Dr. Natale and blood thinners

Thank you for your time everyone.
My ablation is on 3/14 and Maestro Natale wants me to keep taking Eliquis until the morning of the procedure.
I always bleed very easy and just slightly concerned.
If God forbid something goes wrong during ablation, wouldn't it be easier to bleed out with all the blood thinners in my system?

You absolutely must be on anticoagulants during an ablation. In fact, during the procedure you'll be given heparin, which is a another anticoagulant. There's very little risk that something "goes wrong" leading to bleeding. That's a very unusual complication, especially for someone like Natale. Nobody bleeds out during ablations. That just doesn't happen.

Many of the things they do during an ablation can cause clotting, including the burns themselves (dozens of them), the septal puncture where they push a needle through the septum to go from the right atrium to the left, and even just the presence of the catheters themselves. All these things create a significant risk of creating clots, so that's why they want you on an anticoagulant right up until the procedure and then give you heparin during the procedure. Clots are far, far greater risks to you than bleeding. In fact, it's so important that if you told them that morning that you stopped the Eliquis, they would cancel the procedure.

Relax. Eliquis is your friend in the coming months.

Carey, that was the best, most educated response ever. Thank you for putting my heart at ease.
It all makes sense now. Thank you.

Ditto what Carey said New Yorker.

The only two things you are required to do in an ablation with Dr Natale are

1. Don’t be late to the ablation prep ... be on time or even a bit early
2. Make Dang sure you take your last dose of Eliquis right on time like 5am on moringvof procedure for example , but they will tell you the day before when to take last dose. This is part of Uninterrupted Anticoagulstion Protocol for AFIB Ablations pioneered largely by Dr a Natale and other elite centers like Univ of Penn, Bordeaux, etc. developed to insure no stoke or TIA occur periprocedurally (i.e. during or after the ablation and included the large IV Heparin bolus injection just before dual transeptal puncture occurs ... not after as occasionally I hear of some EPs still doing whichbus a ‘no no’.

3. Since you could not possibly have made a better choice upfront anywhere on the planet for who to care for your heart on Ablation day ... after your two part job is done just relax and go with the flow and you will be gliding h on a gurney everywhere and the rest is truly effortless on your part.

Try singing to yourself as they push you down the hall the old nursery rhyme that is actually very insightful .... “row, row, row your boat gently down the stream ... merrily merrily merrily ... Life is but a dream” . Next thing you know in goes the propofol underscoring the reality of the last phrase of the song and the next thing you know it’s all over and you’re on the other side of the fence! Easy as pie!

No worries at all!

Shannon

If I were to consider this tx, and it includes frisk for dangerous clots, would only work with physician who would be willing to read pubmed
studies of nattokinase which find no adverse defects unless combined with aspirin- over a thousand year safety profile in asia as a
delicacy, although very stinky- available in capsules-works differently from warfarin and other lab creations - works like body natural
fibrinogen system that creates necessary clotting as part of healing lesions, and fibrinogen system to dissolve these clots as no
longer needed for healing

Quote
Carey
You absolutely must be on anticoagulants during an ablation. In fact, during the procedure you'll be given heparin, which is a another anticoagulant. There's very little risk that something "goes wrong" leading to bleeding. That's a very unusual complication, especially for someone like Natale. Nobody bleeds out during ablations. That just doesn't happen.

Many of the things they do during an ablation can cause clotting, including the burns themselves (dozens of them), the septal puncture where they push a needle through the septum to go from the right atrium to the left, and even just the presence of the catheters themselves. All these things create a significant risk of creating clots, so that's why they want you on an anticoagulant right up until the procedure and then give you heparin during the procedure. Clots are far, far greater risks to you than bleeding. In fact, it's so important that if you told them that morning that you stopped the Eliquis, they would cancel the procedure.

Relax. Eliquis is your friend in the coming months.

Cary is right on. Dr Wharton requires that you be on Eliquis for 30 days prior to the ablation procedure for the same reasons.

Hi Everyone.
New to the Board.
Underwent an ablation procedure 10 days ago. Still on Eliquis. Not due to see the cardiologist until May for a review. No underlying reason for my continued use When have others been advised to come off or reduce? Thanks

Quote
bluehouli
Hi Everyone.
New to the Board.
Underwent an ablation procedure 10 days ago. Still on Eliquis. Not due to see the cardiologist until May for a review. No underlying reason for my continued use When have others been advised to come off or reduce? Thanks

You absolutely cannot stop the Eliquis until you see your EP in May. There is definitely an underlying reason and that reason is you had an ablation 10 days ago. Anticoagulants are usually considered mandatory for 90 days following an ablation. After that it's going to depend on the success of the ablation and your CHADSVasc score. Talk to your EP before you do anything.