Warfarin and Ablation

I'm on the waiting list for my ablation and the EP said it would be approx 12 weeks, he also referred me to my GP to start warfarin as a prerequisite, which I have no problem whatsoever with. 3 weeks after seeing the EP I got a letter to see my GP with a view to starting warfarin. My GP instructed me I will have to attend hospital to start warfarin and gave me an appointment request for me to contact the hospital. I have done all this, but the booking line I contacted couldn't give me an estimate of how long it will take to receive an appointment.

I'm going to contact the Anti Coagulation Clinic to see if they can give me a rough time, but my concern is my ablation date will be fast approaching and not having started anti coagulation yet how long do I have to be on it prior to my ablation? That's not taking into account getting it to the required level either.

12 Replies

  • Oh dear that isn't good news. I feel that you really need to bang some desks as I was told three months anticoagulation prior to ablation. Sometimes we need to be very proactive and assertive in order to get the required treatment I suggest that you speak to the EP's secretary and ask for help in sorting this out..


  • Thanks Bob, I've left a message with the Warfarin Clinic to give me a call, but if I get no joy there, I'll go through the EP route.

  • You may be one of those people who take to warfarin like a duck to water and get to a good level quickly. No problem. On the other hand, it can be frustratingly difficult to get a steady INR. I had my ablation postponed because I kept dropping out of range, so get going at once, if not sooner.

  • I have been on Warfarin for a very short time before (Approx two weeks) and my last INR reading was 1.9. Hopefully things will go swimmingly, but what concerns me is with Christmas coming up I get over looked and as a knock on effect it delays my ablation.



  • That sounds very hopeful, Jason. It is my opinion (my INR people do not agree) that you should aim for 2.5 and if your INR is below, the dose should be increased. If you are below 2.3 a drop could see you out of range and back to square one. It is very annoying when it happens and I had to cut out anything green for a couple of months while I tried to achieve stability. I did get there in the end! Good luck.

  • Jason

    You do need to get started, advice varies from different EPs etc but mine wanted me in range for 4 weeks running - no dropping out of range (so add in the weeks getting into range and you are on the edge of your waiting list time). I realise how lucky I have been with my GP and the local testing clinic reading all the posts on this site. I would call and explain why you want to get started sooner rather than later. My GP notified the clinic the day they got the EP letter and called me to say that they had prepared the prescriptions and that they were waiting for me (Friday) and I was at clinic Monday.

    Hope you get sorted real soon, both on Warfarin and with the ablation.


  • Thanks Jo,

    Things certainly haven't run that smooth for me so far. I had my EP appointment on 7th November, which went great and he said he would send a letter to my GP about starting warfarin. A week after my appointment I received a letter to say I was on the waiting list (Ablation). My GP didn't get the letter until last week and I had an appointment today. I assumed I would be starting then, but he has referred me to the hospital to start with a warning waiting times tend to be quite long, so suggested I give them a call to hurry things along. I do think he is sending a follow up letter to them, but I guess that could take another week.

    Thanks again,


  • Jason - this all sounds very frustrating. Is there no-one at your GP surgery that could get you started on Warfarin? As the others have said, it can take time to get into range and then I also had to have 4 consecutive readings (weekly) above 2 before ablation and it took 5 weeks to get within range. In the end, one of the GP's at the surgery put me on the drug as the practice nurse was on long-term leave, so you could see if one of your GP's could do it. I suppose you could always ask about one of the NOAC's as they don't need weekly testing and I'm assuming that once you've been on one for a month then you should be OK for ablation. I recently swapped from warfarin to Rivaroxaban and have been perfectly happy with this drug. Sorry no solutions for you though :{

  • Hi Therealsue,

    I was placed on warfarin a couple of years ago when I first had AF with a view to a cardio version. I went private back then, so I was seen, diagnosed and anti coagulated in the matter of an hour :)

    I thought the appointment with my GP was to be given the go ahead for warfarin and I would be told when and where to be tested, however he informed me I had to be started in hospital and even though he would send a letter stressing the urgency of my appointment, I should contact them myself too. I have now left two message with the Warfarin Clinic, but no response back.

    Bob suggested I contact my EP's secretary and try and progress through them, which will be my next attack if I hear nothing by the end of the day.

    Thanks again for sharing your experience and I'm sure I will get there in the end. I've put up with AF for two years now, so if it does end up delaying the ablation I'm sure I will be fine.

  • Hi Jason. Bob always has very sound advice and a I've found that a letter from one's EP works wonders in these situations. Good luck and let us know how you get on.

  • Jason I was only on it 6wks before my recent ablation two weeks ago, it took a couple of weeks to get into range, but on the day it dropped to 2.0 so they gave me an injection and went ahead. I must say you've been waiting much longer than me, I live in Glasgow too where heart problems are common. I just kept on phoning pushing them!!!

  • Cheers Kaiser, I'm due a little luck at some point so hopefully when I do get on it my INR levels will behave like yours. I'll just have to steer clear of the spinach and sprouts come Christmas.

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