Blood thinner

ANTICOAGULATION COVER

by Gemita - 2020-08-03 16:36:00

Hello Vandyike,

Are you wanting to know about stopping the newer oral anticoagulants like Apixaban, Edoxaban, Rivaroxaban and Dabigatran before an implant?  Each hospital/pacemaker clinic/EP will have their own guidelines to follow.  My EP told me to miss the last dose prior to my implant (so only one day's missed dose), some clinics however I believe don't recommend stopping at all.

What did your hospital recommend and were you happy with your treatment ?  I think too it depends on the patient, their health conditions, the safety or risk of stopping the anticoagulant.  My husband for example had quite a serious bleed because they failed to stop his anticoagulation but he was on triple therapy including Clopidogrel, Aspirin and Edoxaban, so they really messed up and my husband paid the consequences

Stopping anticoagulants

by AgentX86 - 2020-08-03 23:19:29

Gemita makes a good point.  Some of the NOACs (new generation of anticoagulants) have a very short half-life.  Eliquis, for example, has a half-life of 12 hours, which means that half it is gone from the blood stream in 12 hours.  This is why it's taken every 12 hours. Minor surgery like a PM implant is often done with just one skipped dose because that's enough to lower the concentration in the blood low enough that there is rarely a problem.  It's mnor surgery so it's not likely to be a problem anyway (why some don't stop it at all). 

I've cut myself (I'm on Eliquis) and it didn't bleed much more than it did before.  Aspirin is an anti-platlet drug so can make it a lot harder to stop bleeding. I'd never heard it being used in conjunction with a NOAC until here, the last couple of days.  It seems dangerous to me.

blood thinners pre implant

by Original Cyndy - 2020-08-13 14:49:44

They sent me to the ER at 5:30 PM to get set up for PM, doc told me they were scheduling it for the next morning so my previous morning eliquis could wear off (and so skipped the next morning's dose).

However, another doc the next day said they don't really have to stop blood thinners "anymore"--meaning, the newer types? Newer thinking? For all surgeries? Due to covid micro clots? Who knows?