Typically yes for the first 2-3 months. Immediately post ablation, due to irritability of the heart, pts tend to have atrial arrhtymias which may or may not mean a whole lot in the long term. So we generally continue antiarrhythmics (Tikosyn) in your case for at least 2-3 months. After that based on how you do, we generally discontinue it. Eliquis is typically continued for the first 4-6 months. Long term Eliquis would be based on you stroke risk as defined by CHADS2Vasc or CHADS2 score.
We generally recommend taking AV node blockers (beta blockers) or calcium channel blockers with Flecainide even when using it a PIP to prevent the risk of 1:1 conduction. Having said that, if you are having resting bradycardia, and if your heart rates are not in the tachycardia range when you are in Afib, the likelihood of you going into flutter with 1:1 conduction is very low. Since its only PIP approach, it would generally safer to take at least one dose of a low dose, short acting AV node blocker and it should not be impacting your rates for too long.
In your case the indication to perform an LAA closure and stop anticoagulation is given. This is a good argument to go for a thoracoscopic procedure. This will include bipolar RF PVI in addition to LAA Clipping. After this procedure you will require anticoagulation for 6 Weeks afterwhich this can be discontinued safely.
The results fo this procedure are excellent.
I agree. Go seek advice in an experienced ablation venter. either catheter ablation or thoracoscopic ablation will be a good option.
Dr. Andrea Natale
Dr. Andrea Natale is a board certified electrophysiology expert and practices at executive medical director of the Texas Cardiac Arrhythmia Institute at St. David's Medical Center in Austin, Texas. Dr. Natale also is the Senior Medical Director at Pacific Atrial Fib and Arrhythmia Center in San Francisco. He visits MetroHealth in Cleveland, and Akron General, Ohio. He has pioneered a new circumferential ultrasound vein-ablation system to correct atrial fibrillation and performed the procedure on the world's first five patients. For further details Please visit :Link
Dr. Dhanunjaya Lakkireddy
Dr. Dhanunjaya Lakkireddy, MD, F.A.C.C, FHRS. is a board certified electrophysiology expert and practices at Mid-America Cardiology and The University of Kansas Hospital Clinics in Kansas City, KS, USA. He has several distinctions in clinical and research career to his credit and serves as an associate editor for Journal of Atrial Fibrillation.For further details Please visit :Link
Dr. Dhanunjay Lakkireddy, MD, F.A.C.C, FHRS, The Kansas City Heart Rhythm Institute (KCHRI), KS, USA.
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