colonoscopy and A fib

I should be having a colonoscopy but am concerned that the procedure or the prep might trigger a fib. I had a successful cryoablation about 18 months ago and have not had any episodes of A fib since that I am aware of. I do however get ectopic beats which my cardiologist says is OK.My a fib began about three years ago after a mitral valve repair.

I am still on coumadin and probably always will be as the cardiologist and EP feel that A fib may recur. I am also concerned about stopping the coumadin four days before the colonoscopy.

I would appreciate hearing about any experience others have had with a similar situation. This forum is really very informative.

Thanks- Rebecca

25 Replies

  • Hi Rebecca,

    Had the same thing last year, stopped my blood thinner and had the prep as directed, no problems at all with AF and bonus was slight weight loss!!

    You will be fine ,try not to worry.

    Wendi x

  • Use the search on HUL because there have been at least a couple of posts recently colonoscopies in the last few weeks. These are more relevant because practices have changed in the last year or two.

    If worried about stopping coudamin you can always get bridging before and after.

  • What is bridging

  • I think they mean you stop coumadin/warfarin and have heparin jabs daily for 4 days before procedure. Missing jab on day of procedure as heparin leaves the system within 24 hours.

    Perhaps this is a good time to transfer to new generation of blood thinners. Ie rivaroxaban.

  • Icenae is correct re bridging. Also can bridge after a procedure or an operation. However if you were going to transfer to a NOAC then you could only do so after colonoscopy as you would be able to stay on for same reasons as with warfarin.

    However if you do intend to swap to a NOAC then this would be a good time since usually there has to be a 48 hour gap between stoping warfarin and starting the NOAC. Someone recently posted a link to a good document published by Gloucester hospital's re transfer gaps.

  • My biggest concern when I had a colonoscopy was the fact that I would be required to lay on my left side for an extended period - something that so often triggered an AF episode while in bed at home. But it all went well and I had no episode. It makes you wonder how much is psych rather than physical. Anyway, that was in those long ago days before my AF was cured by those wonderful folk at Leeds GI though I still avoid sleeping on my left side to this day.......just in case!

    The purpose of a colonoscopy is to ensure you don't have anything wrong with you that is infinitely more serious than an AF episode. Now, while you probably don't, you should never, never, never consider cancelling this procedure for fear of an AF episode. That's just plain silly isn't it?

    Good luck for a negative outcome....on both counts.

  • Much as one doesn't want AFib to occur, if it does do so during some procedure, one is in the right place for prompt treatment and any ECG taken would be of interest to an expert eye. It's always worth asking for a copy of any ECG that's taken, even if it's normal.

  • I have had a couple of colonoscopies without any complications.

    Needing to have a colonoscopy obviously has been deemed to be necessary and hopefully will not reveal anything else to worry about.

    Best wishes


  • I too am booked to have a colonoscopy on the 8th of Nov . I have had one before this time line you I am concerned as he has said not to stop Apixaban and then goes on to say there's a 1in 500 he could puncture my bowel ! So I'm not concerned about the thought of Afib

  • I just didnt take 1 tablet before my procedure.

  • I think I'm going to do the same miss the night before and morning

  • Don't worry about the AFib. You might have been going to have an episode anyway. What will be will be!!!

  • I've had three colonoscopies. Firstly, check beforehand with the colonoscopy team about medication that you are taking. On the day you will probably be given the choice of an injection of a mild pain killer, gas and air, or nothing at all but holding the gas/air inhaler. If you have an injection or gas and air, you will need to to sit or lie down for awhile afterwards (with a cup of tea and biscuits) whereas if you have nothing you can leave quite quickly. You won't be able to drive if you've had an injection or gas and air. I've had an injection and also nothing (but holding the gas / air inhaler). The procedure is a bit uncomfortable and much like have a cystocopy from the other side. For me Moviprep was the best pre-treatment so that thaere was a clear view.

  • I'm concerned as well, but of the bleeding ... As I always have polyps that the dr I'm really scared to get another one, and I know it is soooo important to get one......anyone else have polyps removed now that they are on blood thinners?

  • I had a small polyp removed last time (3 yrs ) so that is why I'm having another on 8th my consultant has said not to stop apixaban and has said if he finds a large polyp he won't remove but if only small he will I too am scared 😳 scared to stop Apixaban if needed and the thought of bleeding but know I need it done ✅

  • Yeah I am too also afraid to stop Xarelto and scared not too...I am scared to death of bleeding but I know I need to have it done...have had two and both had polyps, not big bit still polyps

  • Has your consultant said not to stop your thinner ?? Mine said he has done lots while taking these drugs

  • I had the same concerns and opted instead to do a DNA test called Cologuard which has recently been approved by the FDA in the US. A recent study published in the New England journal of medicine compared Cologuard with traditional colonoscopies in 10,000 people and found that it caught pretty much the same number of cancers as a traditional colonoscopy. However, it does not catch as many precancerous lesions and polyps (presumably they shed fewer abnormal cells than a cancerous growth) so you have to repeat the test more often (current recommendation is every 3 years) and if it does pick up a precancerous lesion then you have to follow up with a traditional colonoscopy to have it removed. If that unfortunate event happens, then at least you know you are going through the whole colonoscopy ordeal because you absolutely need it.


  • Thanks to everyone for sharing your experiences. I will discuss all the issues with the gastro and keep you posted.

  • Just be aware that doctors and medics in areas other than heart or Anticoagulation aren't necessarily aware of current practices or alternatives and posters on here have alerted them. That's because they still practice what they learnt years ago or what they have been practising for years.

  • I've had "lone Afib" for about 15 years and have had colonoscopies twice, maybe 3 times now and no problems with the quasi anesthesia. Not on coumiden either since I've only had 2 episodes including the first one 15 years back. Just don't think being on drugs of any kind is a good idea unless absolutely necessary, especially blood thinners. All depends on how bad the Afib is I guess. But I do take 80mg baby aspirin a day.

  • Why would it?

  • I had a colonoscopy just a few weeks ago and was told to stop warfarin five days prior to the procedure. Following advice on here I asked for bridging treatment and injected myself with Fragmin for a few days before and after until my INR levels rose again. The anticipation of injecting myself was far worse than the actual act which was truly painless. I had a couple of biopsies during the colonoscopy and passed a small spot of blood but absolutely no problems with bleeding otherwise. Opt for plenty of sedation during the procedure.

  • The first time I had AF was during a colonoscopy last year. It's my feeling it was brought on by the prep causing an electrolyte imbalance.

  • My AF started after my aortic valve replacement in May 2012. I was back in sinus rhythm after cardioversion in September 2012 until I went into AF during colonoscopy in December 2013 as the probe stimulated my vagus nerve. Dehydration from the laxative could also cause it.

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