Cardiologist suggests I can stop taking Eliquis. Any thoughts?

Posted by dsisko @dsisko, Nov 18, 2020

I have been on Eliquis for about 2 years now for afib. I had a successful ablation at Mayo in Rochester in August 2019 and have had no afib incidents that I’m aware of since that time. I track my pulse with my iwatch and regularly track my blood pressure. Both are fine. I’ve been of the understanding that I need to take Eliquis for the rest of my life, however, my cardiologist in Florida has suggested that I could stop taking the Eliquis. Has anyone had a similar situation or has stopped Eliquis because of a successful ablation?

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Very happy to hear about your situation. It’s great to hear something hopeful instead of frightening experiences.👍

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@gloaming

There are pauses in all arrhythmias. If there were no pauses, there could be no 'rhythm' per se. Otherwise, I'm not sure what your meaning is. The point I was making is that, keeping hydrodynamics in mind, that being the science and engineering dealing with fluid flow, an atrium in flutter beats so quickly that it can't fill itself properly, and then expel the volume into the ventricle below it. This is why so many people feel out of breath and faint. Even so, a person I knew was active and didn't know he was in flutter until an EKG revealed it. So, each patient experiences arrhythmias differently, and that is why the medical community tends to deal mostly with symptoms and trying to manage them for the patient's sake.

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You said "I'm not sure what your meaning is".
Well I was replying to what you said earlier and I quote "Flutter is simply the musculature of whichever atrium has it contracting dutifully, as it is designed to do, to signals that come one after the other with no pausing interval."
The part of this sentence that is incorrect is "signals come one after the other with no pausing interval."

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@mjarkie

After my first ablation, six months of no return of the AFib including 30 days of heart monitoring, I was off both Pradaxa and Sotolol. Ten years later I had my second ablation done in 2021 and was all set to get off the Sotolol and Eliquis. At my first checkup I was told that I no longer needed to take the Sotolol but I should take the Eliquis the rest of my life because of my age (73 at that time). I took the Eliquis twice a day for 2 more years dealing with bone, joint, and muscle pain daily which I finally discovered could be a side effect of the Eliquis. I was told that that was not a side effect of Eliquis so it couldn’t be the Eliquis. I finally convinced my cardiologist that I was not going to continue the Eliquis so he agreed to do a Holter monitor and I had no AFib during the wearing of the monitor so I now take a baby aspirin twice a day. I have always been able to feel when my AFib begins and I do check for it with a Kardia device if I feel even a little bit like I might be in AFib. So far it has not reoccurred. Within a week of quitting the Eliquis my daily bouts of bone, joint and muscle pain were gone. (Of course at 76 I still experience some of that from time to time but not the intensity I felt every day on the Eliquis). I do plan to have the Watchman implant eventually as an added precaution against stroke. I have found that doctors do push you to take prescription medications. So you do need to be your own advocate about what you can tolerate. I have refused to take cholesterol drugs because after ablations, angiograms, and other tests, I have never been told my arteries are bad and my cardiologists have agreed. Quality of life is more precious to me than length of life. Listen to your doctors but advocate for what your knowledge of yourself tells you. Ask questions, know what side effects drugs can cause, if possible do your own research into treatments so you have the information to make the best decisions for you. But be aware of the consequences of your choices and your responsibility for them.

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I hear you. Afib/heart failure convinced me to go on Eliquis 7 years ago was ok since a stroke would be terrible. About a month ago, I noticed I was having increased shortness of breath, lot's of fatique, strange feeling around waist, and an odd stomach ache when I would exert myself with yard work etc. First I thought my heart failure was returning, but didn't have the water gain. I think it's the side effects of Eliquis. I have asked for a smaller dose but dr says no, that the dosage is fine. I think I need less or something else. Frustrated by the narrow minded dr. I think they are afraid of the drug industry coming after them. Any ideas before I take on the dr again. They didn't want to do baby aspirin, not effective enough. I wonder who sponsored that study. I'm 76 and take good care of myself.

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@harveywj

You said "I'm not sure what your meaning is".
Well I was replying to what you said earlier and I quote "Flutter is simply the musculature of whichever atrium has it contracting dutifully, as it is designed to do, to signals that come one after the other with no pausing interval."
The part of this sentence that is incorrect is "signals come one after the other with no pausing interval."

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I see what you mean. I could have phrased that better, and thanks for pointing out my mistake. There have to be pauses...period. So that much we agree on. What I should have typed was that the flutter continues essentially indefinitely, with some exceptions. Flutter tends to stay in flutter, so the impulses come repeatedly with no 'breaks', probably the better choice of words.

Thanks, again.

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@healthytoday

I hear you. Afib/heart failure convinced me to go on Eliquis 7 years ago was ok since a stroke would be terrible. About a month ago, I noticed I was having increased shortness of breath, lot's of fatique, strange feeling around waist, and an odd stomach ache when I would exert myself with yard work etc. First I thought my heart failure was returning, but didn't have the water gain. I think it's the side effects of Eliquis. I have asked for a smaller dose but dr says no, that the dosage is fine. I think I need less or something else. Frustrated by the narrow minded dr. I think they are afraid of the drug industry coming after them. Any ideas before I take on the dr again. They didn't want to do baby aspirin, not effective enough. I wonder who sponsored that study. I'm 76 and take good care of myself.

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I am appreciative of the prescriptions that help me with various health issues, but I have encountered several that have side effects (not always listed as such) and cause other problems. After my double mastectomy, I was told I should take a drug that MIGHT prevent the breast cancer from returning somewhere else. I was told I needed no chemotherapy and no radiation treatment and no cancer cells were found in my sentinel lymph nodes. With the drug I had a 5% and 8% chance of it returning; without the drugs the chance doubled. Taking the drug would increase my cholesterol and bone loss so I would have to also take drugs for those as well. I opted out.
Some drugs seem to exacerbate other conditions and Eliquis was one of those for me. I'd wake up in the morning with pain in my shoulders, or hands, or legs, or back and even my ribs and sometimes in all of those places. The pain would usually get better once I was up and moving around, but it was always there. When I told my cardiac electrophysiologist, my internist, and my cardiologist that I believed the pain was from Eliquis the response was always "that is not a side effect of Eliquis." They are correct in that joint, muscle, and bone pain are not listed as side effects. I finally told my cardiologist that I no longer wanted to take the Eliquis. He had me wear a Holter monitor for 14 days. I had no A-Fib and he agreed that I could take a low dose aspirin twice a day instead. Amazingly, the joint, muscle and bone pain was gone within 2 weeks of my last dose of Eliquis. I am well aware that the A-Fib can return at any time and I am still at risk of a stroke if the A-Fib returns but I take responsibility for my choices. Some doctors support my decision to refuse certain drugs and some are not happy with my refusal. I believe I have to do what provides the best quality of life for me.
I do believe that there is too much reliance in the medical profession on drugs and the claims of the pharmaceutical companies.
I am considering the Watchman implant. My sister has a Watchman and is off the Eliquis now. She was prone to falling and the concern was that on Eliquis if she fell and hit her head she might have a brain bleed. You might want to ask your doctor about the Watchman implant.

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@lfbarrett

I had a TIA several years ago & one side of my mouth is still slightly droopy. Then I had 6 concussions from falling, 5 of which were within 2 years. As an Afib patient, I was put on Eliquis - 2/day. Because of the head injuries, my cardiologist and electrophysiology cardiologist have scheduled me for an ablation and then the Watchman procedure. Each one is preceded by a TEE, followed by another TEE after the surgical Watchman. Once they feel the incision in my heart has healed I’ll have another TEE to ensure it’s completely closed. At that point I only have to take a baby aspirin every day - no more Eliquis. You may want to ask your doctor about this course of long-term preventative treatment.

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After the site is sealed, then most people don't take any blood thinners. I just had The Amulet done myself. Three years of Eliquis caused 15 side effects. That is big price because of an algorithm based on gender and age alone,

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@no1gaga

My husband had the WATCHMAN procedure December 6 & is doing well. He was on was on blood thinners since 2001, Eliquis was the latest one & he has afib. He was falling when his dr. Suggested it. His blood counts are coming up & we are very encouraged. Very simple procedure. Good luck.

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Did your husband have any funny feelings or things after his procedure.

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Three years after the Ablation procedure, male age 77, and wearing the chest monitor two different times in the following 18 months, my new EP took me off Eloquis. He felt that med was not needed after the two periods wearing a monitor did not record any Afib events. I check my HR via a Fitbit hourly. Also, I had a pacemaker implanted 6 mos ago due to bradycardia/chronotropic incompetence. I don’t worry about being off Eloquis, there is a risk/reward which you need to make a decision. I did in the Fall of 19 leave my initial Afib cardiologist as that man was a distracted cardiologist going to Vanderbilt. Be an informed patient/consumer and make the best decision after asking questions. It could be that your EP really believes that the most safe treatment plan for you does involve Eloquis.

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This is great news, Bill. Usually, once a person has a formal diagnosis of a heart disorder, but especially if they are...umm......ripe....and long in the tooth, the assigned CHAD2S score places them over 1, and often the cardiologist or EP will urge the patient to just accept that taking an NOAC for life is a good idea.

I recently evaluated myself using an on-line CHAD2S calculator and found that I merit a a solid 1.0. However, when I first presented to my cardiologist, newly diagnosed with an arrythmia, he mentioned that my BP was creeping up and he wanted more control over it. Now, six years later, and with a successful ablation, and even with a few kg added around my waist, my waking BP is 112/73. And that's a year without any metoprolol, the medication he said would do two things: keep the rate down when in AF, but also prevent each stroke of the heart from being so forceful, meaning a reduction in BP.

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Has anyone had the lariat left atrial closure? Had does it rank compared to the watchman?

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