AFIB stopped-should I still be taking Xarelto?

If you have short episodes (hours) every 6 months you could ask your cardiologist about "pill in the pocket" meds, including anticoagulation, meaning you take as needed for whatever time your doctor suggests for the duration of your episode.

If the above doesn't match your situation, and your afib episodes last days or occur more often, and if meds are needed as suggested by your doctor, then the above does not apply.

I am just describing what has prescribed for me with once/year episodes that are relatively short and self-convert, and I am not on any meds. It may not be relevant for you!

This is definitely a question for your doctor. Do you have an EP?

Agreed, run your situation past your cardiologist and ask her if you really need to be on a DOAC. Note that you may have other risk factors that raise your CHA2DS2-VASc score upwards of '2', in which your cardiologist would almost certainly advise you to stay on it. But if you go long spells in NSR, you have minimal risk...on the face of it.

Don’t stop unless you talk with your cardiologist! I had the Watchman procedure in August & will be able to stop taking Plavix the end of February. It’s an outpatient procedure - ask your dr about having it.

I always talk to my doctor but the reality is, doctors often feel obliged to start or continue a medication due to generalized protocols and liability, and we as patients have the right to decline. I have never declined without full discussion with a doctor after research and reading and thinking about risks/benefits. And yes the CHADS score can help, though when I hit 75 mine will go up and that will cause more discussion with MD!

Hi - Mayo Clinic data might be useful - http://www.youtube.com/watch?v=zVF0Z4y0wzs

as I understand it - the Garfield risk calculator and AHA 2023 Guidelines are well respected data sources - might be useful - good luck!
https://af.garfieldregistry.org/garfield-af-risk-calculator
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193

Are you sure you know when you are in Afib? I am one of those people who always knew when I was in Afib. I recommend a Karida regardless of how good you are at detecting Afib. Check it regularly. During the period when my Afib was very intermittent I carried a DOAC with me. I talked to my EP and he was OK with it. Eventually I became more frequent and I took eliquis regularly. Then I had an ablation and stopped DOACs 6-9? months after the ablation. I needed it only 3 times over the next 4 years and then I started to have more recurrent bouts of Afib. This time I also had a Kardia to prove it. So I started back on DOACs regularly. Last Sept I had my 2nd ablation. I haven't thought about it yet as I think it is too soon to come off it. Plus this ablation I had a couple of short lived Afib events in the blanking period (3-6 months? for blanking). I will not take a chance on it until I am clean for at least 6 or more months. I am 77 now so that adds a point. But I am not overweight nor diabetic nor do I have high BP. But I do have Factor V Leiden. So I still say you should talk to your doc. So are firmly ensconced in the "prevailing" view and others are more reasonable.

@woodside these are fantastic, thank you! I have saved them in my Google docs.

My stroke risk and bleeding risk are still pretty equal so the decision on anticoagulation depends on other factors so far. The calculator was reassuring.

I will share the two takeaways from the guidelines that apply to me (and my posts on Mayo), based on my experience and my more recent reading ("The Afib Cure", Day and Bunch). I can see that my EP is using the more flexible guidelines.

Others can read the whole list of takeaways on more aggressive treatments and the article as a whole in detail but I am just posting excerpts.

2.
AF risk factor modification and prevention: This guideline recognizes lifestyle and risk factor modification as a pillar of AF management to prevent onset, progression, and adverse outcomes. The guideline emphasizes risk factor management throughout the disease continuum and offers more prescriptive recommendations, accordingly, including management of obesity, weight loss, physical activity, smoking cessation, alcohol moderation, hypertension, and other comorbidities.
3.
Flexibility in using clinical risk scores and expanding beyond CHA2DS2-VASc for prediction of stroke and systemic embolism: Recommendations for anticoagulation are now made based on yearly thromboembolic event risk using a validated clinical risk score, such as CHA2DS2-VASc. However, patients at an intermediate annual risk score who remain uncertain about the benefit of anticoagulation can benefit from consideration of other risk variables to help inform the decision, or the use of other clinical risk scores to improve prediction, facilitate shared decision making, and incorporate into the electronic medical record.

@harveywj when you did DOAC as pill in a pocket, did you have a protocol for how long to take it depending on certain durations of an episode? Did you only take it for afib longer than 5 hours or after any afib?

The protocol was < 12 hours I took DOAC for 2 times/one 24 hour period. If greater than >12 hours and I took DOACs for 30 days. Any Afib event I would start DOAC immediately as soon as I recognized it. Clots can start very early in an Afib event. Hence I didn't wait.