Warfarin clinic problems, a word of warning

I started Warfarin a few weeks ago in preparation for my 4th ablation on the 8th November. My initial INR was 1.1 then 1.7 after a week, then on to 2.2 at which the lovely nurse told me that I could come back in two weeks for my next reading.

I went along today and had a reading of 2.3 at which the same lady told me to come back in a month. Now this didnt sound right so I told her that I was having an ablation on the 8th Nov and she very apologetically told me that they had made a mistake and that I should of had a reading taken the week before because they needed four readings in the correct range. And I am now facing the possibility of my ablation being cancelled!!!!

Nobody explained to me that I needed four readings, I just thought it was a case of getting the INR at the correct level.

My EP is onholiday this week and his secretary is trying to contact him to find out if we can still go ahead. This is all stress that I could do without!!!!

I should point out that I wasnt required to be on Warfarin for my first three abalations.

14 Replies

  • Tiimmo, Yes it is normal to be on warfarin with an INR between 2 and 3 for four weeks prior to ablation and I don't understand why you weren't before. I'm sure there is some leeway so don't get too stressed. You would normally stop five days before anyway and maybe go on clexane.


  • I agree with Bob- it shouldn't be a problem- if they do it next week and then the day before your ablation that seems reasonable. Also there are other anticoagulants they can use during surgery too( heparin etc) if they felt you were not in range. I have been reading up on things re ablation and there are some recent cardiology articles saying they continue with warfarin in some centres. You could possibly make sure you have consistent amounts of vit k for the next couple of weeks too as it will help to keep the range

    Good luck- do let us know how you get on- am trying to get as much info a possible before dec appt!!

  • I'm having my first ablation this Friday, and been on Warfarin since January. But, due to a stomach issue and not absorbing Warfarin properly, my INR only went up to 2.2 for the first time last Wednesday. I'm on 8-9mg Warfarin and only have that one reading in the required range.

    I am going today to the clinic and have to call the ward with my level. This is because they normally get people to come off Warfarin 2 days before ablation, but with me they might not stop it. Depends on reading later. I asked if it might be cancelled and told no. Good luck.


  • I had my first ablation last Friday.

    I was given lots of information regarding all aspects of ablation from my case manager at a pre-admission appointment. It clearly stated that INR had to be 2-3 for 4 consecutive weeks leading up to the procedure. So I did not receive my ablation date until my INR was stable. I was not taken off warfarin at all throughout my time in hospital. So it seems that hospital policies vary.

    Best of luck Timmo , I hope all goes well

  • I am lucky enough to have private health through my work, and there seems to be a break down in communication with the NHS who are sorting out the Warfarin.

    My local NHS hospital is a 10 minute walk from home so I chose to go there for Warfarin as the Private Hospital is 10 miles away.

    Still not heard from my EP but am staying positive and planning as if the Ablation is going ahead

  • It went on the test on the day with me.

  • I`m hoping thats the case with me, because all the EP said was warfarin for 4 weeks before and 4 after.

  • I had my INR taken just hours before the ablation. It was 3.4 which was only just within limits for the procedure to go ahead.

  • warfarin levels between 2 and 3 for your safety i have never stopped mine for ablation

  • so many variations AGAIN!

    I was told by my EP, I saw last Wednesday, that my GP should prescribe me 1 of the new anti-coagulants preferably, if not (because he says many will not bear the expense) then go on Warfarin, and that I need only be on it for 2 weeks prior to the Ablation and 3 months following - which is just as well as I can't speak to my GP until Thursday morning and the ablation is booked for 27th Nov. He verified that INR needs to be 2-3 range, I do have a very low CHADS score ????? Hope it goes well for you Timmo

  • I am on permanent warfarin following my second ablation. I found my INR was all over the place and was attending the local clinic every 2 weeks. I then decided to buy my own INR testing kit with my G.P's approval. I paid for the kit, the practice provide everything else. It has made a world of difference and having taken my INR weekly for about 2 months, I can judge reasonably accurately what my reading will be and adjust my warfarin intake accordingly. I now test every 3 weeks and to date my INR falls happily within the 2 - 3 range. I also have flexibility to test when convenient to myself.

  • Well I have just had the call that I will be OK to be admitted on the 8th and they will test my INR on the day!!!

  • You are brave having another ablations! Hope it goes well.

  • With all the problem with regular testing if on warfarine why is a drug like Xarelto/ Rivaroxaban not always used now?

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