I asked a Mayo Electrophysiologist and this is what they said: A few points to consider. First, the symptoms described are fairly atypical for Eliquis. Therefore, it would be important to review all of your medications to make sure there isn’t a different cause of the symptoms.

Assuming the symptoms are entirely due to Eliquis, the original question is whether the dose can be lowered following Watchman placement. The answer is yes. Published studies have looked at using half-dose Eliquis, or 2.5 mg twice daily, following Watchman placement. Although these studies were modest in size, involving roughly 500–600 patients, the results were very encouraging: lower-dose Eliquis appeared to be as effective as full-dose Eliquis, with fewer complications. There are also substantial data supporting other medication regimens after Watchman placement, including warfarin, dual antiplatelet therapy, and rivaroxaban. It would be best to discuss these options with your clinician to determine which approach makes the most sense for you.

Lastly, the vast majority of people—over 95%—will discontinue oral anticoagulation approximately three months following Watchman placement. Typically, imaging is performed to determine whether there is a leak, which may help guide the choice of therapy. Therefore, Watchman therapy can be a good option for discontinuing anticoagulation in people who are at risk for stroke.

One other important point: recent studies have shown that if atrial fibrillation is successfully ablated and a normal rhythm is maintained for one year, there may not be a need for either long-term blood thinner therapy or Watchman placement. Therefore, it would be important to discuss with your physician whether ablation of your atrial fibrillation is an option. Most people in these studies had a stroke risk score, called CHA₂DS₂-VASc, of 1, 2, or 3. If your risk is in this lower range, this may be a particularly attractive option. However, patients in these groups were treated with ongoing blood thinner therapy for a full year following ablation to ensure that the abnormal rhythm did not recur.

I hope this is helpful.