Afib/dangers of eliquis

@marybird
You have a pacemaker for flutter? Was the a-v node also ablated? This is something my husband might need. We understand the pacemaker essentially protects the ventricles from reacting to high atrial rate.

@tsch my pacemaker was implanted for the treatment of what they refer to as "sick sinus syndrome", or sinus node dysfunction. That's basically when the cardiac sinus node, located in the atrium and which normally works to initiate each heartbeat doesn't function normally, resulting in a heart rate that is too slow, or pauses between heart beats. It's also associated with various atrial arrhythmias/tachycardias (SVTs, atrial tachycardia, atrial flutter and atrial fibrillation. I have a history of different types of atrial tachycardia, including atrial tachycardia, atrial flutter, and more recently, A-fib, and these are treated medically, but I received the pacemaker for symptomatic bradycardia as my heart rate would frequently go into the high 30's-low 40's. I was one of those lucky people whose sinus node dysfunction was of a tachy-brady type. I got the pacemaker to treat the bradycardia, but having the pacemaker also allowed for me to be treated with medication to treat the SVT, A-fib and A-flutter ( my multi-talented heart does all those!) without my heart rate going even lower than it would on its own. Fortunately it's all paroxysmal, and most episodes last only a few minutes, thanks to the medication ( rate control metoprolol tartrate 150 mg/day) I take, so I have never had or even considered an ablation of any kind.

A pacemaker will also allow a person with tachycardias to be treated with medication that otherwise would cause their heart rate to go too low as the pacemaker is set for a minimum heart rate ( usually around 60) and the heart won't go below that number.

Far as I know they don't implant pacemakers solely to treat A-fib, A-flutter, as there are medications that can be effective, and they seem to be encouraging people to undergo cardiac ablations, even as a primary treatment, to treat those arrhythmias.

As I understand it, the AV node ablation ( ablate and pace) is considered pretty much a last ditch effort to relieve the symptoms of persistent/permanent A-fib in a patient with this condition. The AV node is ablated so that the electrical signals from the atrium ( disordered as they are with the A-fib) no longer reach the ventricles- this eliminates the "rapid ventricular response" which would drive the heart rate way up. Since it's generally the ventricular response that the person feels, the patient reportedly is relieved of the symptoms associated with A-fib. The person still has A-fib, but doesn't feel it any longer. A pacemaker is needed since the AV node ablation destroys its function, so electrical signals no longer get through to the ventricles. The programmed pacemaker provides the electrical signals to the ventricle(s) so they beat normally.
I've been told, and read that A-flutter ablations ( these are not AV node ablations) are pretty successful and straight-forward in getting rid of the flutter. I doubt they'd do an AV node ablate and pace for A-flutter, but that is a conversation to have with an electrophysiologist.

I've included a link to an article that explains sick sinus node syndrome, and another on AV node ablation and pacemaker placement.
https://www.mayoclinic.org/diseases-conditions/sick-sinus-syndrome/symptoms-causes/syc-20377554
https://www.mayoclinic.org/tests-procedures/av-node-ablation/pyc-20384978

@marybird
Wow, thanks for taking the time to write such a detailed response. I think a person should have good knowledge of their heart issues, and you do. My husband had a complex ablation in 2020 for paroxysmal afib, and has been pretty good since. However, in November 2025 and now, April 2026, he had high heart rate but low blood pressure, and that is the current issue. He cannot take meds to slow the heart rate since his blood pressure is naturally low, and would become too low on meds. He sees an EP mid June to further discuss options. We don't think his situation is that bad right now, but may learn more from EP. We actually don't know if in April it was flutter or SVT or even afib. Atypical flutter had been mentioned and that may be the key to this all. Thanks for the links.

I agree 100% with tsch. I've been on Eliquis (5 mg / 2x per day) for 3+ years with no side effects, other than a lighter wallet. Had a pulsed field ablation 15 months ago. Have not experienced an AF episode since. Maybe it's just in my head, but I feel assured that by taking Eliquis, exercising regularly and eating properly I'm doing the best I can to promote a healthy life. BTW, I'm 72.

@debzathome I was given Eliquis after I had a pulmonary embolism and experienced the same problem as you. Immediately (after 1 dosis of 5mg) I was too weak to stand up and felt faint. This weakness stayed with me for several weeks, eventhough I had only taken 2 dosis of 5mg eliquis in that first day and stopped taking it after the first day.
Ofcourse it is possible that there is another medical problem for you, but you are not the only one to feel faint, weak with this medication.

Did you experience any dizziness or heart fluttering on Eliquis? My husband had aortic valve replacement last December. He has had dizzy spells and heart fluttering since. Has had numerous tests, scans, bloodwork. Doctors can not find anything!

Hi - I understand everything you stated. I've had Afib since 2020 and it got persistently worse over the years (by this I mean from occasional to all the time). I had an ablation and it stayed away for several years but now is back again. They want me on eliquis and I struggled with taking it because of possible internal bleeding and easy bruising. However, I don't want a stroke so I have resigned myself to it. I have no side effects. It's expensive though. I get it from Canada for 10% of the US cost. I also am active; ride my bike, walk, go to the gym, garden. Hope it works out for you!

Also new to taking Apixaban and frankly any drug at all. Was very resentful at first esp. since I was very active. However, I realize that a much higher stroke risk makes the drug mandatory. After a mitral valve repair I had to take warfarin for three months. Warfarin requires frequent blood tests to check for Inr levels and the avoidance of many foods I eat regularly like leafy greens so it was a lot worse than taking apixaban. I typically get nosebleeds in dry winter weather. They lasted a bit longer but still could be stopped with consistent pressure. Kind wishes.

@koleke
What I’ve learned is that a fib is not a permanent fix. Also catheter ablations vary in quality. The more persistent a fib, the more sites that have to be scarred with ablation. All 6 walls. If you don’t kill off all the electrons firing, the a fib grows like a wild fire over time. Watch utube Dr. Scott Lee, a well known electrophysiologist who treats a fib, “ what the doctors never tell you”. You will learn all about a fib and why you need to treat it well to eradicate it and have lasting results. I’m on a freaking one year wait list and I’m in 100% a fib all the time since it started January 2026. I’m anxious and breathless on exertion….. unlike me. Age is a big factor in a fib start up. Many have paroxymal a fib. Occasional bouts but it will grow to persistent and then permanent over time with worse symptoms if left untreated.