Question re second ablation

I need a second ablation in Bordeaux which I'm hoping I can arrange in the next few months if Covid restrictions and leaving the European Union on 31st December allow.

My problem is that there is no way where I live of having a TOE done in the week before the op.

Bordeaux will do a CT scan when I get there as a substitute but if it shows a blood clot in the heart they will not be able to do the operation.

Will starting an anti-coagulant mean there is no possibility of a clot and how long would I need to be on it to be sure?

Thanks

Sam

Please explain your situation to Bordeaux. Ask them if due to your circumstances the test can be done just before your ablation.

Sam, you need a second ablation and you're not already on an anticoagulant? If you have enough AF to consider another ablation, you should almost certainly be on one and if you're not, you need to get on one ASAP. The usual time period required to be sure any clots that exist have dissolved is three weeks on an anticoagulant, so you should have plenty of time.

Would they recommend both and anti coag like eliquis 5mg BID and anti platelet like 81mg ASA BID?

Doubt it. I've never heard of anti-platelet drugs being used for that purpose. It's usually just an anticoagulant for 3 weeks followed by a repeat TEE to make sure the clot is gone. I don't think an anti-platelet drug like aspirin brings anything to the table in this situation.

Thanks for the replies!

Carey - after episodes two days running (the fourth and fifth episodes since my June 2018 ablation) I started Flecainide 50 mg twice a day and this has kept me in NSR since 17th March.

Sam

That's great! But I take it that means you're not taking an anticoagulant? What's your CHADS-Vasc score?

I'm going to be heading back to Bordeaux in the new year too Sam - again as soon as Covid-19 considerations permit - owing to post-PVI (Aug 2018 - i.e. a month or two after you) focal atrial tachy issues. I'm taking 2.5mg Eliquis BID already as an anticipatory precaution and will up that to 5mg BID as soon as I get a date. I too can't get a TEE of CT here in the UK - even privately - and will instead have the CT scan at Bordeaux when I get there.

Cheers,

Mike

Carey - not using an anti-coagulant at present but will be using the same system as Mike.

I've forgotten my chad score but it was very low and Prof Jais said I didn't need an anti-coagulant except for the first couple of months after the ablation.

Sam

P.S. Might see you in Bordeaux, Mike!

Mike and Sam

Please keep posting here about your plans. My husband might be heading for Bordeaux in the near future so it would be really useful for us to know the details. Much will have changed since my ablation there in 2003.

Gill