Getting Off Blood Thinners after ablation

[Jjda]

Have any of you who have had "successful" ablations (not sure what is considered a successful ablation) talked to your EP about getting off blood thinners? I have read a few articles that indicate the risk of serious bleeding by staying on OACs after successful ablation outweighs the risk of stroke. My ablation was last September, and I have had no incidents of AFib since. I am not even going to broach the subject with my EP until it has been at least a year, but I am 67 years old, started on Eliquis last June, had the ablation last September, and do NOT want to take Eliquis long term, if I can avoid it.

[Dawsonmackay]

EP's typically recommend continuing anti-coagulant therapy for one year after a successful ablation.

[bigking]

My EP told me on last appointment that if still in rhythm in July he will take me off Xarelto. My second ablation was in March.

[BobD Volunteer]

Most of us prefer to stay on anticoagulation for life. There is no meaningful data which suggests that successful ablation removes stroke risk so if it existed before then it still will. Of course if you only went on a/c for the purpose of the ablation and recovery then you may decide not to continue. The big question is do you know 100% that you never have AF events? Many people are asymptomatic.

I would not agree regarding the bleed risk either. I have been taking warfain for over 15 years, do normal things like building race engines using machinery and sharp instruments, frequently cut myself and have never had a serious bleed. My wife even managed to hit me on the head with the tail gate of her car as she slammed it on my head and I survived. She is still trying I think. lol 😁

[Jjda in reply to BobD]

Just curious, do you stay on Warfarin instead of changing to the more recent anti-coagulants because you don't have any side effects and you don't want to risk changing, or is there some other reason you prefer Warfarin? I take Eliquis, and have not had any serious bleeding, but have only been on it for about a year. I have been hyper aware of hurting myself, and carry extra bandaids everywhere I go. It makes me feel old and sick, and I just don't like meds, but will do what my EP suggests until I can overwhelm him with research.

[BobD Volunteer in reply to Jjda]

If it aint broke don't fix it. My INR chart shows better than 85% in range over the last 5 years which actually should give better protection than DOACs. Any comparisons seem to be based on 75% in range. In fact there are only six dates in the last three years when i dropped out and the lowest of those was 1.7 This becasue I did as I was told not what I knew I needed. With zero side effects I would need to be certified insane to change.

As others have said elsewhere warfarin has been used since the fifties (Eisenhower was one of the first famous people to use it) and there is nobody on this earth has taken a NOACs for ten years yet.

[allserene in reply to BobD]

lol...when I broke up with an ex girlfriend, she knocked on my door at 1am and punched me in the nose.. Much blood all over the kitchen. I wasn't on a/cs in those days.. If I ever get divorced and go back on match.com, I will be sure to get off a/cs. These 2019 gals are not like Victorian ladies... ok seriously now, I thought I took my little 25mg metopropol last night, but must have dropped it. Luckily wife's cat didn't get it and wife found the pill just now.., but I felt semi flutter a.m. today and the monitor was giving me weird readings... I must be MORE CAREFUL ! These drugs are powerful ... If the bloody cat had eaten the pill and if the post mortem fingered me, then a divorce would have been certain

[jedimasterlincoln]

I remember when my dad commenced Warfarin, mum stopped him washing up incase he cut himself. He hasn't done any washing up since. That was over 10 years ago. He has no AF symptoms but has other medical problems like high blood pressure, a high BMI, etc...

I have only really been antigcoagulated (Warfarin/Apixaban) for ablation, my CHADVSZYX(!) score has always been low due to age and so on, and my AF has always been severely symptomatic/debilitating) and I have discussed this at length with my EP/GP. They consider me to only need to be on it if unstable/awaiting ablation/having an ablation and usually only for 6-10 weeks post ablation.

Everyone is different.

[Hidden]

Why come off? I have no issue taking Apixaban.... I’ll take it as long as I’m told to. I don’t want a stroke.

I’ve had surgery and a few instances of bleeding.... with no issues. Seems fine to me.

[Ianc2]

I don't like taking pills - but having seen one of my relatives have a devastating stroke which completely wrecked her life and left her in a very expensive, barely satisfactory care home, I regard warfarin as an essential pill every morning Take care.

[Hidden]

Not sure if you are male or female? If female, your Chads score is at least 2 taking age & gender into consideration & assuming you have no other risk factors. If this is the case, take the anticoagulant & regard it as your best friend. You never know when AF may return & don’t want to risk a catastrophic stroke.

Take care

Pat x

[MydogBrandy]

Hi , I was taken off mine straight after my ablation which was successful but my ablation was for tachycardia , svts and they said they could not see any evidence of AF So I was told that that was the reason I could come off them. This sounds to me that if I had had AF they would have kept me on them.

Hope this helps but I would check with your specialist . I understand what you mean I am 70 and hate taking tablets so it was lovely coming off all heart tablets after taking them for 18 years.

Good luck x

[allserene]

People often say ah but what if its 'silent af'. My first thought was "If its silent then ANYONE could have it right now". My second thought was that this holds true, but surely a proven afibber is more likely to have silent afib than someone who has has never been shown to have it (silent or shouting).. Does silent afib work like that ?

[allserene]

Interesting ! I had been having 'palpitations' for at least a week and went to the docs and asked him for an EKG... He did it and reported pulse 150 and atrial flutter, not afib... Go to emergency NOW !... They had no problem getting me on a cardizem drip and down to pulse 75...but it wouldn't stay there, and every time they turned off the drip, it went back to 150....... So at 2am they gave me metopropol beta blocker AND a cardizem drip and turned my heart off full stop ! I saw the pulse go to 43 just before my heart stopped. Big panic ! Anyway, if 'silent afib' is rare, and if you and me are now very aware of flutter/afib syptoms, and we have a monitor and a supply of fast acting anti-coag (Eliquis)...... I reckon one day we can stop the anti coag and still be anti--coaged fast if we have an event... Just a theory...

[allserene]

I agree, and ablation is my route to no meds eventually, but will the EP agree to ablation when I see him in July after only one; ok one a half, flutters ? The studies are all showing early ablation is the most successful ablation... The hospital did say they suspected my problem stems from the left atria which is unusual. Maybe that is harder to get at via a catheter.. All will be revealed one day, but I am glad my max annual out of pocket is 5,900 and I am determined to stuff all the procedures in this insurance year...

[Jjda in reply to allserene]

I had my ablation after just one episode of AFib last June that landed me at the ER, where they got me immediately back to NSR with a Metoprolol IV. I went to the Cardiologist the week after and the EP the week after that. He gave me the option of staying on meds and seeing what happens or having the ablation, so I opted for the ablation in Sept 2018, only to find out I still have to be on the meds. But, I have had no more Afib, even with monitoring by a 30 heart monitor and my little portable Kardia Mobile.

[BC50]

After my ablation E.P. has me still on blood thinners

[allserene in reply to BC50]

How long since was the ablation ? I read stuff that suggests 3 months blank period while it all settles down and they know you are nor afibbing...and if it isn't 100%, they do two or even 3 retries the ablation..

[BC50 in reply to allserene]

Yes unfortunately you are right. My first ablation was Halloween day 2018. After a number of visits to EP given a clean bill in February. When he lectures he uses mine as an example. Then in April afib returned. My problem is that I do't feel it. HR 207 in ER. Another ablation on the Friday and Afib back on Monday. Had shock and on Amiodarone with all of it's side effects. It has been 3 weeks now but, I feel I have more energy. BTW bought the apple 4 watch. It checks HR and does an acg

[allserene in reply to BC50]

Wow you have had a rough ride ! Hopefully it will settle soon. They do reckon it takes multiple goes quite often, but with a very high success rates with the follow on procedures... (Process of elimination) ...Hope you are improved soon but you are nearer then end of it than the start...

[BC50 in reply to allserene]

thanks

[allserene]

The hospital was a nightmare with screaming lunatics shouting all night and the doctors went through in 10 seconds and they and the nurses all had a different replies to my questions.. I was sat there, back in sinus rhythm, and they were keeping me there day after day and postponing procedures over and over (maybe tomorrow). Telly was on the blink and shower curtain in rags etc etc...and they stopped my heart ! I just checked out. Shredded their 6 page questionnaire which had self congratulatory questions... Never going to that hospital ever again... Can't say their name but it's Wisconsin and rhymes with "pay dirt".. I converted myself with meto the next time......

[allserene]

In Wisconsin I use United Medicare Advantage which has the Obamacare limits built in... I pay zero premium and they administer medicare.. But I pay 550 a month to medicare as I have no medicare entitlement built up.. That figure is based on 'cost' (no profit) per the government actuary.. Wife pays double for regular market insurance as she is a young chick short of medicare age...... I got a $27,000 Cyberknife op on my prostate 2 years ago and I stuffed as much as could in that year...everything except a nose job ! Wife had a 2 hours outpatients kidney stone job for a 35k bill, her limit is 7k...so annual limits are wonderful ! 193,000 can be racked up so easily, and after donkeys years on the NHS, I am still shocked... I was charged $185 in 2008 in Washington State to say hello to my new doctor who had to met me before adding me to his list (15 seconds meeting)...

[allserene]

Wow that was quick....Months for me to even see an Ep ! With my suspected left atria problem I may have to do some kind of investigatory procedure before ablation. TEE esophageal ultrasound scan at least... Don't know......I expect to be on meds for 3 months after ablation by all accounts.... Anyway good news that they do ablations after one event !

[guitarman57]

I am 65 on my second ablation. I stopped Pradaxa one year ago and my doctor just ordered Xarelto for me. I am the same in where I do not want to go back on thinners. I am doing some statistical research but also also realize good data will be hard to find.