Rivaroxaban

[TG21]

Does everyone have to stay on an anticoagulant, such as Rivaoxaban, once they have had an ablation?

It has been suggested to me that I will be on it for the rest of my life!

[IanMK]

It’s recommended, yes. The normal blood flow in the atria is impaired leading to the risk of blood clotting and stroke. The risks are assessed according to your CHADSVASC score (chadsvasc.org/) and NICE guidelines recommend anticoagulant used with a score of 2 or more.

[TG21 in reply to IanMK]

Thanks. Shame because I am always conscious of the threat of internal bleeding if I have an accident whilst cycling etc.

[Hidden in reply to TG21]

Bleeding surely fits into three categories - a) controllable, b) life threatening and c) uncontrollable. Anyone, regardless of anticoagulant, is out of luck in the latter case. It's just the middle band that's a bit wider if one takes an anticoagulant and although I'm on Rivaroxaban, I have the feeling that it actually it's not that wide - though I may be wrong.

[IanMK in reply to TG21]

Personally, I wonder if the bleeding risk with a DOAC is overblown. I’ve not noticed any difference in being able to stop any bleeding when I have cut myself. I’d be more concerned if I was on warfarin but that’s probably because of its use in rodent control. I may be wrong, of course, and it’s also possible that people react differently which is the case with many drugs.

[vernaloliver in reply to TG21]

I ride , and worries me on anti coagulant , if I may have a fall or bang my head x x

[TG21 in reply to vernaloliver]

As my Cardiologist and GP say. Ride, it will be good for you, on balance..........just don't fall off!

[vernaloliver in reply to TG21]

Bless you , trying hard not to fal off x x

[CDreamer]

There are no absolutes but the consensus of medical opinion seems to be that it is safer to do so, especially as you get older and providing your HASBLED score is appropriate. You should ask your doctor.

I wanted to come off anticoagulant after 12 months of no recordable AF after successful ablation and had more than one long debate with my EP who would have ‘preferred’ me to stay on them. My CHaDS was 1 - for being female which goes up to 2 when 65. Eventually he told me it was my choice but he would ‘insist’ once I reached 65 Which was then a few years away. Well AF returned about that time and I couldn’t go back on them quick enough. Last October I suffered a small TIA anyway.

Evidently lack of detectable AF doesn’t mean a decrease of stroke risk after you have had AF. I think this ablation therapy is all so new (ie last 20 years or so) that long term affects are still unknown - we are living experiments really.

[BobD Volunteer in reply to CDreamer]

As Dr Gupta said once It is not the AF that is the trouble but the company it keeps!

[icklebud99]

I have been told to keep taking Riveroxiban by my EP for at least the next year after my ablation in April. I am more than happy to take this as the odds of having a stroke are 5 times more for people with AF and that scares the H... out of me, and as I see it, I have not had a major bleed in my 58 years of life, nor have i had a major accident or incident to cause me to bleed out so I am not worried about that and as I have had the odd finger cut and scrape since starting Riveroxiban and the bleed stops after a minute or so more than normal, I am happy to continue with this drug. I will be asking to stay on Riveroxiban for life.

[vernaloliver]

Oh god I hope not , I feel the same as you x

[3killeens]

Had a successful ablation but told I will be on rivaroxaban for life ,just had to accept it ,

[Tapanac]

I have been told that I would no doubt be on Rivaroxaban for the rest of my life. Touch wood all ok and I don't mind as that is better than blood clots and a stroke

[Suzanne-Cheshire]

I was allowed to come off all my drugs once I was 3 months post second ablation and episode free. No problems for a year but then it started up again so I'm back on the meds. Third ablation tomorrow. I would think maybe a lot of it depends on whether you have resolution from ablation and whether you have any heart disease or long term conditions.

[TG21 in reply to Suzanne-Cheshire]

Thanks. Good luck for tomorrow. Wythenshawe? They were great, considering it is a stressful time.

[Suzanne-Cheshire in reply to TG21]

Thank you, it's at Hammersmith Hospital. The ablation team were brilliant there on my previous two occasions.