Is it safe to stop taking blood thinners for afib before hip surgery?

Rishi Anand, MD
Clinical Cardiac Electrophysiology
If you suffer from atrial fibrillation (afib) and are taking blood thinners (anticoagulants), you will be taken off blood-thinning medications before hip surgery to avoid bleeding and serious complications. A preoperative evaluation will focus on the following:
  • assess your rate and/or rhythm control
  • identify whether you have valvular disease or heart failure
  • determine if you have experienced prior thromboembolic events
  • take a thorough history of previous management plans you used when cessation of anticoagulation was required 
Your doctor will also perform a thorough cardiovascular examination, including a review of your ECG and prior echocardiograms. It is also important for him or her to know about prior factors that induced afib episodes, including any episodes occurring with prior surgical procedures.
Preoperative management will include optimizing the heart rate, which is individualized according to your needs. Medications known as AV nodal blockers are typically continued around the time of surgery, and a post-op plan should be made for continuing these agents, taking into account whether or not oral food and fluids will be withheld from you after the procedure (if you are "NPO", or nothing by mouth). Your preoperative management should generally include a discussion with your cardiologist if you are receiving antiarrhythmic medications, such as sotalol, propafenone, and amiodarone.
The use of anticoagulation around the time of your surgery requires complex decision-making.  A plan should be developed prior to surgery whenever possible. This plan should include anticipating the postoperative conditions affecting the resumption of anticoagulation. 
If you are being treated for atrial fibrillation and will be undergoing any type of surgery, talk your doctor about management of your afib and blood thinners around the time of surgery.

Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.

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