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Dental Extraction after Ablation
Hi all, I was scheduled to have a tooth extraction today, which meant stopping Pradaxa (blood thinner) this past Sunday. Well, I have been having afib episodes (sometimes I didnt even realize it) so I thought it was a good idea to postpone the extraction.
My PFA is scheduled for May 29. Ironically, they say keep taking the Pradaxa even on the morning of the procedure.
My question is, since I will have to have the tooth extracted sooner or later, how long have you had to wait before you can skip 2-3 days of Pradaxa for the extraction? Someone told my dentist 3 months. TIA
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@bohaiboy
If me would surely asked your question to the medical professional who put you on Pradaxa.
One of the issues with AFIB is the very fact many have no symptoms. It is why the risk of stroke is so high with AFIB because of the blood clotting and stroke increase and you don't even know you are at risk and in AFIB.
I have a lady that does water aerobics and she was gone for a awhile. When she came back I asked her if okay. She replied no she had a stroke in her eye and lost some vision. She went on to say they found she was in AFIB and it caused the stroke in her eye (blood clot). She did not have any symptoms of AFIB. She is on Eliquis now
I have an ablation scheduled for June 4th to correct PVCS in LV. I hope it works as will allow me to come of amiodarone.
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3 ReactionsThe half-life of Pradaxa is the same as the half-life of most other DOACs like Eliquis and Xarelto: 12+ hours, depending on dose and the patient's metabolism/liver function. So, 12 hours after ingesting a single dose, approximately half the original serum volume remains. Twelve hours later, only 1/4 of the original dose remains. and 36 hours later, about 1/8th. So, in general, you would need between or three full days taking no DOAC by mouth or having it introduced intravenously before you would have your normal platelet response for clotting.
If you are advised to continue to take a DOAC through the three month blanking period (and this is standard advice because the Holter assessment takes place two or three weeks out of the blanking period, and that is when you learn if your ablation was successful, after which you can safely discontinue taking the DOAC, but only if you have no other risks and your cardiologist/EP say it's safe for you to stop), you should do that. If you require urgent care that might involve bleeding, such as surgery, you should be able to go off the DOAC two days ahead of the surgery, three might be better. Note that this assumes you do not have a severe risk for stroke, that your heart is healing normally after the ablation, and that it seems to be happily in normal sinus...no obvious arrhythmia that might elevate your risk of stroke.
In summary, you do have a risk of stroke, and it rises for a number of reasons. It goes up five (5) times if you have AF. After an ablation, if things look good, it would be okay to go off the DOAC for urgent care DURING THE BLANKING PERIOD, provided your cardiologist knows and doesn't object for very strong reasons.