afib and surgery

[brit1]

I have had AF since 2010 when a stupid dr overdosed my thyroid meds. I convert at home and HR is under 100 while in it. I am on Eliquis and metoprolol ext release 25mgs daily but I take metoprolol tartrate 25mgs when I go into AF. I eat plant based diet/slim/fit/85yo female. I usually have a total of 4 episodes a year, sometimes close together, sometimes a few months apart. Was disappointed today to wake up with an episode (last one was Nov 23) as I need to have surgery for an eye that has ptosis (a medical surgery not cosmetic). I had picked an ophthalmologist/ocular surgeon and was scheduled for next week but cancelled as I discovered another one that has huge ratings and experience and decided best to go with him but now surgery will be a few months out. My fear is that I will go into persistent AF prior to surgery which would then be dangerous to come off the Eliquis. I am so frightened because I had the episode today (HR around 80 and lasted from 4am-1pm). I take magnesium taurate/CoQ10/taurine/hawthorn daily and take extra magnesium/hawthorn when I have an episode.

[CDreamer]

Would your surgery mean GA? My husband had eyelid surgery with just a local. As I suffer paroxysmal ptosis as a result of neurological condition I know how irritating it can be. I think it unlikely your AF would suddenly become persistent within a few months but no one ever knows with AF.

I would have thought it very unlikely you would need to stop Apixaban, I’ve had 2 surgeries and not stopped - just didn’t take my morning tablet and they ‘bridged’ me with an injection - I think it was heparin and I took evening dose as per normal so I don’t think you have anything to worry about but ring the surgeon and ask.

[brit1 in reply to CDreamer]

thnx for response. Yes it would be IV sedation apparently due to age/af otherwise I would certainly just have local. Would have to stop Eliquis 2 days prior I have heard of heparin being used as a bridge.

[MWIC]

Hi - Why do you think your AF will turn to persistent if you only normally have 4 episodes a year? I had episodes every 2-3 days for a year and still paroxysmal ?

[Tapanac]

80 isn’t high. Hopefully it would have calmed down before surgery

Best wishes

[Vonnegut]

I am almost 80 and have found taking 100mg Flecainide twice daily has virtually put an end to episodes of AF for me ( just one when I must have been infected with covid, ended in a couple of hours with an extra pill almost a year ago). I too have a healthy diet and have never been overweight but I did acquire chronic fatigue around the same time as the heart condition so no longer able to be as active as I used to be. As I don’t have episodes I no longer take anticoagulants any more.

[Modog]

i’ve had two procedures which required me coming off Eliquis once for 24 hours and once for 48 hours. Fortunately everything turned out fine. Wishing you the best.

Bill

[WildIris]

I doubt the overdosed thyroid would have caused PAF for so long. It certainly could have given you an episode until the thyroid meds cleared. Just that I have thyroid issues and PAF too, and too much thyroid med can definitely make me more likely to have an episode, but that's it. Just a comment.

My ex-husband has had AF for 40 years, is near 80, takes apixiban and recently stopped it for 2 days for a procedure, but he's never ever worried about AF, and this didn't worry him either. Seems like you have a fairly light AF burden, and are doing everything right, including asking this question, so yay.

[JOY2THEWORLD49]

Hi

Metopolol did nt control my H/Rate Day avge 185 bpm. Pauses at night, breathless on exertion, exhausted, sleep heaps. Asked for a public heart specialist at 1 year 4 months as no followup to stroke, with rapid AF and 4 stays still in hospital they diagnosed thyroid cancer through the carotid arteries scan.

Changed to Bisoprolol another beta blocker and better for Afers. Still uncontrolled @ 156bpm Day avge.

Left and annoyed - still sweating uncontrollable the Locum Dr suggested her preferred private Cardiologist.

Introduced CCB Calcium Channel Blocker. The 156bpm fell to 51 on Diltiazem 180mg 1/2 dose. Revalued to

AM Diltiazem 120mg controls H/Rate Day - now down to 60s after 6kg weight loss from higher 86-96bpm.

An Anaesthetist will not operate if you are over 100 at rest bpm.

I have had 3 operations since stroke - thyroidectomy, Johnson & J mesh sling out, R Shoulder rotor cuff done Oct 30 2023.

With all 3 ops I stopped PRADAXA 3 x clear 24hr days prior to op day and 2-3 days after. No problems. I take PRADAXA 110mg x twice day.

I also take Thyroxine Synthroid 125mg daily.

I am knowledgeable and keep a watch and maintain my meds.

I am sure that you will be OK.

Take care, JOY 75. (NZ)