hi all I am new here, just wondering I am due to have a liver biopsy next week really worried.
I am on apixaban for atrial fibrillation and have to leave it off for 5 days before procedure just wondering when can you go back on it after the biopsy and has anyone on here had liver biopsy whilst taking anticoagulants .
What does you cardiologist say about the five days? This is excessive for the new oral anticoagulants. Maybe OK for warfarin but the new ones do not need that long at all. They usually only need a day or so as they have a very short half life. Please speak to your doctors about this as i suspect that the hospital are not really up to speed on these drugs and are basing the advice on warfarin.
thank you for replying I was supposed to have the biopsy last week but it was cancelled there was a big fuss over 48 hours or 5 days i had already started to leave them off when I was told it was cancelled it seems to be ultrasound dept that are saying I have to be off it 5 days and because of this liver specialist is agreeing with them . I have not got a cardiologist well I don't see one. I have taken my last tablet tonight ready to start 5 days off I'm not happy but if I don't they wont do biopsy I have been to see my gp and he says I have to listen but so worried .
I agree with Bob about trying to get a cardiologist’s opinion. I was told by my cardiologist to to off Rivaroxiban 2 days before my ablation 2 weeks ago and in those 2 days a blood clot formed in my heart which they picked up with the transoesophageal echocardiogram (TOE) so my procedure was abandoned. I’d be worried about being off anticoagulants for 5 days, especially as they are unlikely to be checking with a TOE for a liver biopsy. I’m now on Dabigatran and will have the last dose the 24 hours before my rescheduled procedure. I’m 54 and generally healthy apart from my arrhythmias so initially wasn’t even on the high risk list for anticoagulants.
thank you for your reply i am worried sick but the biopsy is next week and i have to start leaving it off today .
It may well be fine but it’s worth asking the question again.
Hi I was on Rivoroxaban last year although i'm now on apixaban and i had an ablation last september but it was planned for the morning so i had to leave the one the day before until the evening! in the days preceding that i had to start taking it a bit later each time so it worked out i could take the evening before, I did not stop at all. i always took it first thing in a morning you see and after the ablation over the following week i had to take a little earlier each day to get it back to morning. In no way was i told to stop as they said it could be dangerous to do so. However mine was an ablation and not liver biopsy.
I suspect that the liver specialists are factoring in the liver's role in blood clotting and clotting disorders. As this this is a biopsy I would think they don't have all the results they need to treat you and are trying to take a middle road. Sometimes there is no right way only the best way for you and the specialist is trying to do that.
yes thank you for your reply i think i will just have to do what they say i would like to know if anyone else has left them off for 5 days though say for a big heart operation .
I become more and more convinced that hospital staff have not come to a consensus where stopping new anticoagulants are concerned. This year alone I have had several procedures including surgery and different instructions from various depts at my local hospital.
Gall bladder removal, had to stop rivaoxaban five days before. I asked my top notch EP if this was reasonable, yes was his reply.
Endoscopy told to stop two days before.
Colonoscopy told five days which I challenged and agreed to two days.
Having a 24 hr ph test which requires a tube down my throat to stomach for 24 hrs they said not to stop rivaoxaban.
Four years ago told to stop five days before and EPStudy which was reduced to four days by the consultant.
It's a minefield, looking on line different hospitals suggest different timeframes for the same procedures.
In your case five days fits with my surgery however please check things out with your hospital consultant and a cardiac consultant. Best wishes.
I'm in Uk , thank you for your reply . i cannot speak to anyone today as its Sunday i have had conversations with a number of people about 5 days off and basically feel like a nuisance ,cannot get hold of anyone i don't know who my cardiologist is. i was referred to someone when i suffered a TIA then put on apixaban and that's been that I'm afraid i have the procedure next week and have to leave them off from today i noticed you said you were off them for 5 days obviously no harm came to you so that makes me feel a little better that some one else has left them off for 5 days so thank you for that information.
Hi thanks for your reply i have had a fibroscan but still having lots of symptoms only started with these liver problems when i started taking this medication well worsening of symptoms i should say I'm a non drinker and smoker but take lots of different medications for different illnesses so think that's why the liver biopsy for a definite diagnosis.
How about a second opinion from another specialist ?
thank you for your reply and best wishes much appreciated.
What a quandary for you, especially as you are not on a cardiologist list and hence more difficult to speak to someone.Is it possible to ring the cardio department and ask If they have an arrhythmia nurse? They are very good,and can speak directly to the doctors.How often do you have AF? Sending best wishes
thanks for reply i never though of that i have left them off now so hopefully i will be ok, I had no choice as I'm due for biopsy in 5 days .i don't have a fib so much now I'm on bisoprolol and they seem to have lowered my heart rate a lot it is now in the 50s to 60s and I am on 2.5mg i do get occasional palpitations but nothing as bad as they were before bisoprolol.
It is very important not to risk bleeding anywhere near the spine. This probably isn't relevant here, but does explain why different procedures may require different times.
Flecainide and liver change 
Anyone else have bronchitis and liver issues post ablation?
Liver
