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AF Association
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What about stopping the anticoagulant for another procedure?

I have AFib and I'm on Eliquis. I'm due for a colonoscopy. I'd have to stop the Eliquis temporarily. My dr will have an opinion but I'm wondering what others do. Forgo the procedure? Opt for an alternative perhaps? Accept the risk of stroke from being off the anticoagulant? I'm just starting to research it.

Thanks for your opinions.

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My suggestion would be to hook up your colonoscopy doctor with your Electrophysiologist and have the 2 of them work out a plan for how to handle your anticoagulant meds for your colonoscopy. I have done things this way for dental procedures, a pacemaker, an ablation, a cholecystectomy and it has always worked out fine. I was on coumadin and the docs involved always let me know where they felt my clotting times should be and how to achieve the correct numbers. I never had a problem.I am off anticoagulants now as I had a left atrial appendage occlusion this past January so this is no longer a problem. Letting the doctors involved make joint decisions seems to me the way to go. Good luck with your procedures. Take care. irina

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Depends partially if you are in NSR or afib now. If you are in afib or going in and out of it I would question the reason for the colonoscopy. If just routine screening I would be hesitant to stop the eliquis. If you have been in NSR I would worry less. I would also question the gastroenterologist if he/she feels it is absolutely necessary to stop it. The risk of bleeding is low unless a biopsy is done or polyps are removed.

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I was potentially in that situation being coagulated and needing knee surgery, normally the surgeons ask that you stop it 5 days before, and you can usually recommence soon after. My cardiologist didn't have a problem with this as it was short term and only a week. Fortunately I opted not to have anything surgical.

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If you remain anticoagulated you’d presumably be in the right place to be able to handle the situation should a bleed occur. The Eliquis doesn’t prevent clotting, just extends the time a little.

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I’ve stopped my Apixaban 2 days prior to pacemaker implant. As the half life of the drug is 12 hours I am assuming that it will mostly have cleared my system by then. Wafarin is a different matter and I think you need to get tested but everything is weighed against the bleed risk and any invasive procedure will increase bleed risk. They will often give you something to bridge the gap if required.

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I had the same procedure three weeks ago and had to stop my rivaoxaban anticoagulant for several days before. This past year with various procedures undergone I have had to stop it a number of times.

My EP was happy for me to do so as the procedures and operation were necessary, I didn't have any problems. Speak with your cardiologist for their opinion. It's a regular occurrence I guess for people needing to temporarily stop for some medical procedure or other.

The first time I had to stop it I was nervous but not so much now.

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They deal with people on Anticoagulants daily. What have they said to do?

I had a colonoscopy earlier this year and stopped taking my AC for two days or whatever was required.

It's a small, calculated risk

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Same here have had to come off warfarin many times including a colonoscopy.

It's important for that to go ahead in Afib or not ,don't worry about it you will be fine

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Thank you all for your comments. It's true that the elevated risk will be confined to a very small window. I also thought they could check the prothrombin time with the Eliquis. It might have a different effect in different people. Of course, my cardiologist will be involved in the decision. Thanks again.

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Couple of things to add to irina1975 reply.

I had my cardiologist and urologist get together about stopping anticoagulant for prostrate exploration.

Also I had a left atrial appendage occlusion whist having OHS in Jan 2016 but am still on anticoagulant. Doctor says it won't cause problem and better safer than sorry. I am happy with this.

Hope this helps you.

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Yes, there are standard procedures for coming off anticoagulants. One of them is known as the Heparin Bridge. A few weeks ago a relative was released from hospital (stomach ulcer problem) and took heparin injections, while they brought up his warfarin slowly -- a new method to me.

The Heparin Bridge is known to give problems in its own right.

There seems to be a historical trend away from the Heparin Bridge. to operating with continuing anticoagulation. You can google the different opinions on any procedure. The problem is of course, that not everyone moves with the times, and each team will do what they want.

You might get a doctor willing to listen to your own preferences about relative risk.

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I had a colonoscopy last year and my cardiologist took me off Apixapan (Eliquis) for a couple of days prior to the procedure. The procedure went well and I had no problems with bleeding. I would heartily recommend it as a proven preventive measure against developing colon cancer. The doctor removed removed 2 very tiny polyps that were not precancerous. I am in permanent afib with no symptoms and have a defibrillator implant due to a sudden cardiac arrest a little over 3 years ago. I am 76 in otherwise good health which I maintain with a good diet and regular exercise. Good luck!

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