This question keeps coming up over and over, perhaps we can get some sort of "Sticky Post" on Post Conversion Anti-Coagulation.
What do mean by "Is there a SOP?"
This question can only be answered by assessing one's individual Stroke Risk (Chads-VASc), and AFIB Frequency. By "Frequency, we mean Frequency of episodes, how likely future episodes are, and most of all the confidence you have in being able to tell when you are or have been in AFIB. The Doctors most often tend to error on the side of caution and Liability Protection, and recommend or mandate Anti-Coagulation, as they usually do not trust the Patients awareness of AFIB frequency or duration. Indeed there many who are not sure when their AFIB has started or stopped, or if they were in AFIB during sleep.
The Atria becomes "Stunned" (does not contract) as a result of the AFIB. It is during this period Clot Formation is a risk as the Blood is not circulating normally in the Atria. The Atria resumes normal function after some point after a Conversion. This usually happens within minutes or hours, but it can take upwards of 4-6 weeks in some cases.
I will just say what I have decided for myself, I have Lone-AFIB, Chads score 0. I absolutely know when I am in AFib, or not. I have lived through many Conversions over the last decade. I have talked to 5 Cardio Dr's about this and 3 of them were EP's. I also did much Internet research. If I have an Episode that lasts less than 8 hours, I don't take AC Drugs. If my episode lasts less than 48 hours then I take Xarelto for 4 days Post Conversion, and then taper down to a half-dose of 2.5mg for another 3 days. For longer Episodes I extend the Eliquis out to a max of 10 days. That is just my risk assessment that my Dr. has gone along with based on my situation and circumstances. If I was having multiple Episodes in the same month, and then ongoing AFIB recurrences, then my Dr. wants me on the AC Drugs continuously.
Edited 2 time(s). Last edit at 02/12/2019 05:33AM by The Anti-Fib.
