Blood thinners

Is anyone taking blood thinners. I was recently told by my pacemaker/defibrillator reading said I had an Afib episode. Very upset and disappointed because I have a pacemaker and did not think that could happen. Thoughts? Comments?



by Violet West - 2019-11-01 12:59:06

yep, I have persistent/chronic AFIB (symptoms relieved, thank goodness, with PM implant and AV node ablation); and I'll be taking them the rest of my life.  

Better than a stroke any day. 

Blood Thinners

by jute57 - 2019-11-01 13:52:57

Thank you!  agree better than a stroke a day, what is AV node ablation?



by AgentX86 - 2019-11-01 14:22:51

I've been on blood thinners continuously for five years and occasionally for several years before that. I had my LAA clipped five years ago and an AV/His ablation in February of 2018 but neither matters. I'll be on anticoagulants (Eliquis,  in my case) for life.

The NOACs aren't a big deal except for their cost, which is substantial if it's coming out of your pocket. Warfarin is the pits. Stay away from the rat poison if you have ANY choice in the matter.

A pacemaker doesn't matter one little bit. A PM can only make your heart go faster. It cannot slow it down and it sure can't eliminate arrhythmias. The heart is going to do what the heart is going to do between beats. It seems that you're asymptomatic, so count your blessings and move on.

AV node ablation

by AgentX86 - 2019-11-01 14:30:13

The kill the AV node, so the atria are isolated from the ventricles. The atrial arrhythmia doesn't make it to the ventricles however, neither does the pulse, so a pacemaker is implanted to pace the ventricles and the atria are ignored. They're completely out of the picture. In fact they're a load on the heart, rather than being an assist.

An AV node ablation is the LAST option considered to eliminate the symptoms of Afib or flutter.  It only eliminates the symptoms, as the arrhythmia is still there. It's only considered as a last resort.


by Gemita - 2019-11-01 14:38:55

Hello Jute57,

Yes, like you I initially thought my pacemaker could perform miracles and in many ways it does by keeping my heart rate up to a steady 70 bpm.  However, it only takes a short run of AF to put us at considerable risk for an AF related stroke if we have risk factors.  Doctors use the CHADS2-VASC score to determine whether we need to be on anticoagulation (if you google you can assess your score).  I believe the guidelines have recently changed.  I sense though you have already been told you need to take them ?

It can be difficult to find the best med for you.  I tried therapeutic 5mg, 2 x daily Apixaban (supposedly one of the safest in terms of low risk for a bleed) but this did not suit, so I switched to low dose 30 mg Edoxaban, once daily dosing, because of my low body weight.  Speak to your doctors/Anticoagulation Clinic until you feel comfortable with your anticoagulation treatment.  Good luck


by LondonAndy - 2019-11-02 13:21:44

I have been on Warfarin for 5 years now, without any problem.  I hav no choice about what type of anticoagulant is used, as I have a mechanical aortic valve and only warfarin is allowed.  

There are a lot of myths about warfarin - the comparison with rat poison is typically misleading.  The dose of warfarin that kills a rat is far higher, and if you applied the same comparison to water we would drown at the quantities needed!  But nobody says you must not drink water.

However, it is true warfarin has to be carefully managed, and I would agree that the newer anticoagulants are better for AFib.  If warfarin is proposed, check out my amateur notes about managing it at  This includes a link to a report by the UK's 'regulator' recommending that allowing patients to use a hand held meter and do a finger prick blood test weekly is the best (safest) way to avoid complications.


by IAN MC - 2019-11-02 14:13:36

You make some good points , Andy.    Warfarin continues to be the most widely prescribed anti-coagulant in the world and has been for over 60 yrs.  Without any doubt , if you suffer from arrythmias the benefits of taking warfarin greatly outweigh the risks.

To describe it  as " the pits"  and " rat poison " is not at all helpful  to the millions of people worldwide who take it.  Many people, like yourself, simply have no choice.

I have always been intrigued why chocolate is not known as " dog poison " . Chocolate contains theobromine which is highly toxic for our canine friends.

Feed your dog chocolate at anything over 50mg per kg of dog body-weight and you  are highly likely to have a dead dog lying on the floor.  As you rightly say it is all a question of dosage !

Oh, before you cat-owners start feeling smug ......the toxic dose of chocolate for cats is even lower than that for dogs so if you were thinking of buying your pet cat a box of chocolates for Xmas, think again !


Rat poison

by AgentX86 - 2019-11-02 21:17:21

Chocolate isn't advertised as dog poison.  Warfarin is rat poison.

Yes, I was on it for a couple of years - the pits.  Sure, some don't have the choice in the matter but the NOACs are far superior for those who have the choice. Fortunately, I have that choice because I'll be on Eliquis for life.

BTW, the reason NOACs can't be used for some heart valves is because it hasn't been tested - and the manufacturer doesn't want to pay for the test. Not enough money in it.

Thank you!

by jute57 - 2019-11-04 10:23:22

Thank you everyone for your words of encouragement and information!  Thank God I am alive!



by Philcomm - 2019-11-08 22:30:48

Been on warfarin for 10 years.  At first, it was a pain to go to the lab so they could check the INR.  After a few years at that, I signed up to home test with Roche-far better for me.  I test once each week and if something is going on that upsets the INR( test result) I test more often.  I send the daily result to Roche and they send it to my doctor.  Its worked well and my doctor is fine with my home test.  I order supplies and send test results to Roche via internet, but I can also call.  They also have nurses to answer question, when I cannot contact my doctor.  For some time now, I also self dose-with my doctors approval.  I think this system works well for me, as I travel a lot and do not need to find a lab to get results.  DOAC my work better for some, but warfarin works good.


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My pacemaker is intact and working great.