My EP took me off eliquis. But I’m petrified. I’ll have a stroke now.

Posted by kmj126 @kmj126, Jan 1 8:09pm

I’m a 53-year-old female and I heard my first afib episode in October which lasted about eight hours of my converted with mediation. I haven’t had any episode since and I was given to echocardiograms and a two week Holter monitor and the doctor said because my chads score is 1 due to being female that I don’t need the blood thinners anymore. He said if I have another episode that we can further discuss what to do then but I’m definitely afraid right now that I’ll have a stroke. Does anyone that have had one episode of a fib not on a blood thinner?

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Profile picture for gloaming @gloaming

@chickenfarmer I understand your position. Here is what I know, or 'think' I know 😀 :

When the left atrium is fibrillating, the circulation of blood is reduced. It can't fill properly by the time the next untimed contraction takes place. One serious outcome of this is that the 'left atrial appendage', a small pouch at upper extreme left of the left atrium, doesn't get flushed out properly with a fresh supply of blood. After a while, still in AF, whether a few minutes or several hours, the pooled and stale blood has begun to clot. Then, by bad luck, or when the heart reverts to normal sinus rhythm, which happens to you almost every time, the new vigorous refilling of the left atrium might cause one or more clots to get washed out of the LAA, and it goes out of the heart on the next ventricular contraction. Where it goes means life, life in a wheelchair or on your back, or death. It can travel to the heart, itself, and cause a heart attack because it blocks the left anterior descending artery. Or it can travel to the brain and give you a nasty stroke. Or, maybe to the lungs. Or to a kidney.

The risk of a stroke from AF rises five times ( X 5) over a normal person's risk at the same age and with a good heart. The risk of a major bleed is somewhat less. When was the last time you had a catastrophic bleed, say from a terrible fall that broke bones and had a sharp bone pierce an artery? Or in a car accident where a limb was almost completely severed? Those events are rare. and even when they do happen, someone nearby will call for help and attempt to stanch the worst of the blood loss. Minor cuts and abrasions don't even figure here. It's just the serious bleeds, and for all of us, it's very remote. But.................you do NOT want a stroke.

Last part of this...sorry, it gets long....and that is that the EP community have established that you can die from an AF related stroke months after a successful ablation or after reverting to normal sinus rhythm and not having any more AF over that long period. It is for this reason that the Watchman device was engineered and is offered to many patients. It seals off the mouth of the LAA and doesn't let any clots issue from it, ever. At that point, with a confirmatory trans-esophageal echocardiogram (TEE), your cardiologist and EP will agree, usually, to let you stop taking Eliquis/Rivaroxaban, maybe with a baby aspirin each day instead. But this depends on your overall risk. You may have other things going on that also raise your risk of a stroke....not just the history of AF.

I hope this very long explanation helps you to situate yourself in this unfortunate condition.

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@gloaming you scaring me. I was on eliquis for 3 months after afib. I was told I have a low stroke risk and I can safely go off thinners unless I go back into afib again and it becomes more frequent. I’m going to the er to check for clot and beg to be back on eliquis even tho I cant afford it.

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Profile picture for kmj126 @kmj126

@lwools wait a minute are you saying that you won’t stop taking it because you might have a stroke? I do realize there’s other risk factors as well. You could bleed out. The fear mongering on here is horrible. I gotta get off this board.

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@kmj126 I have atrial fibrillation and that’s what my cardiologist told me. I’d rather not take it. Do you know something different?

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Profile picture for lwools @lwools

@kmj126 I have atrial fibrillation and that’s what my cardiologist told me. I’d rather not take it. Do you know something different?

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@lwools I haven’t noticed any issues with bleeding!

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Profile picture for chickenfarmer @chickenfarmer

@lwools this is an issue I’ve studied a lot as my EP directed me to 81 mg aspirin after ablation. It sorta makes sense why take anticoagulant if I’m not experiencing AFIB. If I’m constantly in AFIB then elliquis makes sense but why take anticoagulant expensive pill that increases my chances of a bleeding episode if AFIB isn’t happening. It seems that cardiology community would put all patients on anticoagulants regardless of situation.

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@chickenfarmer I think your right. I saw an EP once and he put me on eliquis. I fought it for along time and am not happy with seeing my episodes of AF increase after taking it. Don’t know what to do!🫩

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Profile picture for kmj126 @kmj126

@gloaming I’m sorry I’m frustrated. My EP said I didn’t need the thinner but I keep hearing I’ll have a stroke if I’m not on it.

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@kmj126 Personally, in your shoes I would listen to your EP rather than to the varied opinions of strangers on the internet when it comes to matters of your health. Your EP is an expert in the field of cardiac electrophysiology, as well as other medical issues related to "electrical disorders, he/she knows your personal medical history and can best advise you on your options. His best judgement that you don't need a blood thinner following your A-fib event is based on the fact ( as shown in the CHAD2 score of 1) that your risk factors for A-fib other than the statistical, (not medical) score assigned because of your gender are very very low, almost nonexistent. Believe me, if he thought you needed a blood thinner, he'd prescribe one!
Unfortunately, the knowledge base for the people who post on the topic is wide and varied, and while they mean well, along with some of the good information they share is also a good amount of misunderstanding, misinformation, and opinions based on what individuals THINK they know or understand about a topic. This mishmash of good, bad and misleading information can lead ( as you've indicated) to confusion, frustration, sometimes even panic in a reader trying to sort it all out and just doesn't know what to believe.

For what its worth, my cardiologist also did not prescribe a blood thinner for me after my first go-round with A-flutter ( that's also associated with clot formation so treated like A-fib). After a 3 week monitor study showed normal results, informed me that should a second event like that occur, then he would start me on blood thinners, but it was around 5-6 years after that when short runs of A-fib showed on my pacemaker reports. Even then, while these were short, infrequent and less than 1% of my heart rate burden, he didn't jump on the blood thinner ( though he said they had to watch them), it was not until I had several hours long A-fib events that he prescribed the blood thinner.

Hopefully you can sort all this out, and come to some peace of mind about your situation.

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Profile picture for kmj126 @kmj126

@lwools wait a minute are you saying that you won’t stop taking it because you might have a stroke? I do realize there’s other risk factors as well. You could bleed out. The fear mongering on here is horrible. I gotta get off this board.

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@kmj126 agree 1000%.

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Profile picture for lwools @lwools

@chickenfarmer I think your right. I saw an EP once and he put me on eliquis. I fought it for along time and am not happy with seeing my episodes of AF increase after taking it. Don’t know what to do!🫩

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@lwools Bingo. wake up.

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Profile picture for lwools @lwools

I had Atrial Fibrillation about 3% of the time for 4 years . Then I was put on Eliquis as my Cardiologist said I could have a stroke or heart attack . Since I started taking Eliquis my Atrial fibrillation has increased to 30% . Has anyone experienced this happening to them?

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@lwools Not me, because I quit caffeine and too much sugar. No way would I swallow Eliquis.

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Profile picture for lwools @lwools

@kmj126 I have atrial fibrillation and that’s what my cardiologist told me. I’d rather not take it. Do you know something different?

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@lwools get off all caffeine and high sugar, meat, dairy diet.

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Profile picture for marybird @marybird

@kmj126 Personally, in your shoes I would listen to your EP rather than to the varied opinions of strangers on the internet when it comes to matters of your health. Your EP is an expert in the field of cardiac electrophysiology, as well as other medical issues related to "electrical disorders, he/she knows your personal medical history and can best advise you on your options. His best judgement that you don't need a blood thinner following your A-fib event is based on the fact ( as shown in the CHAD2 score of 1) that your risk factors for A-fib other than the statistical, (not medical) score assigned because of your gender are very very low, almost nonexistent. Believe me, if he thought you needed a blood thinner, he'd prescribe one!
Unfortunately, the knowledge base for the people who post on the topic is wide and varied, and while they mean well, along with some of the good information they share is also a good amount of misunderstanding, misinformation, and opinions based on what individuals THINK they know or understand about a topic. This mishmash of good, bad and misleading information can lead ( as you've indicated) to confusion, frustration, sometimes even panic in a reader trying to sort it all out and just doesn't know what to believe.

For what its worth, my cardiologist also did not prescribe a blood thinner for me after my first go-round with A-flutter ( that's also associated with clot formation so treated like A-fib). After a 3 week monitor study showed normal results, informed me that should a second event like that occur, then he would start me on blood thinners, but it was around 5-6 years after that when short runs of A-fib showed on my pacemaker reports. Even then, while these were short, infrequent and less than 1% of my heart rate burden, he didn't jump on the blood thinner ( though he said they had to watch them), it was not until I had several hours long A-fib events that he prescribed the blood thinner.

Hopefully you can sort all this out, and come to some peace of mind about your situation.

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@marybird I agree fully...always, but ALWAYS follow the advice of professionals. I am just passing on my own learning, but I don't know the people here and their history. I make no recommendations or advice...I just pass on my reading and the rationale expressed by the many authors. It's always up to the patient, and in concert with expert instructions, to decide for him/herself what is best for them.

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