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Suggest Treatment For Atrial Fibrillation While On Eliquis

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Posted on Tue, 16 Feb 2016
Question: I have been on Elliquis for a couple of weeks Now I have been scheduled to undergo cardio version on Monday for the atrial fibrillation Any additional risk for that procedure or is it an external procedure so no risk of bleeding Also I have a pace maker Any significance to that ???
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Answered by Dr. Dr. Meriton Siqeca (1 hour later)
Brief Answer:
Safe conversion

Detailed Answer:
Hello, sir. Thank you for your question and welcome to HCM. I understand your concern.

Apixaban is given to anti coagulate (thin the blood) in cases of atrial fibrillation. What happens in atrial fibrillation. Well, cardiac atria lose their normal contraction (mostly due to enlargement of the chamber) and they contract irregularly and, therefore, they produce a "futile" contraction. This kind of contraction makes the propelling of the blood from atria to ventricles of no use and, therefore, blood is pooled in the atria. Pooling of blood in the atria may produce thrombi (blood clots) which may be "thrown" in the pulmonary or systemic circulation in any time. I am assuming an echo cardiogram was performed before cardioversion, and no thrombi were found in the atria, whatsoever. One thing is for sure: cardioversion is risky if you are not on blood thinners. On the other hand, there is no risk of bleeding, because it is not a invasive procedure (procedures during which the tissue integrity is concerned and, therefore, may be loss of blood). My opinion is that it is totally safe to perform cardioversion while you are taking blood thinners. As for the other concern, there are reported cases of pacemaker battery discharge after the cardioversion. However, a body of studies recommend that the cardioverting paddle should be placed at least six inches away from the pacemaker, which has been proved to be safe for the pacemaker. I am confident that almost every cardiologist is aware of this and will be careful with the procedure. I wish you a successful procedure.

I hope I was helpful with my answer. I am happy to help, if you have follow-up questions. Please rate the answer, if you do not. Good luck!

Best regards,
Dr. Meriton
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Dr. Meriton Siqeca

Cardiologist

Practicing since :2009

Answered : 775 Questions

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Suggest Treatment For Atrial Fibrillation While On Eliquis

Brief Answer: Safe conversion Detailed Answer: Hello, sir. Thank you for your question and welcome to HCM. I understand your concern. Apixaban is given to anti coagulate (thin the blood) in cases of atrial fibrillation. What happens in atrial fibrillation. Well, cardiac atria lose their normal contraction (mostly due to enlargement of the chamber) and they contract irregularly and, therefore, they produce a "futile" contraction. This kind of contraction makes the propelling of the blood from atria to ventricles of no use and, therefore, blood is pooled in the atria. Pooling of blood in the atria may produce thrombi (blood clots) which may be "thrown" in the pulmonary or systemic circulation in any time. I am assuming an echo cardiogram was performed before cardioversion, and no thrombi were found in the atria, whatsoever. One thing is for sure: cardioversion is risky if you are not on blood thinners. On the other hand, there is no risk of bleeding, because it is not a invasive procedure (procedures during which the tissue integrity is concerned and, therefore, may be loss of blood). My opinion is that it is totally safe to perform cardioversion while you are taking blood thinners. As for the other concern, there are reported cases of pacemaker battery discharge after the cardioversion. However, a body of studies recommend that the cardioverting paddle should be placed at least six inches away from the pacemaker, which has been proved to be safe for the pacemaker. I am confident that almost every cardiologist is aware of this and will be careful with the procedure. I wish you a successful procedure. I hope I was helpful with my answer. I am happy to help, if you have follow-up questions. Please rate the answer, if you do not. Good luck! Best regards, Dr. Meriton