Eliquis after Watchman device insertion

Hi
Q, what are the side effects you are have with Eliquis
I hate it also

First, it's always, and still, strictly YOUR choice about what goes into your body. The rest is merely negotiation, hopefully with education....on the part of both parties....you and they. Your advisor's role is to be educated, to learn about you fully, and then to make a professional guess as to what is best for you, and then communicating that to you in useful and comprehensible form. Written and spoken, ideally.

You don't 'have to' stay on apixaban or any other DOAC. You probably should, from the sounds of things, but you must not. Have you asked why you are being encouraged to remain on a DOAC?

The Watchman device is all but a guarantee of no issue of clots from the left atrial appendage (LAA). This is where most of the risk of a clot comes from if you have an arrhythmia like atrial fibrillation (AF). Once the device is proven to be leak-free, you 'can' go off a DOAC, but you might be advised to take a 'baby aspirin' daily as a prophylactic to keep your whole body risk of a thromboembolic event low as you continue to age.

Some Watchman devices never do completely seal off the LAA. This means your risk remains approximately five times that of a normal person for a stroke as a result of what may be leaking out from behind the Watchman. That's if you're still in occasional or persistent/permanent AF.

Until you are deemed free of all unreasonable/non-normal/healthy risk of a stroke, you really ought to listen to the advice and continue the DOAC...this is my opinion as a person who'd rather survive and not have a stroke. I'm not a health care professional, only a fellow patient.

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.

While side effects are not common from Eliquis, it does not mean they do not exist. I am having GI issues - which they say are not from this medication. I have read on Mayo Connect of some others who have some side effects from Eliquis. They have switched to another anticoagulant, such as Xarelto. Have you tried another medication before having the Watchman procedure? I am no expert in this field, but I would look into a similar medication to see if that would help. Good luck.

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.

@vickilf5 Hi Vicki - yes, I am well aware of everything you said. My journey to the Watchman has been very thorough. I didn't mention it, but yes, I will be having an ablation too, which is supposed to deal with the Atrial Natriuretic Peptide hormone and eliminate the need to live in the bathroom! I am resigned to possibly needing a small dose of Eliquis, at least for a while, but full dose forever is just not acceptable. It is so hopeful that they are exploring and clarifying combination therapies that can be tailored to each person. Thanks for adding this good information for those who may not have it.