Safe INR level for Ablation?

[willec49]

I am one week from my first cyro ablation and my blood INR is 1.2. Most recommend a value between 2.0 and 3.0. What are folks' knowledge and experience in this area? Might I be canceled as, according to these numbers from today's tests, the Pradaxa hasn't thinned my blood much. Are these the cases where they go ahead with the procedure anyway and just add heparin during the procedure? Literature notes a higher risk of completions with INR <1.5 - 2.0 Thanks.

[Hidden]

Hi there,

Your question doesn't really add up. You talk of an INR - well now I stand to be corrected - but an INR is normally associated with those taking Warfarin. I read on in your post you talk of Pradaxa (Dabigitran) so, I think there are other tests available for this drug which give a similar reading but its not called an INR.

So, what have you been told by your medical team ?

[willec49 in reply to Hidden]

Thank you for this. I saw this reading of 1.2 on my test results today which note that the normal range was between 2.0 and 3.0. I assumed this must apply to me as my doctor must know which blood thinner I am on. Perhaps he will adjust the meaning of that reading for Pradaxa. I emailed him and asked him if this seemed a bit low. I haven't heard back yet. Also, my APTT is borderline at 40.6 seconds where the normal range is 25.0-39.0 seconds, not that far off.

[Hidden in reply to willec49]

Thanks. Sorry if I seemed pedantic. Just cautious about making a comment. I am on warfarin and self test at home with my own device. So, if I had an INR of 1.2 that would be an acceptable INR for a surgeon to proceed with, say, knee replacement surgery. If it were 1.0 my bloods would be normal. I am a candidate now for guided cortisone injection into right shoulder and will need to stop warfarin to get it down to around 1.6. But all this of course is in the context of warfarin. So yes, again as a warfarin user this would be very low/ normal! I think the aptt is the measure the medics use for Pradaxa.It's all rather a dark art isn't it?

🙂John

[willec49 in reply to Hidden]

Thanks again for your message. After I emailed my EP and Cardiologist, my PCP emailed me that all my blood work is good and that he'd seen those other emails. He assured me that for Pradaxa with this value, I am normal and right in the ball park. So that was reassuring. Yes, your descriptor, "dark art" definitely applies to every part of this enterprise. Wish you all the best.

[Hidden in reply to willec49]

Thank you, and best wishes for your venture.🙂John

[CDreamer]

As John has explained - Pradaxa doesn’t work by affecting your INR. The hospital will always test for INR prior to operation anyway, along with the other tests but it has nothing to do with you taking Pradaxa - which is an alternative to Warfarin for and works to prevent clots forming at a completely different level than the VitK level which warfarin works at.

You should follow your Doctor’s recommendations as to if or when to stop taking your Pradaxa prior to your procedure. If unsure then please ring the clinic that is performing the procedure to ask.

Pradaxa only stays in your system for a 24-48 hours. Normally one would be asked to just not take your dose the day before or the morning of the procedure but preferences tend to differ.

Hope that helps and good luck with the procedure and hope it works for you.

[willec49 in reply to CDreamer]

Thanks for your reply and the helpful information which, along with others here, have put me wise to the difference between Warfarin and Pradaxa. My procedure will be on Wednesday, March 16 and my last dose of Pradaxa will be on Sunday, March 13, three days before. Those are doctor's orders so I will, of course, comply. Thanks for all the good wishes here.

[BobD Volunteer]

Pradaxa does not need INR testing so it is largely irrelevant. Dont worry, the doctors will understand.

[willec49 in reply to BobD]

Thank you for your reassuring message. As you have advised myself and others here before, I should curtail my time on Google.

[angiek]

I’ve got to go for a bronchoscopy with biopsy next Wednesday, and was specifically told that as I am on Rivaroxoban I’ll have to have an INR test on Monday. So perhaps it’s the terminology that is wrong, and there is a requirement for a test of some sort?

[willec49 in reply to angiek]

All the best of luck with your procedure. It seems that, for anyone on any type of blood thinner, they want to know the clotting capability before any kind of cutting of tissue.

[CDreamer in reply to willec49]

For any procedure they will want a clotting test, even when not taking anticoagulants.

[Suebo2 in reply to angiek]

I think that it’s because they routinely do clotting screens before operations and an INR is included in that. Also many people do not understand about the newer anticoagulants.

[angiek]

Good luck for your ablation too!