If your ablation went well and your EP said OK to stop blood thinners would you agree to that?

venicearrhythmias.org/wp-co...

academic.oup.com/europace/a...

It won't be too long that what seems pretty obvious, that ablation has the potential to reduce stroke risk, will be shown to be probable in some big prospective trials.

But I know that even if I have a successful ablation I won't ever stop my thinner till it becomes too risky to carry on taking it. If I started having AF without being aware or during my sleep I could well have a stroke if I wasn't protected

[UScore]

I have literally just come out of my ablation pre-op assessment, were they told me if the ablation is successful I'd be taken off anti-coags after 3 months.

[Hidden in reply to UScore]

Are you on them now? With your 0% stroke risk score I'm guessing you are happy with the advice. What would persuade you you ought to go on a thinner in the future if your Chads went up?

[UScore in reply to Hidden]

I'm on them because of the ablation in a few weeks. Wasn't on them before, because of the 0% score.

My chads score going up would persuade me to go on them! Or if they changed the advice.

I'd possibly stay on them anyway at 0% (if the GP would prescribe them) if it wasn't for wanting to continue playing 5aside football for a few years yet.

[UScore in reply to Hidden]

Interestingly, I was told that if the ablation was successful, and I came off anti-coags, and then reached 65 years of age with no further visits of AF, then I wouldn't need anti-coags then either.

It all seemed a bit too hypothetical and far off to start discussing this assertion at the time!

[johnMiosh]

I have stopped, but my CHADSVASC score was zero, I have had a LAA occlusion and my Left atrium is apparently reducing in size. So I am happy with it.

[KMRobbo]

I am on anticoagulant s awaiting an ablation . As soon as I can I will stop them. I am scared I will get a bang on bike, motorbike , mountain walk etc and get an internal or external bleed

I do not wish to give up any of those activities which are part of my life.

I suspect it depends on what you do as to whether this is an issue.

[RexH in reply to KMRobbo]

I totally agree. Was on pradaxa for year after ablation, went off it my self, told Diabetes specialist, said no problem, as long as go back on it if AF comes back. Do not see cardiologist for 8 months.

Ride bike to gym, and go kaYaking. Type 1 Since 1993, now 66 years old. Take mini aspirin 100 mg.

[Hidden in reply to RexH]

RexH

Aspirin why? Primary or secondary prevention?

Not without risk .PPI cover?

? Clopidogerol

[seasider18]

You could get a Watchman Device or an Amplatzer fitted and not have to worry about taking NOAC's

[andy1875]

I came off warfarin about 5 months after ablation which was in april 2017 and so far i have been AF free since ablation.I have CHADS score zero and when i used to get AF i was instantly aware of it.All medication carries a small risk so its all about risk versus benefit.So at present i dont have AF so presumably risk is greater than benefit.Its a hard one to call really as everyone is different.I think you just have to go with what feels right for you.I personaly like the idea of not being on any meds but i do appreciate peoples concerns

[wilsond]

Me too!

[wilsond]

It dependson your score ,mine is 4.Dont think Iwill be off ac anytime,even after ablation

[Hidden]

Thanks. Points all well made.

[fnurd]

Pilgrim3

The counter-argument to yours is that there is now quite a bit of evidence that a successful ablation reduces stroke risk to that of non AF sufferers. In that case the benefits from anticoagulants (reduced stroke risk) are less than the increased bleeding risk (especially for warfarin). There are studies which back this up. In the event of AF returning then the NOAC can be restarted.

However I don't think the answer to this is at all simple. There have been a number of trials on this, with conflicting results. The ones I have quickly looked at have been observational. I suspect this would only be definitely answered by a big RCT, which may never take place.

If my ablation appears to have worked in a couple of months I will try to go through all the evidence and also see what Prof Schilling has to say (I think he may slightly favour coming off the apixaban).