Eliquis after Watchman device insertion

Posted by shepsiccle @shepsiccle, Oct 2 6:37am

Hi all. Because of debilitating side effects, I would do just about anything to get off Eliquis and other similar drugs. I'm having a Watchman device inserted in late October. I'm now hearing that some people still have to take Eliquis even with the watchman. Has anyone had this experience? Were you able to lower your dose and did your side effects abate somewhat? I absolutely loathe this horrible drug.

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chickenfarmer | @chickenfarmer | Oct 4 6:50am

In reply to @vickilf5 "I asked a Mayo Electrophysiologist and this is what they said: A few points to consider...." + (show)

@vickilf5

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.

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@vickilf5 there are now a few mega studies which support the notion that DOACs are not needed for those with successful ablations.

Vicki | @vickilf5 | Oct 4 7:32am

That is correct as noted in my original post. In those studies, patients maintained sinus rhythm for one year before discontinuation of DOACs.

bryanta | @bryanta | Oct 5 6:28am

Sorry for what you are going through.
I had ablation/watchman in August.
I can get off eliquis in November, three months after procedure.
I think the area where clots form is grown over around the watchman.
I plan to quit the other heart drugs too, which have bad side effects.

shepsiccle | @shepsiccle | Oct 5 11:45am

In reply to @bryanta "Sorry for what you are going through. I had ablation/watchman in August. I can get off..." + (show)

@bryanta Bryanta - I am so happy for you!! It is wonderful to hear about success stories. That gives me hope. You are correct - the Watchman seals off the place in the left side of the heart where 90% of clots form. The remaining question, which seems to differ for each person, is whether they feel there is sufficient risk of a right-side clot forming to have you stay on a low dose of Eliquis or use another drug instead. Paws crossed I can follow in your footsteps and just have the Watchman and ablation. Please let us know if/when your side effects go away - and enjoy life without Eliquis!

pams333 | @pams333 | Oct 13 5:50pm

My brother just got a watchman and still on Eliquis . I just went to meet a doctor for ablation and watch and he said the watch only stops blood clots in the heart and not anywhere else. He said that the Eliquis helps with blood thinners thru out the body. You can still have blood clots in other parts of your body that could cause problems. Have you tried other kinds of blood thinners? Like warfarin or something else?

shepsiccle | @shepsiccle | Oct 13 6:35pm

My understanding is that many folks can get off Eliquis entirely but there are those who will need to stay on it. Some of those can take a much lower dose and thus mitigate the horrible side effects. It just depends on the person and their unique circumstances.
I have tried pretty much all the blood thinners - Warfarin was difficult for me because, as a colon cancer survivor, I have a somewhat limited diet. When you match that against the Warfarin food exclusions, I wasn't left with much to create a balanced diet.
The only one I haven't tried is Pradaxa, and again, because of the colon cancer and Pradaxa's risk of gut bleeds, I am wary of it. Plus, my mother died of an intestinal bleed, so that rattles around in the back of my mind.
I'm beginning to think there are no good options and for some of us, being told to be on blood thinners is just a permanent damper on a happy life.

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