Pacemaker and TAVR

Had my pacemaker in Feb.  no problems,  all was well until I had my TAVR heart valve on May 17th.  During my recovery I had a bleed and they had to do another surgery to put in a stent to stop the bleed.  After that, all was well.  When I went home the heart doctor changed my blood thinner because of the bleed and worry of blood clots.  Stopped my Eliquis and changed to Plavix, also changed blood pressure meds and added something for heart burn due to one of the other meds.  Anyway, after about two weeks I get a call from my pacemaker folks telling me my heart rate is racing (even though it just felt like an occssional palpitation).  Then heart Dr. calls me at work and tells me to go right to the Emergency room...so I go.  After I was hooked up to the EKG, I could see my hear rate jumping all over the place (but I did not feel bad)..also, my blood pressure was really hight but I thought that was because I was told to get to the ER right away.    Anyhow, they put me on another med to slow my heart rate down and that seems to be working.  The good thing was this is the first time both heart Dr's and EP Dr's talked together.  I guess in a month or so, I am to get with my EP and they are going to see what they can do with the heart rate.   In a month I am to stop the Plavix and go back to the Eliquis.  So far, the new meds are working...I take one every eight hours.  I am concerned what to expect in a few months.  We will see.    Just not too happy with issues this new heart valve has caused.

 

 

2 Comments

Arrhythmia

by AgentX86 - 2023-06-22 22:27:32

It's hard for us to know what kind of tachycardia you have, not that really matters.  As long as they're keeping the rate down, you should be OK.

Changing from Eliquis to Plavix is a no-brainer.  Eliquis is not for patients who have had a valve replaced.  Plavix is specifically for this.  I am really surprised they want you to go back. And why in a month?  That would be off-label but I'm sure they have a good reason for it.

Use of Clopidogrel and Apixabam ( Plavix and Eliquis)

by Selwyn - 2023-06-23 12:44:41

Actually, I have been on this combination for some years.

There is no great agreement when it comes to anticoagulation as to what is best. 

The type of coronary stent used is important. The drug eluting stents tend to delay epithelial ( cellular) coating of the stent and the prolonged use of clopidogrel ( an anti platelet adherance drug) is advised.  How long for? There is disagreement. The usual is a year. In my case I was advised to take this for life.

Apixabam is an anti blood clotting drug. This is useful for arrhythmias that can cause thrombosis, and other conditions causing thrombosis.

Typically, mechanical valves were anticoagulated for life. Newer, biological type valves do not need anticoagulation.  

The combination I take is not without risk. There is clearly an increase risk of haemorrhage. 

The problem of hypertension increases your risk of a bleed. The reversal of apixabam is difficult.  

I am pleased to hear that your doctors are keeping a close eye on you as you have complex problems needing a careful balance. 

There is a lot of variation in medical opinion in this area which needs more research. 

 

You know you're wired when...

You have a $50,000 chest.

Member Quotes

We are very lucky to have these devices.