I am having an operation at the end of the week. It’s not major major but requires a general anaesthetic.
I have been asked to come off Apixiban 48 hours beforehand but because of the timings, it will actually be at least a 55 hour gap, possibly more.
I am particularly concerned as my PAT has been worse recently with almost constant peaks to 100-150+ bpm during day time (particularly when I move briskly) whereas at rest my heart rate is 44-46 (presumably due to my 100mg Flecainide twice daily).
My question is, I suppose, should I be concerned about the more constant high bpm (probably worry about the operation but who knows!) and lack of Apixiban? Or, perhaps the timings are not so terrible after all and I am worrying about nothing...
Experienced ‘hearty’ people, your advice and knowledge is welcomed!
Many thanks
Written by
Rostom
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It might be worth checking on the NICE recommendations by clicking on the link below. Click on “scenario Apixaban” and then scroll down to “Surgery and dental treatment”. If the information there differs from what you have been told, then maybe you should speak to the hospital. Of course, stopping an anticoagulant is always a worry but we are told the risks are low. You will be closely monitored once you are in the hospital and after the operation, which I hope will be very successful.
I was in a similar situation in august and stopped the apixaban 48 hours prior to the procedure, all went well except that i was thinking about when I restarted the apixaban would i get the side effects that I had when I first started them but I never did, i was also given a heparin jab at 3am and then restarted the apixaban again that morning,
If you have atrial tachycardia I'm not sure just how much risk of stroke you have. With AF the risk comes from the irregular pattern allowing clots to form but thinking about ATach it is not irregular it is a constant fast beat. Ask yourself would you worry about stroke if you trained every day three times a day for a marathon and then relax and do as they tell you would be my way of looking at it
It's natural to worry but try not to. Your operation is planned and the hospital will know of your PAF. Two years ago I had an unplanned operation under general anaesthesia due to a sudden onset of appendicitis. I have Permanent AF, AF all the time, for every minute of every day. The difference between Paroxysmal and permanent AF is that I can't feel my heart beating out of sequence.
Because I take Warfarin they recoagulated me intravenously for 12 hours and started the operation at 2.30 on a Sunday morning.
Yes you may feel unprotected as I did. But try not to worry as worrying gets you nowhere.
Just to say, operation yesterday and all done and dusted.
I was not advised when to restart the Apixiban and was bit too doolally to ask, so am giving myself 24 hours from operation and will restart then (later today).
Thank you for the moral support in as much that I wouldn't pop my clogs without the Apixiban! I felt much happier after reading your posts.
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