Ablation....INR to high!

Booked in for 2nd ablation Monday 8th August. Went for pre assessment on Wednesday only to discover my INR was at 3.6, had been in Italy for 2 weeks previously so think it may have been extra alcohol. Have reduced warfarin from 3 to 2 for 2 nights then back to 3. Been told to go along for admission on Monday morning but will depend on my INR as to whether or not they will proceed with Ablation. Need to get my level between 2.5 and 3 any help would be appreciated??

15 Replies

  • Hmm, that's quite a tricky one, because you also don't want to take the level too low either. Not that I think you could get it excessively low in the short amount of time remaining.

    Is your INR normally settled on 3mg daily and how long have you been back from Italy? This sort of thing really has to be your decision as any advice followed by members on this forum could be totally wrong.

    Hope it goes ahead for you on Monday.

    Best wishes


  • Thanks Jean, INR been pretty stable for several months now, think I was a bit naive to not have it checked last Friday when I returned from holiday!

    Not much else I can do now just keep my fingers crossed for Monday. Hope they will check as soon as I am admitted.

    Will let you know


  • Can't really add much help as for both my procedures they wanted my INR between 2.5 and 4 and the closer to 4 the better! Just for the ablations, afterwards back down to the norm, 2- 3 !!! Mind you it didn't get that high for either. 2.7 for the first, 2.8 the second. The heparin dose 'on the table' was adjusted accordingly, 6000 units first, 5000 units second. It all depends on how 'sensitive' you are to Warfarin whether you will adjust by Monday. I am slow to react. My EP said afterwards that as long as someones INR is above 2 he would go ahead with a procedure and use the Heparin as he did with me.

  • Apparently my consultant won't proceed with INR above 3.1and 5 years ago I wasn't warfarinised at all! Suppose they all differ slightly. Are you in the UK?

  • Actually practices and levels have changed quite significantly in the last few years due to greater understanding and knowledge.

  • Yes, UK.....you?

  • Yes in the Midlands.... North Staffs University Hospital

  • West Midlands me, University Hospital, Brum.

  • I struggled to get a steady INR between 2 and 3 for an ablation and was for ever dropping below and then on the day it had shot up to 3.5. They still went ahead.

  • My EP wanted 2.5 to 3.5 but it was only 2.2 on the day so I was "topped up" with heparin.

  • Are they leaving you to decide what doses you need to get the level right? In my opinion they should be guiding you. It is very expensive and frustrating for all concerned if the procedure is cancelled at the last minute. I suggest you get some advice.

    I too was in Italy last week and because I too have an ablation looming I abstained from drinking and have done for some time as I was aware that alcohol affects INR levels. In my case it can also instigate an attack of AF. Not every time but enough to make me wary.

    My thoughts will be with you for the 8th take care and good luck.

  • Hi Pete, the warfarin clinic reduced my dose for 2 days, not much more I can do just hope it doesn't go too low now!

    I blame myself as I should perhaps have had an INR a few days before my pre assessment, but came home from hols and straight back into work!

    Thank you for your good wishes.

  • I was instructed to have weekly INR blood tests for the 4 weeks leading up to my ablations.

    I find it amazing how requirements and advice differs so much from hospital to hospital.

    Hope it all goes according to plan


  • Agree. Same here re weekly tests. Key is they want to see not INR but doses and trends. This is because it is vital to be properly anticoagulated afterwards. If just one test don't know where someone has been or is heading.

  • I am so glad that I don't have to go through all that rigmarole anymore.

    I had my cardioversion cancelled twice first time INR too low. Next time INR too high. But it's the build up to going to hospital then being told the procedure can't go ahead is upsetting and frustrating.

    I was taken off warfarin because i was intolerant to it and am now taking 'Rivaroxoban'

    Therefore no more blood tests and no more worrying about what not to eat/drink. And mostly no more cancelled procedures.

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