Post op AFIB & anti coagulation drug

I agree, as many of you have stated, that it is important to do your homework, research evidence-based, trustworthy resources and to ask questions. A good cardiiologist will work WITH you so that you can share in treatment decision making. There are many factors to consider and your doctor can help make sense of the risks and benefits of each treatment option available to YOU, and relevant to your current medical status as well as medical history.

Questioning and discussing a recommended course of treatment is not only the right of the patient, it is good practice. It helps inform the physician of your preferences and goals. If a physician isn't willing to take the time to discuss, consider options and include you in the decision making, it's time for a second opinion.

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Here is more information about "shared decision making" and "minimally disruptive healthcare" that I think the group will appreciate. It is supported by physicians, the kind I think you're in search of, and frankly are the kind I want on my team.

- Shared decision-making as a method of care By Dr. Victor Montori, et al. https://ebm.bmj.com/content/28/4/213
- Is healthcare careful? Is it kind? by Dr. John Mandrola https://minimallydisruptivemedicine.org/2015/01/26/repost-is-healthcare-careful-is-it-kind-by-dr-john-mandrola/

@ernie4040, if you'd like to consider a third opinion with Mayo Clinic experts, you can request an appointment here: http://mayocl.in/1mtmR63

I can understand the reluctance to be on medication forever. It sounds like you are reviewing your options carefully, researching evidence-based resources available to you, and with input from health professionals. I imagine your cardiologists are encouraged about your healthy lifestyle goals and diligence in self-monitoring.

I wonder if 4 months is not long enough to know if the afib is persistent or not. What is your follow-up schedule with you cardiologist to reassess treatment vs Watchman vs monitoring alone?

Thanks for tip on Dr. Mandrola article. I’m a new heart patient at 71 that had no previous heart, hypertension, cholesterol, etc, etc. Didn’t even have a Cardiologist. After a PVC during vein ablation I was told to see a Cardiologist before doing the second leg. After 6 visit culminating in an arteriorgram I have a 40% blockage in my D1 artery as it branches off of the LAD. All the Cardiologist did is change my statin that my Internist prescribed as precautionary 20 years ago to a brand he like better - Crestor. He sent me home, instructed me to lose 40 lbs and check on my snoring, come back in 3 months. After I got over the fear of having a heart attack, I’m fine. In the gym 3-4 days a week. Losing weight, 20 lbs so far. Seems like the Crestor hurts my joints worse than my previous statin but could be the treadmill activity too. I agree that we should all educate ourselves on what our Doc is telling us. Seems to be a bit of uncertainty about many of these heart ailments.

In our area the Hospitals executives push procedures like the watchman because that is what makes them the most money. They do not care about you or I as patients. Once the device is in and they have been paid, it is "So long sucker." Their advertisements state: "We do the most Watchmans." Etc. The unassuming patient in thus convinced that it must be good since they do so many of them. This also happened with stents in our area until a few cardiologist got caught and one sent to prison.

When you came off blood thinners, did you wean off or just stop.

When giving my experiences and malady's with medicines and doctors I just want to reiterate that my metabolism and situation is probably a bit different than yours, as you're condition and response to different medications is also unique to you.
I quit cold turkey as my nose and hemorrhoidal bleeding was a bit out of hand. I also ate lots of vegetables, (that I had been eating before, that contained vitamin K), such as spinach, cabbage, etc. It still took awhile for the bleeding to settle down. I had to have my left nostril cauterized in the emergency room as the bleeding would not stop. The problem was the Cardiologists would not listen and insisted I be on a blood thinner or I would have a stroke. It is doubtful I would have had a stroke, but that is me. Everybody reacts to medications slightly different. You also have too, (well you don't have too but might be a good idea) consider the half life of the medications you are taking. If your not careful your body ends up with more of the medicine being retained in your body than the amount of the dose you are taking. My point being, the more knowledge you have about your condition and the medications you are taking, the better chance you have of avoiding one of the mental or physical problems described in this forum. All Cardiologists are not created equal.

I am 79, I got off of Eliquis after four months by wearing a heart monitor for 30 days to be sure AFIB was gone after a successful ablation. Weaned off of it in about a week. That was almost a year ago. Numbers are great and feeling good. Best to you.

My understanding is that
paroxysmal Afib can be very dangerous when unmedicated or unprotected a watchman device. See in my case unless it happens again my afib resolved itself because it was only related to the stress / anesthesia associated with total knee replacement.
Senator John Fettermanwas elected in 2022. You may remember he was guy who had a stroke. He has ignored doctors instructions to anticoagulate after having afib. I'm sure he isn't you since your Afib is so infrequent and you have already gone 5 years with no problem. Still I wanted to bring him to your attention

Thank you for reading and replying to my message. I appreciate your taking the time to reply to me and offering me a opportunity to make an appointment @ mayo. Problem is I live in Rhode Island. Truth is I saw 2 cardiologists associated with respected organizations including Boston based Massachusetts General hospital. Actually three cardiologists if I count the doctor who advised me to have watchman installed. Such a fancy name for what is really a plug. i could not get them to respond to the post op nature of my Afib. I am still using 5 mg Eliquos and monitoring myself with Apple 8 watch and Kardia device. If I have any evidence of even 1 incident of Afib I would quicky up the dose to 10 mg. I figure 5 mg is a compromise designed to give me some protection from blood clotting if AFib returned and bleeding. And then like I said I would quickly go back up to 10 mg per day.

@ernie4040 both my cardiologists now agree I should not (and never should have been) anticoagulated. At this point I have gone 28 months without a problem. Knock on wood. I am not opposed to it when needed.

If an episode lasts less than 5 hours, it is less risky, I was told. And for a 7 hour episode, I had an echocardiogram to check for clots. Not fool proof but helpful. Most of my episodes are about 2-3 hours. They are dramatic with heart rate 180+ , shortness of breath, chest pain, etc.

I don't eat after 5 and if I get a certain feeling in my chest I take GasX rather than a heart med. Everyone is different. I am not at all saying the everyone should follow my path. Only that I had to think for myself a bit rather than follow the first doc's opinion (which has changed).

It seems most people with afib do need blood thinners. But remember those come with risks too , including stroke.