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pamela
Dear Forum,
Three years ago I had to have my second ablation. I was blessed with 10 years of being free from afib before that. It reconnected in my left appendage and had to have that area ablated. I was told to stay on Eloquis. I had a TEE six months after the second procedure. My local cardiologist thought it looked good. Dr. Natale said he could still see a shadow. Not sure what that meant, but I continued with my Eloquis. At my last checkup with my local cardiologist, he told me my risk factor of bleeding was higher than stroking and he felt I only needed an aspirin..
I was wondering if it is protocol for all patients of Natale's patients, that have to have the left appendage ablated that they are destined to always be on blood thinner. I have not had any problems with Eloquis. But I feel I am a young, active 60 year old and I am concerned about taking Eloquis for the rest of my life.
No, it is not Natale's protocol to require everyone with an isolated LAA to take anticoagulants for life. His protocol is to do that six-month TEE you had and to make the decision based on that. There are three criteria he looks at: the flow velocity within the LAA, the E/A wave measurement, and the presence of "smoke" in the images. I don't know what they found on the first two but it sounds like you failed the last one.
I would be extremely cautious about taking any other doctor's advice on your need for an anticoagulant. The vast majority of doctors, even most cardiologists, are not familiar with LAA isolation and the risks it involves. In a nutshell, if you don't meet the criteria for stopping anticoagulants then your risk of stroke from stopping the Eliquis is very high, much higher than your cardiologist supposes.
If I were you, I would get on the phone to Natale's office and ask how to proceed.
You absolutely should not stop the Eliquis until you do this. Asking them to send their opinion to your cardiologist would be a good idea.
If you want off the Eliquis, doing a repeat TEE is one possibility. Sometimes the numbers do improve with time, so a second TEE might get you cleared to stop the Eliquis. Another possibility is seeking an LAA occlusion device such as a Watchman. Being only 60 and probably having a low CHADS score, you might have difficulty getting your insurance to cover it, but I think that will change in the near future. If they won't approve it this year, they might approve it next.
Edited 1 time(s). Last edit at 07/12/2019 02:18PM by Carey.
