my ablations. I have had 3 ablations in total , my last one in October last year. I am so much improved since my ablation and I consider it 'successful' but do occasionally have the 'odd run' of irregular heart rate. Due to see EP soon but don't really expect him to discontinue any meds, I have a Chad score of 1 ( as female) which is very low but have been on anticoagulants for the last 4 years. I wish you well.
Still on bishop roll and warfarin one year post ablation, and happy to be, feels safer
Don't you love predictive text! I meant bisoprolol of course!
I'm still on bisoprolol, xarelto, inspra and ramipril eighteen months after an ablation. I saw my EP a few months ago and wondered if he would reduce anything but he didn't want to. Quite surprisingly, to me anyway, I was back with a bit of AF last week, so presumably he knew what he said as doing. Whatever I certainly wouldn't want to discontinue the anticoagulants.
After each of my numerous ablations I have been kept on my warfarin, flecainide and bisoprolol.
Regarding the anticoagulants - I had a conversation when I was discharged last week after my ablation. The doctors told me that even if I eventually came off Flecainide and Bisoprolol they would want me to keep me on the anticoagulant. they have a points system based on a number of factors calculated on you as an individual and in my case it states I would otherwise be at risk of a stroke.
Pete
My EP left me on everything to begin with but,later took me off all to do with blood pressure because I am still passing out. He says that this isn't to do with HR, but either BP, or epilepsy. That also hasn't done the trick, I'm still taking trips to hospital in an ambulance.
Stay on the Rivaroxaban, surely it has to be a no brainer
I am to stay on Pradaxa and 2.5 bisoprolol.
Coming off your anticoagulant is a no-brainer. Once you've had AF you are vulnerable as it can return at any time. CDreamer's story (see posts of yesterday) is a warning to each and every one of us.
As Bob says " You cannot undo a stroke----"
Thanks for your reply- just a pity my GP doesn't agree! Perhaps he doesn't understand AF!!
I would go with my EPs advice on any heart related meds., especially the afib ones. My EP took me off flecainide three months post ablation but continues blood pressure and anticoagulant indefinitely. Of course, I'm a 69-year-old female, so that figures in, too. Also, I can feel every irregular blip of my heart, so no afib sneaking up on me. All individual factors to consider.
Unfortunately a lot of GPs and other medics (including other consultants, nurses and dentists) are not up to date on anticoagulation. I suspect that quite a bit of that is because in the last 5 years there have been significant changes in knowledge, understanding and practice let alone the introduction of the NOACs. There are also a lot of hereditary myths around that have now been disproved.
Part of the problem stems from their training days. GPs now in their 50s may have only had a few hours worth of lectures on AF. Also I think that their is a lack of knowledge that links AF to the serious and fatal strokes and also how to apply CHADSVAC. They are also unaware that we are one of the worst in Europe re anticoagulation and strokes.
For instance when I was admitted to A&E one of the doctors (I guess in his late 20s or early 30s) straight away said you shouldn't be on warfarin because you are only 61. That was without going through the details of my case and co-morbidities!!!! Fortunately I am a person who wouldn't just take what he says and enlightened him as to the number of things as to why I should be taking an anticoagulant and let alone that when various heart consultants at one of the leading UK heart establishments says they should be taken then that is good enough. They had to administer vitamin k on two different days to get INR down to do test but when I gave the info to the heart consultant he said that I should have been bridged!!! They bridged me when I had an angiogram.
I had my ablation last November, and so far it seems to have been successful. I am still taking bisoprolol and anticoagulants. My cardiologist has suggested I stop taking bisoprolol when I feel ready. I wanted to leave it a while for my own peace of mind, and he and my GP have been fine with that, so I am going to make the decision to stop when I feel confident enough to do so. As far as stopping the anticoagulants is concerned, I want to stay on those for longer, as I am fully aware of the risk of an AF return, despite the ablation. I think you have to listen to advice and go with your instincts really. I hope all continues to go well for you.
After my 4th ablation Feb last year I am still on bumetanide bisoprolol losartan and edoxaban
2 years down the line from my ablation I am still on Dronedarone,Bisoprolol and Warfarin and am now waiting for a 2nd ablation and another angiogram, hopefully this next one will sort it all out.
Listen to your cardiologist.
A compromise would be to stay on anticoagulant but keep bisoprolol as pip. That's my solution. I would take EP advice over GP. Is GP refusing meds or just giving an opinion.
A successful ablation ....depends which way you look at it. I have had 2ablations and I have to say success is based on how it was before. I still have the odd flutter but I no longer have a fib and I can live with that therfore still on bisoporol flecinide and rivaroaoban
Keep well!
THANKYOU to all of you kind folk who have replied to my post. So reassuring to have support from this website! X
Hi linc2u, had my ablation in Feb, was on bisoprolol flecainide and rivaroxaban. Had my three month check in May and they took me off of bisoprolol and flecainide. Had a heart scan in august and went for my results on sept. 5th. They said heart was pumping normally again and took me off rivaroxaban as well. 7months post ablation and touch wood everything OK and no tablets. Hope you get it sorted, good luck, Greg.
My reply is that the EP is far more knowledgeable than the GP. Hence, it is best to listen to him.
My experience with GPs is that one over-prescribed Bisoprolol which caused Atrial Flutter to last 42 hours in the early stages of my having it. Otherwise, it would be 3 to 18 hours approx. Another GP prescribed Digoxin and took me off the Bisoprolol after that. The result was that I landed in A & E. You can draw your own conclusion.
I know that my EP would take me off medication if he thought it safe to do so. My Chad score at the moment is 0. Someone with a higher score should stay on the anticoagulant which I started to take just 1 week before the first ablation. From what I can understand, is that one should continue with the anticoagulant after an ablation to avoid stroke after an ablation.
I don't know if my ablation of 5 weeks ago is successful. I am still on Amiodarone because my AFib was starting to be on a daily basis before the ablation. I started taking it three weeks before the ablation and was told to take it 10 weeks after. What will happen after that I do not yet know.
Good luck.
After my second ablation which worked straight away (for 4 years) my EP stopped all my meds immediately, including warfarin. But af crept back. After third ablation didn't work so stayed on them and increased.
New anti coags are much better than warfarin btw.
Somehow I missed this first time round so apologies.
An increasing number of EPs and people who actually understand AF and stroke risk feel that even an apparently successful ablation does not remove stroke risk. There are many reasons for this, not least that AF changes the internal structure of the atria which can make eddies more likely and therefore possible pooling leading to clots forming. It is for this reason that continued anticoagulation is advisable .
Many people like myself have been able to stop (eventually) any rhythm or rate control drugs once the healing process has finished, usually three to six months .(I took eight months). Obviously people's level of "success" will vary as we are all different and whilst some may be symptom and drug free post ablation others may still need some assistance from drugs. If you have any allied problems such as hypertension then this should of course continue to be treated.
One needs to come off bisoprolol very slowly, as decreasing may initially seem to increase incidence of AF etc. Decrease by 1.25 at a time, and only continue when any 'negative' symptoms have died down.
I had my ablation 6 months ago. I came of bisoprolol after 2 months and am about to come off apixaban. Not all EPS agree obviously -but mine feels very strongly as your GP does and I promise you he is a good doctor who is well aware of all the latest research. Despite what some people say there is no definitive right or wrong in this - only what is right or wrong for YOU. Not everybody is identical and as such our risks are all different . My understanding is that if you are otherwise healthy and reasonably young the risks of anticoagulation may well outweigh the benefits once you have had a successful ablation. Obviously AF often goes hand in hand with a number of other conditions which might increase stroke risk, which is the case I suspect for a number of people on this forum, but in my case AF was the only thing I had... Also I can't see the point of being on a beta blocker if you are in NSR - and I for felt 100 X better when I stopped taking bisoprolol!
All this is not to say I don't have some misgivings about giving up "my safety blanket" NOAC and I have thought long and hard about it but I also worry about the risk of bleeding whilst on it AND I trust my EP so will ultimately take his advice which is to be drug free for as long as possible.
I appreciate this is a contrary view to a number of the more regular contributors to the forum but I hope it has some value nonetheless !
Ruth
@lin2u The Ep is electrical heart activity expert. He/She know things your GP does not. They decide whether to continue a drug based on your risk factors. If your direct biological relatives--1 died of a stroke and the other had a small stroke-- then you are at greater risk. Also the ablation scars your left atrium slightly which creates a sort of risk with the blood flow. Then there is the age factor. Doctors assume most people are not unaging themselves with certain foods and supplements because most people are not and most doctors do not know about this or if they do they have a strong disagreement with the scientific research community about the possibility of doing this--basically clinical practice is 20 years behind scientific research--but scientist worldwide have shifted to trying to extend healthy longevity not only for the benefit of the increasing large, longer living aging popluations (the largest of which are in USA, Chna and India, but also to prevent countries from becoming bankrupt due to increasing medical costs--so we can keep you alive for 99 years but with many operations and hospitalizations -not the best choice,so , since people are living longer and the number of knee replacements and cardiac illnesss treatments are bankrupting all our medical and insurance systems, the doctors have to go by the statistics and assume your risk increases with age. Personally, I am doing both--continuing sotalol and warfarin--but taking MK7 12 hours before the warfarin and using various supplemetns and foods that scientists all over the world are saying will mitigate against verious aspects of aging. . You might be interested in the blog by Vince Guiliano vinceguiliano.com This is by Vincent Giuliano Dr.,Phd-his blog is about the science and technology of Longevity. A useful post is about dietary flavonoids that activate Nrf2 and sirtuins--these 2 things keep the mitochondria in great shape . Your body is programmed to produce stem cells for your entire life and the job of this cells is to repair damage in any organ of your body. However the stem cells will not be alive unless the mitochondria are in good shape-- another website agingsciences.com is also interesting. These sound like they are not about afib, but they are in the sense that these are periferral things that strongly affect the healthy functioning of your heart. If you are not averse to reading the science in these blogs and articles you might might the information useful to extending your health longevity ( which by the way includes your heart obviously).
Also read about NR (nicotinimide riboside-invented by MIT scientists) on the website biofoindations.com and Dr. Rhumberger's research on using 300 mg twice a day to reduce lipids, and nexrutine ti reduce cox 2 and 5-loxin (boswellia) for 5- loxin. These are inflammatory cytokines when too high can trigger afib since inflammation is one of the triggers. Just a thought- you canread about these on biofoundations.org
Thanks a lot!! Shall read it several times before I understand though!!
I know my EP should know best .
Post Ablation
Post Ablation
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