Pacemaker & Meds after TAVR

When I had my pacemaker put in and prior to, I was put on Eliquis, and they said it was to thin my blood to help with the flow of blood due to the size of my aorta. Three days prior to TAVR I was asked to stop Eliquis. Upon discharge the TAVR Dr. changed me from Eliquis to generic Plavix (clopidogret). Has anyone else had a change after TAVR? My TAVR Dr. said the Eliquis was for A-Fib. I have A-Fib so I am trying to find out between the Pacemaker Dr. and the TAVR Doctor just what should I be taking for my heart and pacemaker?? They also changed Metoprolos succ from 25mg to 50mg? Any thoughts on medications for both pacemaker and heart valve?

2 Comments

Anti thrombotic therapy following Transcatheter Aortic Valve replacement

by Gemita - 2023-05-21 13:02:35

Indyglo, of course you should be guided by your doctors as to how long you will need to remain on anti thrombotic therapy, but if you have AF, Clopidogrel or Aspirin which are antiplatelets, are no longer recommended as effective medication to protect you from an AF related stroke, so you might still need additional protection.  Clearly with a heart valve, you need to be guided by your surgeon and Clopidogrel, an antiplatelet, sounds correct, but for the AF you need to be guided by your Cardiologist/EP and you probably need an anticoagulant as well if you have AF stroke risk factors.  It seems Warfarin is the only approved blood thinner for mechanical heart valves.  If you have a mechanical heart valve, you may need to take this medication for the rest of your life. 

I have no experience with a heart valve, but when my husband had stents placed he was required to take triple therapy:  Clopidogrel, Aspirin (antiplatelets) and Apixaban (anticoagulant).  This triple therapy initially caused urinary bleeding due to prostate disease.  After three months Clopidogrel was dropped, then after 12 months Aspirin was also dropped and now he is on Edoxaban only (changed from Apixaban) for AF stroke prevention.

You need to go back to your doctors for clarification, since with AF to stop anticoagulation might be dangerous if you are getting AF episodes?  The Metoprolol shouldn’t be a problem and the increase may just be while you are healing from the valve procedure and to help keep your AF under better control.

So don’t panic but please ask your doctors whether you need to be taking Apixaban or another anticoagulant specifically for your AF and the type of valve you have?  Apixaban would have been stopped before the TAVR procedure, but an anticoagulant should probably be started again at some stage to keep you safe with an arrhythmia like AF.  I hope you heal quickly and do very well

Eliquis vs Plavix

by AgentX86 - 2023-05-22 12:33:10

Eliquis is not FDA approved for those who have had valve replacements.  Plavix is.  One isn't a direct replacement for the other but with a heart valve replacement the change is necessary.

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At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!