Hi, I am now 2 months post ablation- no runs of AFIB, but I have been plagued with some palpatations. That being said, my main concern is repeated gastronomic problems- acid reflux to the point where my voice is raspy and I have a nagging cough. I know that GERD can cause these symptoms, and I have struggled with acid reflux prior to the August ablation; however, since the ablation, things have worsened.
This past week, I was hospitalized with stomach and back pain that moved into my chest. I thought I was having a heart attack, so I rushed home from a luncheon to the bathroom; constant constipation was no longer an issue! The results of the ED visit was : no cardiac issues; however diverticulitis was diagnosed along with the problems associated with Gerd.
While in the hospital, a gastronomic doctor came to see me. She wanted to do an endoscopy that day, but I wasn't cleared by my cardiologist. Well, today, as I sat in the cardio' office, he spoke with the gastro doctor. He told her, " my patient is 2 months post ablation; she can come off of the Eliquis for 48 hours prior to the procedure." The gastro doctor set the endoscopy up for Monday afternoon, without consulting me first. When I got to her office to pick up the paperwork, she told me to stop the Eliquis for 72 hours. When I inquired as to restarting the Eliquis, she said 2 days later!! That's 5 days without the blood thinner.
What do you people think??? You have given me good advice in the past; please weigh in!! ( I am nervous as hell to acquiesce to her demands)!!!
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Clarajoan
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The risk between clot and bleed is always a very difficult one.
I wonder if your gastro doctor understands that Eliquis half life (the time it is effective within the body) is 12 hours? I wonder if many doctors still believe all anticoagulants behave like Wafarin?
I think in your shoes, I would challenge her and say you are very unhappy with the contradictory advice and would like her to explain to you her reasoning for wanting that, but if you had to choose you would like to follow the advice of your cardiologist (heart first) and stop for 48 hours prior to the procedure and all being well, restart the day after.
I wouldn't do that without negotiating and informing your doctors and seeking a consensus.
A very personal opinion and not advice, but do get your dilemma.
I agree... even the ablation did not require 72 hours Eliquis free, and I was started in the medicine the day after. I am very leery of the gastro doctor acting as if she knows more than my EP. I am calling the cardio doc first thing Monday. I will also ask my GP for the name of another gastro doctor.
When I severed ghe artery in my left hand 2 years ago (oops) they firstly had to inject me with Vitamin K to counteract the Warfarin and stem the bleeding.
Then when they had completed 3 hours of microsurgery to repair all the nerves tendons and my artery, later that day they then injected me with heparin.
I know. Drama...something we don't need more of in our lives. I've read where some docs forgo the heparin for some procedures. And, as I understand it, heparin is not used for the newer anticoagulants? Not sure.
I too have to go for an endoscopy on 10th October due to severe gastro problems post ablation (4 month now since ablation) and there has been no mention of stopping any medication except the ppi, omeprazole, which I'm suffering badly from stopping!
Oh dear, how very uncomfortable for you, but PPIs are not good news long term so I've always avoided them, even though every doctor I have ever seen wants to prescribe them - ironical!
I was scheduled to have a lumbar puncture whilst in hospital in May and only had to be off Eliquis for 48 hours in total. I would not be happy being off it any longer especially with a recent ablation. Best wishes x
I had to come off warfarin for my colonoscopy - also diverticulitis. It is essential to come off anti-coagulants as they may want to take samples in the colon and they don't want the problem of stopping you bleeding. Obviously it's a small risk of stroke but for a week it's not that likely.
If it were a colonoscopy, I would be more inclined to understand the duration of non-Eliquis, but the endoscopy is less invasive. Honestly, I think the gastro doctor is being overly cautious to cover her own butt. I think I need to find a gastro doc willing to work with my EP.
CDreamer made a crucial point. Some of the advice you had seems more appropriate to Warfarin than the drug you are on.
For anticoagulation, as said, it is always a good idea to insist that the cardiologists have the major say.
There is a difference of opinion out there. That means, the doctors really should be outlining the possibilities for you, with for and against each of the several options.
Crucially, there are different practices. Power and authority and tradition, with deference to the expert (out of date? fearful of litigation??).
There is also the balance of doubt. In the minds of many doctors, the risks of doing something, like bridging therapy, are acceptable even though there is loads of evidence against them. But the risk of NOT stopping anticoagulation are seen as unacceptable. I think the opposite.
You hit the nail on the head! I sat and listened to my EP say-" 48 hours"; the gastro doc decided 72. And then told me 2 more days until I resume- that is not what my EP stated.
Even after the 4.5 hours of surgery for the ablation 2 months ago, I was given Eliquis the next day! I am very leery of the gastro' understanding of the need for the anticoagulant; thus I am not going to use her.
I have an appointment with my GP next week, and I will ask for a referral from him. I also think I will wait until the 3 month mark to pursue the endoscopy- I can deal with bland foods for another month.
After all of the upset and worry about the AFIB, and after what may be a successful ablation, I do not want to undo the positive results I have obtained!
I had to stop for exactly the same procedure but insisted on bridging - they prescribed fragmin which I self-injected with absolutely no problems at all. Best of luck!
I had my blood thinner stopped for 5 days before having pace maker fitted, but went straight back on it after , and they phoned me from the clinic to tell me to get back on it but I had already done so , my INR had dropped very low to 1 so had to increase it for a few days, before I had the pacemaker fitted they had trouble getting blood from me , I think it was because had left me to long without the blood thinner, but everyone is different, but if you are not happy I would ask to restart it again.
I don't like taking Omeprazole but have to because of constant reflux caused by a hiatus hernia. However I now only take 10 mg every other day.On the alternate days I have a cup of hot water with the juice of half a lemon squeezed into it and add half a teaspoon of bicarbonate of soda. An old remedy but it works.DGL liquorice tablets (Amazon) also help. Acid reflux definitely affects my AF.
It creates palpatations for me. I am sure my nagging cough is also gerd. I will try your old remedy!!! Thanks for the information.
Hi Clarajoan,
I am on warfarin (coumadin) for life. I have twice had to come off it for medical procedures. Once for a CT scan and the second for partial knee replacement surgery.
In both cases, I had to stop Warfarin 1 week before the procedure. The knee surgery was by far and away the more challenging and as soon as I came round after surgery and was back in my ward I was given two injections of the bridging anticoagulant Fragmin. Later that day I returned to my normal daily warfarin dose.
No problems.
In both cases it was 29 days before my INR readings returned to the desired theraputic range.
But hey, I'm no medic or doctor or anything but I'm gonna stick my neck out and say that it is always possible that your ablation aggravated the vagal nerve in some wacko way - this nerve controls/regulates many body organs but most notably heart and digestive system. I've managed to tame mine by dramatically changing my food intake and have been AF free since April 2015.
Suggest you Google, vagal or vagus (meaning 'Wandering') nerve and also look at schematic diagrams of this nerve.
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