How dangerous is it to have a gastric sleeve with atrial fibrillation? Can I die?

Question

Just 2 months prior to scheduling my gastric sleeve, I had issues and now have afib (atrial fibrillation) because of age and health we could have just went with an aspirin a day, but because I’m good on it I stayed on eliquis 5mg x2 day. I am also on a very low dose of a beta blocker. Will I be ok going off them for surgery?

Ali Solmaz, MD · Answer

Having atrial fibrillation (AFib) while undergoing gastric sleeve surgery does increase the risks, but with proper medical management, the procedure can still be performed safely. The biggest concern is balancing the risk of bleeding with the risk of a stroke due to stopping blood thinners like Eliquis. Since you are on 5 mg twice daily, your surgeon and cardiologist will need to decide when to stop it before surgery and when to restart it afterward. Most patients are taken off blood thinners about 24-48 hours before surgery, but this depends on individual stroke risk, often assessed using the CHA₂DS₂-VASc score. Some patients may require temporary bridging with a different anticoagulant, such as heparin, to minimize the risk of clotting.
Your beta blocker also plays an important role. Stopping it suddenly could lead to rebound tachycardia, high blood pressure, or even an AFib episode. Because of this, most surgeons and anesthesiologists prefer to keep patients on a beta blocker through surgery to maintain heart stability. If your dose is very low, your doctor may adjust it rather than discontinue it completely.
The main risks of undergoing gastric sleeve surgery with AFib include increased bleeding, stroke, and heart-related complications such as arrhythmia or blood pressure instability under anesthesia. However, with a thorough preoperative evaluation, these risks can be mitigated. You may need additional cardiac testing, such as an EKG, echocardiogram, or Holter monitor, before receiving surgical clearance.
The risks will decrease if your condition is well-managed. The key is ensuring that your blood thinner is handled correctly, that your heart remains stable during the procedure, and that your care team is well-informed about your medical history. Your best course of action is to work closely with your bariatric surgeon and cardiologist to develop a plan that minimizes both bleeding and clotting risks. If your AFib has been stable and you have been tolerating your medications well, there is a very strong chance that you can proceed with surgery safely.

Ariel Ortiz, MD, FACS · Answer

If you are under medical control it is safe to have the surgery. Just before the surgery an adjustment with your medication have to be made.
GR

Hasan Erdem, MD · Answer

Thank you for your question.
Before the operation, we should get approval from our cardiology and anesthesia doctor.If they allow, no problem for the operation. Please no worry ,your health is the 1st position for us.
I wish this answer helps you. 
Best wishes.
Dr.HE

Omar Fabrizio Platero, MD · Answer

Hello, if you plan to perform a surgery regardless, if you are taking Eliquis, you should suspend it, at least 3 days before and keep your dose of blocker and that decreases the risk that could be higher bleeding, greetings

Pablo Garcia, MD - Account Suspended · Answer

Hey! Thank you so much for your answerIf the anesthesiologist and the cardiology doctor approve you, you'll be okBest wishes!

How dangerous is it to have a gastric sleeve with atrial fibrillation? Can I die?

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