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After an ablation and no AFib can I stop my blood thinner Xarelto?

Posted by teacher2001 @teacher2001, Jul 14 6:41am

I am a 79 year old female who has had AFib for nine years. Last March I had a catheter ablation and have since been taken off my beta blocker Sotolol and told I no longer have AFib. Can I now go off my blood thinner Xarelto?

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gloaming | @gloaming | Jul 28 11:20am
In reply to @sandw40 "Unfortunately most physicians don't specify if they are "competent" or not. Also people really need to..." + (show)
Profile picture for sandw40 @sandw40

Unfortunately most physicians don't specify if they are "competent" or not. Also people really need to consider the that there are always possible issues involved anytime someone is inserting anything into their heart. Procedures do not always end as expected. Most important take away is for people to REALLY UNDERSTAND what they are getting into and not just relying on a physician who may or may not be competent.

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Yes, agreed, it's the patient's responsibility, ultimately, to agree to procedures that offer to correct a defect of some kind. However, a little homework and sleuthing will answer most questions about the skill level and the historical success of a practitioner. This is why we at afibbers.org routinely recommend two or three highly accomplished electrophysiologists, although we don't know all of them.

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omiuschi68 | @omiuschi68 | Jul 28 10:30pm
In reply to @gloaming "I would not go off any prescription unless advised to by the person prescribing it in..." + (show)
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I would not go off any prescription unless advised to by the person prescribing it in the first place. I will explain, though, about this specific prescription:
The risk of stroke when experiencing AF is estimated to be six times what an average person bears. That is the reason for the DOAC you are taking (Direct-acting Oral Anti-Coagulant). Even after and apparently successful ablation, you are still at risk of small runs of ectopy or AF. Also, and this is important, scientists have attributed some strokes weeks and months after no detectable AF to previous runs of AF...meaning you can still get clots coming out of the left atrial appendage (LAA). This is why some electrophysiologists want their ablatees to also have a Watchman device implanted in their LAA. If the Watchman seals off over five/six months, and if a trans-esophageal echocardiogram (TEE) shows no leakage from the LAA, you CAN go off a DOAC. The EP would usually agree to this change and say you can stop taking your Xarelto.
So, congratulations on having the ablation, and I hope it continues to show that you are free from AF going forward, but you still have the 12 week Holter monitor assessment coming where you will wear one for close to 24 hours to ensure you have no serious ectopy. If you are given the all clear, from there you must negotiate with your prescribing doctor as to the risk you're willing to accept if you have no Watchman implanted. My own cardiologist and EP have me on Eliquis for life because I'm still under a risk for strokes, even though I have no AF now for 27 months. I also don't have the Watchman, and that's a big difference.

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Wonderful to hear that you haven’t had a fib for 27 months!

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gloaming | @gloaming | Jul 29 8:24am
In reply to @omiuschi68 "Wonderful to hear that you haven’t had a fib for 27 months!" + (show)
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Wonderful to hear that you haven’t had a fib for 27 months!

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Believe me, I pause and thank God every day, several times each day, and I don't take myself or their expertise for granted any more. Life just gets shorter and shorter, but there's an endless supply of happiness and gratitude if you're willing to tap into it. 🙂

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lgusan | @lgusan | Aug 13 12:45pm

I personally would not recommend getting off your blood thinners unless instructed by your doctor. I have had 2 Ablation procedures and my Cardiologist informed me that I still needed to continue taking my Eliquis twice a day (5mg morning and 5mg evening).

My Kardia apparatus that I purchased to monitor my EKG is now reading that I may have possible AF again. What a disappointment after 2 Ablation procedures.

I also have been diagnosed to have congestive heart failure and have severe pulmonary hypertension which affects my breathing and shortness of breath. So I am not in the best of shape as per my heart disease and lungs.

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gloaming | @gloaming | Aug 13 1:49pm
In reply to @lgusan "I personally would not recommend getting off your blood thinners unless instructed by your doctor. I..." + (show)
Profile picture for lgusan @lgusan

I personally would not recommend getting off your blood thinners unless instructed by your doctor. I have had 2 Ablation procedures and my Cardiologist informed me that I still needed to continue taking my Eliquis twice a day (5mg morning and 5mg evening).

My Kardia apparatus that I purchased to monitor my EKG is now reading that I may have possible AF again. What a disappointment after 2 Ablation procedures.

I also have been diagnosed to have congestive heart failure and have severe pulmonary hypertension which affects my breathing and shortness of breath. So I am not in the best of shape as per my heart disease and lungs.

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Yes, this is a disappointing development. AF is progressive, unfortunately. The luckiest of us might only get one ablation and never have any ectopy or AF for the rest of her life. Then, we the average patient, might go two, four, six years free of ectopy after a successful ablation, and then find we are once again in arrhythmia. Happens fairly often. BTW, a 'successful' ablation is one where a year passes before a return to arrhythmia. I haven't seen an argument to support that...not that I've gone looking.
Your pulmonary hypertension is worrisome. I don't know anything about that condition, but it wouldn't surprise me to learn that it is related to myocardial dysfunction, whether problems with heart muscle or with the signaling for it to beat properly. I do know that they have to be careful about pulmonary vein hypertension after an RF ablation. https://pmc.ncbi.nlm.nih.gov/articles/PMC7478431/

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suerte | @suerte | Aug 14 10:24am

I am 85 years old and had a successful ablation (PFA performed at UC Health in Aurora, CO) and am no longer in Afib. Stopped metoprolol, and just had a video conference with the cardio team at UC Health and their comment on the recommendation to continue Eliquis is not just based on being or not being in Afib, but is based on the fact that I am over 75 and the CHA2DS2-VASc score gives me 2 points which means that I am at some risk for a stroke. So the recommendation is to continue Eliquis. Am I happy with this? No. I would like to be off of all meds, if possible, but given the downside of the potential blood clot and resultant stroke I will contine with the Eliquis.

BTW - We discussed the Watchman device, and the UC Health cardio team is not 100 percent convinced that it is 100 percent successful in the prevention and release of blood clots. They will do the procedure, but it is the choice of the patient.

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suerte | @suerte | Aug 14 10:32am
In reply to @suerte "I am 85 years old and had a successful ablation (PFA performed at UC Health in..." + (show)
Profile picture for suerte @suerte

I am 85 years old and had a successful ablation (PFA performed at UC Health in Aurora, CO) and am no longer in Afib. Stopped metoprolol, and just had a video conference with the cardio team at UC Health and their comment on the recommendation to continue Eliquis is not just based on being or not being in Afib, but is based on the fact that I am over 75 and the CHA2DS2-VASc score gives me 2 points which means that I am at some risk for a stroke. So the recommendation is to continue Eliquis. Am I happy with this? No. I would like to be off of all meds, if possible, but given the downside of the potential blood clot and resultant stroke I will contine with the Eliquis.

BTW - We discussed the Watchman device, and the UC Health cardio team is not 100 percent convinced that it is 100 percent successful in the prevention and release of blood clots. They will do the procedure, but it is the choice of the patient.

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I want to add a disclaimer to my post. My post was informational only and it is really up to the individual to work with their cardio team(s) to determine the best course of medical action.

The information from the UC Health cardio team is the opinion of this team and relies on the protocols that they have developed. If you talk to another cardio team their protocols could be different and the recommendations on the use of medications could be different.

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teacher2001 | @teacher2001 | Aug 14 2:14pm
In reply to @suerte "I am 85 years old and had a successful ablation (PFA performed at UC Health in..." + (show)
Profile picture for suerte @suerte

I am 85 years old and had a successful ablation (PFA performed at UC Health in Aurora, CO) and am no longer in Afib. Stopped metoprolol, and just had a video conference with the cardio team at UC Health and their comment on the recommendation to continue Eliquis is not just based on being or not being in Afib, but is based on the fact that I am over 75 and the CHA2DS2-VASc score gives me 2 points which means that I am at some risk for a stroke. So the recommendation is to continue Eliquis. Am I happy with this? No. I would like to be off of all meds, if possible, but given the downside of the potential blood clot and resultant stroke I will contine with the Eliquis.

BTW - We discussed the Watchman device, and the UC Health cardio team is not 100 percent convinced that it is 100 percent successful in the prevention and release of blood clots. They will do the procedure, but it is the choice of the patient.

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Thankyou for your information. I understand you aren’t a doctor but it is comforting to hear other experiences. No doubt I’ll continue with Xarelto but like you I would love to be drug free. xo

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the | @the | Aug 14 3:24pm

Do what your Doctor says. I don’t anyone here is a MD. My doctor says “ no”. Xarelto doesn’t bother me so I don’t care

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dianemari | @dianemari | Aug 17 10:10pm

Not according to my cardiologist. She still has me taking my Xarelto 1 & 1/2 yr after successful ablation and no more AFIB. She says it prevents possible stroke/heart attack.

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