Anticoagulation and PPI

[Gwelos]

Just post RF ablation yesterday and am on zarelto. Does anyone know if a PPI is needed. Thanks

[Hidden]

Why, do you have a gastric problem? Take it easy for a few weeks, if you need a stomach med get someone to pick it up. Oh and relax.......

[Gwelos]

Thanks pilgrim 3 just a tad worn out at the moment- do have a hiatus hernia but I’m trying to get off nexium and wondering if it’s needed with an anticoagulant

[Hidden in reply to Gwelos]

Not surprised. Wouldn't it be better to stay on the nexium in case your HH flares up or are you thinking it might react with the blood thinner? Is somebody making sure you can take it easy

[Gwelos in reply to Hidden]

Yes I'm still in hospital and my daughter will be looking after me thank you

[Hidden in reply to Gwelos]

Ask your doc why he/she feels the Nexium is necessary and why.

[JaneFinn]

Hi Gwelos, hope you’re recovering as comfortably as possible...

Before I was diagnosed with AF, I had successfully managed to wean myself off the PPI (omeprazole) i had been on since erosive duodenitis. I was SO pleased to be off it! Then with the AF diagnosis (and other risk factors) I was put on a mandatory anticoagulant, and both my cardiologist and EP insist that I go back on a PPI ‘for protection’ because of my previous gastric issues. I have argued, but they insist it’s safer for me and will be needed for ever. I’m now on apixaban and lansoprazole (as well as bisoprolol and ramipril).

Hope you can get some good and clear advice from your EP. Please do let us know what they say

Wishing you well as you recover- take it easy xx

[Hidden]

Ji Gwelos I'm not a doctor but it would seem you would still need them. Ablation is something of a trial and error treatment in that it is often difficult to know if enough cells in the atrium have been ablated to cause the ventricle to function better. Hence, the need for repeat ablations at times. From my understanding the goal of an ablation is to create an atrial pulse that closely matches the ventricular rate as much as possible. The difference in atrial and ventricular rates could possibly create conditions for clots. Hence the need for anticoagulants. Your doctor will probably explain this much better that I have. Ask!

[Gwelos]

Thanks for all the replies I am well and recovering thanks, I think I need to chat to my EP on follow up. Like you janeFinn I was hoping to come off the Nexium because of all the side effects, I have Hashimotos and I think it interferes with the absorption of the mess also not good for the bowel and I have IBS too. I'll see what he says but it's good to hear from you all😊

[fnurd]

I was put on a PPI for 2 weeks post ablation. My anaesthetist discussed this at some length. His purpose was to reduced the risk of relatively rare oesopageal complications. He emphasised that there was no hard (ie clinical trial data) to prove efficacy, but he thought it was a worthwhile precaution, which seemed reasonable to me. As a medical statistician I know that an absolutely vast clinical trial would be needed to prove efficacy, so unlikely to happen.