Blood Thinners

Any input very welcome. I’m 6 months post ablation. I’m still getting the odd run of AF. Had around 15 events of AF and Tachy since ablation end March,mostly short lived. A couple of very highTachy /Af combined in May Up to 200+ heart rate. Two AF in July, one 12 hours and one around five hours , heart rate not as high as they used to be, now around 130-140. One AF in early August around 3 hours. I’m also getting spikes in my heart rate where it will suddenly shoot up,160 and then drop back, sometimes to under 50, then stabilises at around 80 to 85. That occurs a few times each day.

My question is, would stopping Eliquis be ok. I’ve recently had a haemorrhage in my eye (diagnosed with Wet Macular Degeneration) and my vision is impaired in that eye. There is no guarantee my other eye won’t go the same way. I’ve read that blood thinners might be an issue, and am really worried about my chances of developing further problems.

Have I asked my Dr…no…I have the greatest respect for my EP and am very pleased with what he has done, after having lived with AF for over 25 plus years. He will probably want me to keep taking it. Just looking for any alternatives to Eliquis.

Quote
JoyWin
I’ve recently had a haemorrhage in my eye (diagnosed with Wet Macular Degeneration) and my vision is impaired in that eye. There is no guarantee my other eye won’t go the same way.

Not commenting on the OAC, but on wet/dry AMD. I first attended a presentation by opthamologist, Chris A. Knobbe, MD, at a conference in 2016 and another in 2020. Dr. Knobbe's website, book and PDF of first chapter of book.

Joy my 2 cents. Imo it sounds like blood thinners ( even though their not) is a must fot you. Too many sporadic events at high rates and lasting hours. I hate eliquis too
I want off but its way down the road for me. LAA Watchman etc etc Just my opinion and am sure your EPs as well. My EP here is pro eliquis. Risking a stroke just not worth it. We re still at some risk even on eliquis. But our blood is not thinner. Its an anticoagulant. Prevents clotting

I read that my LAA being isolated were i to not take eliquis id be at 14–15% stroke risk. Too high for gambling. I do think that as time as gone by there is a much more safety conservative approach. After my 2012 ablation i was warfarin resistant and told: just take aspirin lol!
Tom

What is your CHADS-Vasc score?

Carey, ,
CHADS Vasc score is 3 (age over 75 and female) although I did have an unprovoked PE 3 years ago.
Thanks George, I will follow up.
Poppino, I take on board what you have said. It’s difficult to make a decision one way or the other.

Over 75 female?? Half dose??? 5mg. But a chads 3 i think warrants it. Carey will know

Quote
JoyWin
Carey, ,
CHADS Vasc score is 3 (age over 75 and female) although I did have an unprovoked PE 3 years ago.

I'm sorry, but your CHADS-Vasc score is 5, not 3. That's because of your prior PE. A PE qualifies as "Stroke/TIA/thromboembolism history" so that adds another 2 points. And unlike the point for being female, those points count kind of big time. The point for being female doesn't count with afib under current guidelines, so you can subtract 1 point, leaving you a 4. But at your age it's also very likely that if you did a TEE they would find aortic plaque, giving you another point, so it's likely you're really a 5.

I wouldn't even consider stopping Eliquis if I were you. You have active afib and you're at high risk of stroke or systemic embolism. Without an anticoagulant, you face a 7.2% risk of stroke annually, and a 53% chance over the next 10 years. I would not risk those odds. No way, no how.

Sure, I know how vital vision is, but your brain is even more vital, and being visually impaired won't matter that much if you're a bedridden stroke victim who can't walk, talk, or eat on her own.

I'd recommend having a talk with both your ophthalmologist and your EP. Getting them to collaborate and reach a mutually agreed solution would be awesome. What does the eye doc think about the real risks you face from the Eliquis? What does your EP think about compromise solutions like half-dose Eliquis?

Can’t Joy bridge? I had to bridge for my pacemaker surgery.

Thanks for laying it out Carey. Gosh…CHADS Vasc score that high, I was not seeing the obvious.
I guess I need to think about this some more.
I am a very visually orientated person and the thought of maybe losing my sight…well, scares the heck out of me.

I am reasonably fit, not overweight, and vegetarian.
I am on half dose Eliquis due to my age and weight, 2.5mgx2. I wondered if I could take it as a PIP. I’m quite symptomatic with episodes, and know exactly when I have one,however that doesn’t cover episodes that don’t wake me up of course, but I’m pretty sure they would be quite brief. Lots to Consider.

George, I read the articles you recommended, I think my diet is pretty much close to what the Dr discusses apart from the animal products.
My eye Doc explained Wet AMD is due to the growth of abnormal veins and just comes on without warning when they burst, as happened to me. One minute I had normal vision and then I didn’t.

Quote
JoyWin
I wondered if I could take it as a PIP.

I actually did that for over a year, but I was a CHADS 1 at the time. My EP only reluctantly agreed to it, and insisted that I take the PIP immediately when an episode begins and continue taking it for several days afterwards. I doubt you'll convince your EP agree to that.