Eliquis or not?

Cardiologists cleared me to stop Eliquis as have a low CHADS score (0) and rare episodes (paroxismal Afib). I do not have any asymptomatic Afib.

My cardiologist/EP indicated to hold off on ablation for a while as he said it is possible my episodes were caused by Covid infection and subsequent long Covid (I am still recovering). He indicated that I take Eliquis as needed, when I have an episode.

Some studies I read on long Covid indicated that the inflammation can cause clotting in very ill patients. I am 60-70% into my recovery, with less and less effects of Long Covid.

Apparently, the risk of taking Eliquis is about 2% to get a life threatening bleeding. And I cannot do activities that could cause me to bump my head (hiking for example).

Any experience in this community I can learn from?

I have no experience with COVID, but from what I know of it if I were in your shoes I would continue taking the Eliquis.

And I don't know who told you that you can't do activities like hiking while taking Eliquis, but they are just plain wrong. I've been taking Eliquis and other anticoagulants since 2010, and I've been hiking and cycling the entire time. There's no reason to stop reasonable outdoor activities.

I don't know old you are, or how stable you are on your feet, but as for myself, I have slipped while hiking about 10 times, as I hike in rough desert terrain, but I never was close to hitting my head. The bigger risk of injury from falling from hiking would be to the lower legs area, unless you are rock climbing or something like that.

Maybe after the Covid clears, try going off the Eliquis, to see how you feel. The key is how confident you are that your not having undetected AFIB.



Edited 1 time(s). Last edit at 12/18/2023 03:19PM by The Anti-Fib.

I was worried about Eliquis because we are building an addition and I am up on ladders, using hammers, tools, etc. I had more bruising,.but nothing else. I work in an ER and the ER doctor said the biggest risk would be a head injury, but they could give.me something to counteract and stop the bleeding. I know quite a but about Covid/long Covid and clots are a real risk as is Afib issues. If you decide not to take Eliquis, I would think about a full strength Aspirin at least. I worried immensely about the Eliquis and it was fine. I had no issues.

It comes down to risk/reward. In general stroke risk far outweighs bleed risk in terms of consequences, however bleed risk should not be dismissed.

If your CHADS is zero, I would go with what your cardiologist says, which is a PIP approach. While not fully accepted, PIP (as needed) thinners has some support and in fact there is as large, multi-institutional trial now enrolling (REACT-AF) which will test the concept in conjunction with Apple Watch.

As to COVID and clot formation, unaware of any guidelines that suggest thinners because of Covid per say, plus sounds like you are beyond the acute phase.

Jim



Edited 1 time(s). Last edit at 12/18/2023 05:56PM by mjamesone.

Thanks everyore for the answers. After talking with my GP decided to wait until I have fully recovered from long covid, which will likely be another few months. Activities are limited at the moment, due to post exertion malaise (a common issue with long covid) , but feel more confident knowing what activities others can do safely.