Got a date for my 1st Ablation for Persistent AF

[mallet-head]

Well, I've finally got a date for my first ablation (mid-April), after a frustrating wait of approx 5 months. My INR has been fairly stable up to 3 weeks ago (2.2 to 2.8), then It jumped to 3.8 and has fluctuated between 3.1 and 3.8 since, despite reducing my warfarin by approx 25% under the guidance of my GP. The fluctuations were caused I think by a course of anti-biotics and steroids I was prescribed to clear a chest infection. My question is :- will this affect my planned ablation? I had 2 cardioversions cancelled last year because of being outside my goal INR range of 2 to 3

Can anyone advise please?

[Hidden]

People seem to be given different ranges before ops. I was given 3-4, target 3.5. At the last moment it dropped well out of that range but they went ahead anyhow. Sorry, that's probably not much use because it's a different range to you I guess?

Good luck with the ablation, mine was a real success.

Koll

PS. not quite sure what "persistent" means in medical terms but mine was 24/7 if that's the same thing!

[mallet-head in reply to Hidden]

Thanks Koll, I am going into the hospital for a "pre-op" a couple of weeks ahead of my ablation date, so I am trying to "get settled" by then. Yes, it's 24/7 but sometimes the symptoms are more noticeable than other times. Mainly, I feel knackered, out of breath, some dizzy spells, and everything is too much like hard work!! Here's hoping mine will be as successful as yours.

Mallet-head

[BobD Volunteer]

Don't pre-empt things as you may be stable again by the time mid April comes. Anywhere up to low three is OK usually and they will do an INR test the morning of the event. Many EPs want you to stop warfarin five days before anyway and often self inject with clexane for that period. Have you had your pre-procedure assessment or any paperwork yet? This often clarifies things.

Bob

[mallet-head in reply to BobD]

Thanks for the re-assurance Bob. At the moment I only have the dates and times of the pre-op appointment (3rd April), the actual ablation appointment (14th April) and where to go for each. I guess further instructions will be given at the pre-op.

Thanks again, Dave

[Hidden]

I've got to ask. Are you the pilot Dave?

[mallet-head in reply to Hidden]

Hi Koll,

Sorry to disappoint you, but no I'm not the pilot.

Just for my interest, what was the siginificance of "Dave the pilot" ?

Cheers, Mallet-head

[Hidden in reply to mallet-head]

No significance Dave, just interested. Although I could imagine one of those fighter planes bringing on AF

[Rellim296]

I struggled with my INR before my ablation - had to be at 2 or over. Missed the first date as I had just dropped out of therapeutic range. I finally managed to get four consecutive weeks when it was between 2.2 and 2.5 and they emailed to invite me to report six days later. INR two days on had gone up to 2.7 and on the day it had shot up 3.5. No problem, apparently.

Am still feeling jubilant five days on and hope you will be the same, mallet-head.

I find the differences in INR hard to explain as life was running smoothly and I was eating very consistently - my husband was on a very strict diet for seven weeks and could eat a small range of low insoluble fibre things like butternut squash and beetroot. His veggies all had to be peeled, and he was allowed only small amounts like a quarter of an aubergine. It was extremely dull and repetitive but suited us both. I'm sure exercise was a factor - I was walking five miles most days (treadmill) but went six miles one day and seven the next immediately before an INR check and it was right down. Reduced to four miles a day and my INR went up. Two days before my ablation I was so busy dotting i's and crossing t's (in case of catastrophe that did not materialise) the treadmill was ignored.

[mallet-head in reply to Rellim296]

Than ks for the response Rellim. Recent INR's readings are 3.1, 3.8, 3.1, 3.6, 3.1, 2.6, 2.2. Whilst returning these results, my warfarin was being steadily reduced from 39, 36, 32, 31, 30 mg/week respectively, so I now confidently expect my next check to be below 2 !! I don't think the computer programme which spews out the required warfarin dose according to your Coag-u-check INR readings is capable of following previous trends or allowing for effects of meds such as anti-biotics . Lets hope if it has to be outside the therapeutic range of 2 - 3, it errs on the high side when my ablation is due!

Thanks again for your comments, Mallet-head

[Rellim296]

Thanks Mallet-head. INRs wander, don't they? I've dropped down to 58mg/week from 61 but now things are less crucial, I'm being a bit more adventurous on the food front. My other half has finished his course of treatment but has to return quite slowly to normal eating.

Hope your INR can toe the line for the next 3 weeks. I agree absolutely that too high is better than too low - and that the automatic dose calculator has no finesse whatsoever. Avoid coughs and colds and be well. All good wishes!