Can anyone tell me if you have to be on bloodthinners if your having a cardioversion or ablation
I'm seeing EP for first time Thursday and will be pushing for ablation bit I'm not taking a blood thinners as my cardiologist felt due to me only scoring 1 on the Chad whatever ever it is test I didn't need them ar this time ...I only take verapmil 40mg 4 times a day and they aren't controlling my afib only my blood pressure
YES in simple terms.
If your AF started less than 24 hours ago then cardioversion may perhaps be performed or if longer one would need a TOE (trans oesophageal echocardiogram) where the put a camera down your throat to look into your heart to check for clots.
For ablation it is necessaray to have been anticoagulated for at least a month and remain so during and for a period after the procedure.
Mmmm...ok thanks.Bob ....I feel I should be on bloodthinners anyhow as a precaution even of I do score only 1 on the Chad stroke risk assessment as since I was diagnosed my afib and become a lot worse
Anticoagulants ( they don't thin blood) are recommended from 2 and considered at 1 but it is hard to understand how a lady can only score 1 unless you are young and have no co- morbidities. My own opinion is that AF should mean anticoagulation unlesss there are good reason not to prescribe them. (I think the score of +1 for being female only applies if there are existing scores. So age 65+ and female =2
Well I'm 53 with no other health conditions and structurally correct heart ..so guessing that's why I scored 1 bit I did question it and have continued to do so .Will mention. It to EP
As I said, I do not believe that you add the 1 for female unless you have an existing score so to my mind you are 0. In fact some specialists question the need for the +1.
Blood thinners/anticoagulants are necessary after an ablation because your heart needs to "remodel" (electrical signals) after the old, nasty pathways or circuits are cut off. Immediately after the ablation and for a period of about 3 months, you may have worse AF and new irregular beats. Blood thinners are absolutely necessary during this time because you can develop clots while your heart is healing, beating inconsistently, and developing new "circuitry." I don't now about cardioversion requirements.
I had ablation four weeks ago and my heart beat was variable (occcasional slow pace & irregular beats) for about 2 weeks. It has been very consistent since. My doctor required blood thinner meds for at least 90 days post ablation.
Ok thank you for your input Trying to gather as much info as possible before my EP app on Thursday
Went through ablation in OCT while on Apixaban (no stoppage). I may get a WATCHMAN Device installed this summer, then I can get off the blood thinner for life. Age 67.
Hi Suntanann, do you have high blood pressure? That would be one + one for being a female.
My EP put me on PRADAXA (Dabigatran) A/C 25 days prior to my ablation , and kept me on it until after my 3 month post ablation review. I was cha2dsvasc2 zero.I understood that this was to ensure that I did not have any blood clots at the time when I was having the ablation.
As my Afib was well controlled by flecainide/ Diltiazem and I had no AFIB attacks for over 3 months prior to the ablation anyway I suspect clots would have been unlikely. ( Not medically trained).
Hi Ann, if you are going to have a Cardioversion then irrespective of your Chads score you should be on an anticoagulant for a few weeks before and after the Cardioversion. The Chads score is relevant regarding the need for long term anticoagulation. The following is from the NHS website;
"Cardioversion may be recommended for some people with atrial fibrillation.
It involves giving the heart a controlled electric shock to try to restore a normal rhythm.
Cardioversion is usually carried out in hospital so the heart can be carefully monitored.
If you have had atrial fibrillation for more than 2 days, cardioversion can increase the risk of a clot forming.
In this case, you'll be given an anticoagulant for 3 to 4 weeks before cardioversion, and for at least 4 weeks afterwards to minimise the chance of having a stroke.
Anticoagulation may be stopped if cardioversion is successful."
Hi, I had to take Rivaroxaban (anticoagulant) 1 month before my ablation and 3 months after which is standard practice.
If your EP can get you in for an ablation quickly, the sooner you start taking the better.
Regardless of your CHADS2 score, I’d still want to take them for now until you have a treatment strategy in place. They are not addictive and for me had zero side effects (you have to be a little more careful picking up cuts).
I’m no longer taking anymore since (fingers crossed) I’m pretty much free of Afib. There is a wider debate whether you should continue to take anyway but I’ve made my own choice on that for now.
Thank you thump ☺
Hi Suntanann,I had an ablation on 5th November 2019 and am now af free. I am still on anticoagulants as prescribed by the doctor and have to be for the rest of my life. I am quite happy to take them as af is in the family and the risk of stroke may be high for me.
Good luck .
Flyer
I would expect you to be on an anticoagulant prior to cardioversion as, if there is a clot lurking, you don't want it jolted into action. If not anticoagulated, then they would probably need to do a TOE as Bob mentioned. Personally, having had an endoscopy, I wouldn't fancy that at all.
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