Stopping Xarelto after ablation

You should probably do some personal fact-finding by reading more about stroke risk, but especially as it relates to you personally. Your CHA2DS2-VASc score of 2 puts you at the bottom of the range above which a DOAC is recommended. It's never mandatory. It's just a conscientious health expert telling you what you should know about your risk of a stroke, but it's all causes, not just the risk of a clot issuing from the left atrial appendage (where 90% of the risk of a stroke during active AF rests). Even with a Watchman installed and it proves to be leak-free, you have other risk factors that take you up to 2 and beyond. I'm just guessing as I wasn't present during the conversation and don't know you. But if you're relatively healthy, no other comorbidities, and your AF is no longer active due to the ablation, and you are under 65, you may actually have a calculated and reasonably accurate score of less than 2. If this is so, you may wish to unilaterally and voluntarily stop taking Xarelto.
https://www.healthline.com/health/age-range-for-stroke#stroke-risk-by-age-range

Thanks for the reply. It turns out that I am not under 65, or under 75 for that matter. However, I am healthy, active, and have no other comorbidities. My Cardiologist is conservative, so he's unlikely to recommend stopping the anticoagulant without reducing the risk of an Afib related stroke, aka Watchman. I'm not comfortable with unilaterally quitting Xarelto, and I'm not keen to undergo the Watchman procedure. Maybe if I tell my cardiologist that gloaming says it ok, he'll go along with it? Just kidding...

@nevets Ha! 😀 I'm happy to see you are fit and young, so if you can go free of AF or any ectopy for a full 12 months, that is the point at which an ablation is deemed to be successful. It's just me saying it, but if I were in your shoes, with no arrhythmia of any description, and you're pretty darned sure of it, then I don't see why you should take more than maybe a baby aspirin (81mg of ASA) each day, and that would have to be approved/negotiated with a real caregiver...not me. I do appreciate that all drugs have unwanted effects, including Eliquis and Xarelto, and it's not like they can be picked off a low bush in your garden a couple of times a day. They cost a bundle!

Thanks. Although I've had no Afib episodes since the ablation, I still have occasional PVCs and PACs. I've had these years before my Afib started and according to my cardiologist, while they technically qualify as abnormal heartbeats, they are common and of little concern. A side note to this issue is that since I started drinking half teaspoon of magnesium citrate in warm water each evening, I have even fewer PVCs and PACs. I think the upshot to all this is that I'll probably wait until the one year anniversary of my ablation (mid January) and reconsider my options then.

@nevets
If you want to see how healthy you have to be to go off Xarelto or any other DOAC take a look here, https://clincalc.com/cardiology/stroke/chadsvasc.aspx . Just 1 age related malady like hypertension and being 75 or older to the medical profession means your a candidate. Not saying there are folks out there who wouldn't meet the guidelines but a lot of us do.

So enjoyed nevets and gloamings dissertations about our doacs. Am in exactly the same place as nevets with exact same quandary and 'demographics' except 1yr post ablation and monitor with no afib, EP ready to quit all meds and BANG, episode!! So off other meds but still on Eliquis. Also do have some PACs. EP says my decision about stopping Eliquis. What to do, what to do!!!! Really a challenge in decision making.

My ablation procedure was in May 2025, and I am still on Eliquis. It is interesting that the EP team who did the PFA believes that I should remain on Eliquis because of my CHAD score. I am 86 years old and that gives me the automatic plus 2 score. My cardiologist group is the opposite and say that I can probably go off of Eliquis and go on baby aspirin. I was presented with the options by the EP team of stopping Eliquis by having a monitor implanted or by wearing a Apple watch or some other device. I do have the Cardio Mobile that I use once a day. My EP team is still reluctant to rely strictly on the Watchman to remove the possibility of a blood clot, so that option is still up for debate. The cost of Eliquis will be going down after Jan 1, 2026, and it will be interesting to see the cost to me after my what my insurance will pay. Right now, I pay $110 for a 30-day supply. If the retail price goes down by over 50% maybe my cost will go down by the same amount.

I have had 2 ablation procedures and no AFIB for about 2 months afterwards and then it returned. That is why my Cardiologist wanted me to continue taking my Eliquis in the event my AFIB returned which it has.

Now my Cardiologist wants to perform another ablation, but I told him thanks but no thanks. I am 80 years old and have a lot of health issues other than my heart and I am just plain tired of being poked through my groin area over and over again and no positive results have come out of my procedures. I also have had a Cardio Cauterization and 3 cauterizations to determine blockage, and I had a 20 to 30 percent blockage which is not bad at all.

Don't get me wrong, we are all different and all have different health issues, but this is my opinion only, but your Cardiologist knows best on what to do. Of course, taking Eliquis is no guarantee that I won't have a stroke and/or heart attack, but it just won't be as bad as if I was not taking blood thinners. I have decided that I am just going to continue to take my blood thinner for the rest of my life for whatever time I have left in this world.

Take care and God Bless.