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After an ablation and no AFib can I stop my blood thinner Xarelto?
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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As you know, the protocol after installing the Watchman is a low dose aspirin "for the rest of your life." If you watch any TV, you will note that the Watchman manufacturer is selling Watchman like GM sells Chevrolets. My experience is that their "after sale" support is lacking.
What after-sale support would you expect from them? What maintenance should the wearer be doing in order to keep the Watchman in place, sealed, and otherwise inert, apart from a low-dose aspirin, as the Watchman monograph suggests?
As far as I know, there is no protocol, only a suggested practice (the citation below uses the term 'recommended'), and it's up to the EP and patient to agree on their own individual prescription for prophylaxis. Dr. Andrea Natale routinely invites some, not all, of his patients to cease taking a DOAC once the six-month TEE verifies that the person's Watchman is still properly inserted and not leaking. From there, other factors and comorbidities might mean that continued use of a DOAC, or a 'baby aspirin', daily is a wise move.
https://citoday.com/articles/2017-may-june/anticoagulation-management-after-watchman-implantation
This study discusses the relative efficacy of DOAC use over aspirin:
https://www.structuralheartjournal.org/article/S2474-8706(22)00827-2/fulltext
Thank you for the very enlightening response to my comments about the follow-up "protocol" related to the watchman device residing in my body. You are probably aware that I was given a card with the telephone number of a support person at Boston Scientific, in case I had any comments or questions about the Watchman.
When I called that person a few days ago to ask a question about the installation, she very specifically told me that I am very definitely following the "protocol" in taking the low dose aspirin. Apparently, she was under the same misunderstanding as I was regarding protocol.
I am completely in the dark as related to a six month TEE. I do not know what that means, and the only TEE I've encountered is on the golf course. I do know that I bruise very easily, and those bruises take what I believe is an inordinately long time to dissipate.
That is something I would like to know to I am hoping to get the Watchman after my ablation next week. My EP has already mentioned it and I am going to ask as soon as I see him which will be right before the procedure. I am wondering how long I will have to wait to have the Watchman implanted. I hate to take any pill
The Watchman can, in most cases, be installed at the same time as the ablation. Two procedures, one anesthetic, one visit to hospital.
https://www.watchman.com/en-us/resources/articles/afib-treatment-options/ablation-watchman-combined.html
My EP who performed the ablation, (2/20) kept me on Eloquis based on my CHAD score. Two years later he moved and my new EP after one year under his care stopped Eloquis and now I am on an 81mg aspirin. Neither EP ever mentioned the Watchman either as an option or a recommended procedure. And I have yet to ask about the Watchman. My cardiologist, former Vandy Cardio head, answered the “why” am I no longer Eloquis He described the first EP as very much an academian while my current EP has a slightly different philosophy. And. Am OK being off Eloquis.