Stopping apixaban for 5 days post pacemaker implant

Had a CRT D implanted today and it seemed to go well but when I got home I had a phone call , apparently a doctor , who told me to stop Apixaban for 5 days. When I said I've not heard of it before she said she didn't know either so I'm wondering if this is misinformation or not ?



I would contact them again first thing tomorrow and get clarity

by Gemita - 2021-01-21 18:01:51


I stopped Apixaban the night before my pacemaker implant (so one missed dose) and then resumed it the next day.  Some doctors maintain cover throughout.  Five days missed doses seems excessive to me and incorrect, but I wouldn't start Apixaban until you have spoken to them tomorrow.  I cannot imagine why you were given this information, but we have to assume it was given for a reason, so you need clarity.  Perhaps any blood tests they carried out during surgery indicated that anticoagulation at this time might be inappropriate.  We have to assume something like this has occurred, unless we hear to the contrary.

Alternatively you could try to contact the ward you were on today and ask to speak to the doctors on duty.

I am glad your implant went ahead and you are back home now.  I send my best wishes to you for a speedy recovery 

Apixaban's effect disappears very quickly...

by crustyg - 2021-01-21 18:19:35

..which is why they are *so* keen to ensure that you've taken the morning dose before an AM ablation.  Even one missed dose increases the risk of clotting.

In your shoes I would continue with twice daily apixaban as normal, unless I had clear instructions and logic behind such an action from my heart doctors.


by sandoval - 2021-01-21 20:20:24

I know they say don't believe what you read on the internet but most people here know their stuff and it is illogical. Because of covid it seemed the nurses weren't cardiac nurse i.e they told me to shave my groin for a CRT D and then they said "what is a crt d?". It was worrying and in all my research I've never heard about stopping Apixaban afterwards and even the doctor who phoned said she'd never come across it before so obviously wasn't a cardiac doctor. It's all very strange and I'm going to ignore.Yes I could try and phone but nobody was cardiac trained who I saw. Just wanted a second opinion guys. Maybe the cardiac nurses are off with covid ??


by AgentX86 - 2021-01-21 22:09:47

I don't like the sound of this either.  I'd call either your doctor or at least his nurse.  Going without an anticoagulant, even for five days, is very dangerous.  I'd want a good explanation. 

Crusty is right.  Apixaban has a very short half life, on the order of 24hrs, which is why it has to be taken twice a day.  It's pretty much gone from the system after a couple of days.

I am glad you have come to a decision

by Gemita - 2021-01-22 01:58:19

Sandoval, yes we are real people on here who have been through this experience perhaps many times.  I am always guarded in my approach since I have witnessed family members having both a serious bleed and a stroke following heart procedures, both frightening experiences as you can imagine.

I am glad you have a made a decision and that it feels right for you.  When you are rested, I would still have a word with your doctors to place on record what you were told and the decision you have taken.  If someone has made a mistake, I believe this should not go unreported.  It is too serious to ignore.  Take good care Sandoval

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I had a pacemaker when I was 11. I never once thought I wasn't a 'normal kid' nor was I ever treated differently because of it. I could do everything all my friends were doing; I just happened to have a battery attached to my heart to help it work.