Eliquis as PIP

Hi guys,

I wonder what the opinions are of taking Eliquis on an as needed basis. I'm closely monitoring my heartrate and AFib with oximeter and Kardia. I have not experienced AFib since last July and am not on an AAD since last August. I started using CPAP last Sep and believe that is keeping me in NSR during the night (I only ever went into AFib middle of the night). I do get PVC's and PAC's occasionally but low level metoprolol helps along with supplementation recommended here and they are less common when my lifestyle is stricter.

My ChadsVasc is 0-1 at most. Is the anticoagulant something I can take as needed if I happen to flip into AFib? Obviously if AFib becomes a bigger burden I would stay on the ELiquis regularly. Is there a concern (besides stroke risk) of starting and stopping Eliquis?

Thanks - Bob

Here is an article on the topic: [www.tctmd.com]

Thanks George, interesting article!

Quote
GeorgeN
Here is an article on the topic: [www.tctmd.com]

Thanks for that link George!
Interesting! I'm one of the risk takers, according to my cardiologist, who also uses PIP anticoagulation, Being not ablated but symptomatic when in AF (or just irregular heart beats?) i chose to use Eliquis for during and a few days after AF stops. Have no electronic monitors/watch etc..
My blood type is O+ - supposed to be less prone to clots, fingers crossed.
Reason for doing PIP for me is that small cuts do bleed quite a bit.

After my ablation in 2012 i went 9 years before developing atrial flutter. During those 9 yrs my EP did just that. Eliquis as soon as i started any episode which were 1-3 a year lasting 30 mins to a few hours. So i just kept it on hand. I though know immediately if an episode begins as all. ALL have been 115-155 bpm. So im in the camp of pip unless you are unaware of being out of rythm. Slow quiet afib is just as dangerous i think as a 175 HR

Quote
GeorgeN
Here is an article on the topic: [www.tctmd.com]

Thanks ! It's interesting !

What if you get non symptomatic afib and take a PIP instead of a daily full dose? The ERs possibility won’t ecv you (malpractice concern) unless you are on a NOAC.

I had my watchman for 46 days and todays TEE showed no leaking. I’m still taking 1/2 dose Eliquis-no aspirin until my 6 month TEE. I had a discussion with an ER dr recently and asked how difficult it would be to get ecv while taking a half dose instead of a full dose with proof one has a watchman? His reply was he would do it but he speculated his colleagues would not. That is on a half dose of Eliquis 2.5mg BID instead of 5mg BID with a watchman. I speculate a PIP of Eliquis would produce more resistance in the ER.

In the past from 2004 to age 66 when I started Eliquis, I would take a daily EKG as proof I was in nsr the past 48 hours. With my frequent flyer ER visits (ecv 51 times), I became a regular and they trusted me since I always brought my ekgs with me. Now since I passed 65, the first question has always been have I been compliant with my Eliquis? Once I said yes I was giving the choice of chemical or electrical conversion. No resistance because I was taking a full daily dose.

I suggest if anyone seriously wants to eliminate daily NOAC, they should wear a holter for 10-14 days to rule out unknown non symptomatic afib before switching to a PIP. Also bring daily ekg printed proof from your Kardia/IWatch etc that you have been in nsr the prior 48 hours. It’s still a gamble because getting a stroke is worst than the inconvenience of taking two pills a day.



Edited 1 time(s). Last edit at 03/30/2022 12:05AM by susan.d.

Quote
susan.d
Also bring daily ekg printed proof from your Kardia/IWatch etc that you have been in nsr the prior 48 hours.

Though I've never had an ECV, I've taken a morning reading with my Kardia since 2014 for use in just in case of this circumstance.

Quote
GeorgeN

Also bring daily ekg printed proof from your Kardia/IWatch etc that you have been in nsr the prior 48 hours.

Though I've never had an ECV, I've taken a morning reading with my Kardia since 2014 for use in just in case of this circumstance.

Wise George. I stopped printing them up because my Metronics pacemaker has a 24/7 monitoring and all I need to do is get an interrogation download at the ER or EP to get my arrhythmia history strips.

My PM self converted me 33 times (63.6% success rate) through its boost (zaps) therapy settings the past 3 months. It would had been a higher success % but one time nothing worked and I was 24 hours admitted at 200hr on my 70th birthday until I was ecv. Great gift finally being in nsr. My boost therapy aborted after 7 times that day and other times that day and lowered my success %. It’s amazing because some of the events were just a second or two before the boost worked and I didn’t notice the arrhythmia but I noticed the instant sudden change in hr from tachycardia to 55. It’s like suddenly slamming on your brakes with your foot flooring the brake pedal. I felt my hr instantly decelerate.

I appreciate the views on this. Beyond taking the risk so to speak or not noticing if you're in AFib (stroke risk), is there any issue with stopping and starting Eliquis from an efficacy or medical standpoint? Some meds you can start and stop however you please. I'm trying to find out if Eliquis is OK to do that with.

Thanks

Bob, what is your age?

"is there any issue with stopping and starting Eliquis from an efficacy or medical standpoint?"

Probably not for you to worry about. If you decide to get off of it, you just get off it. Having said that, there is a Black Box Warning for Eliquis.
[www.eliquis.com];

View this warning with the perspective that there are many AFIB patients who don't take or stop their anti-coagulants when they shouldn't. The key is knowing when your in AFIB and when your in NSR. Then you can make a decision to get off the Eliquis, based on the knowledge you have been in NSR for months now.



Edited 1 time(s). Last edit at 03/31/2022 04:27PM by The Anti-Fib.

Just turned 59. Thanks for the info. It does appear compliance can be a factor over the long term (forgot to take pill, ran out of meds, travelling, etc.).

Compliance rates for anticoagulants are actually appallingly bad. I don't have the numbers handy but as I recall nearly 50% of all people on long-term anticoagulants eventually stop taking them.

i missed the part where taking baby aspirin daily was an option? i am doing that now after being on eliquis.

Quote
adamh
i missed the part where taking baby aspirin daily was an option? i am doing that now after being on eliquis.

It's not a good option for most people who need an anticoagulant. It has a higher bleed risk and is significantly less effective at preventing afib-related clots than all the DOACs.

Dr John Day references the above article regarding PIP. His suggestion is, if you do it, to take the NOAC for 30 days afterwards.