To stop Apixaban 48 hrs before colonoscopy,... - AF Association

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To stop Apixaban 48 hrs before colonoscopy, what if I go into AF during that time, do I cancel and start Apixaban again


Having colonoscopy on Thursday have been advised by hospital to stop Apixaban 48 hrs before. I have PAF and use Bisoprolol as PIP. My AF is, I think, mostly brought on by stress and I must admit I am dreading this. I get so worried before it, I have had two before, and stupidly started crying before my last one. Never thought to ask the hospital what would happen if I went into AF during the 48 hrs when not protected, do I cancel and start the Apixaban, wonder if anyone else has had this experience. Thanks to everyone who replies on this forum, I read it nearly every day but have not enough experience about AF to answer questions, regards, Heather

15 Replies

I remember some years ago I had aflutter and always needed cardioversion(shock pads to chest) to bring me back to normal .As long as I had not been in Afl for more than 48hrs they said it was safe to revert me without blood thinners.

Before being diagnosed I was in permanent Afl for up to 4 years with no meds.

I hope this puts some of your worries to rest.

Remember the risk of having a stroke is, for most people, fairly low anyway. Anti-coagulants decrease it even further. It is standard procedure to stop Apixaban for 48 hours before any invasive procedure. If necessary and appropriate you will be given Heparin (or similar) to help prevent strokes - though there seems to be discussion as to whether this is necessary or appropriate.

I know it is easy to say but please don't worry about it.

Perhaps ask your cardiology team.

Also your GP whether a few days of low dose Diazepam for the anxiety would help.

Hi, hope all goes well with the colonoscopy. Can I ask you, since you say you use Bisoprolol as PIP, how much and is it effective as PIP?

gemsmum in reply to Gwersey

I take 2 x 1.25mg Bisoprolol as soon as it starts. I have a heart beat of around 48bpm most of the time except of course when I go into AF. It definitely slows it down but I usually stay in ‘slow’ AF until it decides to stop, sometimes a few hours but my longest has been around 18 hrs.

Gwersey in reply to gemsmum

Ok just one quick question then I'm done.How long does it take to work?

Thank you for replying.

gemsmum in reply to Gwersey

It varies but usually an hour or two, regards Heather

Hi there! I went into AF while I was off my Apixaban. It happened during the evening after I had taken my prep. (I was actually in hospital at the time) Nobody seemed worried and I went ahead with the colonoscopy the next day. No problems.

Thanks for replies much appreciated, Heather


Isn't the risk of stroke the same weather in AF or NSR?

gemsmum in reply to Hidden

I think you have more risk of stroke when in AF and not anticoagulated.

I had a colonoscopy and endoscopy recently and was not told to stop Apixaban. You make me wonder whether I should have been.

Desanthony in reply to Peddling

I think it depends on whether or not they are intending to take biopsies during the procedure as this may cause bleeding. They also may be preparing to cut out any nodules or ulcers found during the procedure so blood thinners would have to be stopped or a second colonoscopy would have to be done to do this. Of course there is also the risk of cutting or tearing during the procedure anyway - this is rare but can happen but I think they would then give other medication or have to repeat the procedure and repair if any bleeding occurred. For my first colonoscopy where they were just taking a look I was told to stop apixaban 24 hours before but then the Doc needed to do another one to cut out the little polyps he found as that necessitated stopping apixaban for longer so wish the nurses had been clearer about this at my telephone pre-procedure as I would have done that - but the whole thing was a cods up and actually glad I have moved away from that particular hospital as their systems were very bad.

I suppose that removing a colonic polyp would cause bleeding. That’s perhaps why you are advised to stop AC. The colonoscopy on its own doesn’t seem a likely cause of bleeding.

I asked my doc if I could increase my Flecainide / Bisprololto max to reduce the chances of a PAF while I was off the anticoagulant.

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