Help with Atrial Flutter

I have been in atrial flutter for 2 1/2 months now.  I am 74, have had 3 ht attacks, angioplasty, double by-pass surgery and now am waiting for an ablation.  Did all of you have to be on coumadin and get 4 protimes 2 to 3 or above for 4 weeks before the procedure?  I get a couple weeks in, and then I drop below 2 and have to start my weeks over again.  It has never converted for one minute since the flutter has started.  Then I take shots of Lovenox two days before and 2 to 3 days afterwards the ablation. Is this what others have done?  I am really scared having gone on this long, as the bottom part of my heart is just scar tissue from previous ht. attacks.  
  Just want to get it over with.  Anyone?  Please let me know about the Protime and Lovenox bit, as it worries me!
  Thanks everyone!

[ksig]

Hi!
I have been on coumadin for 4 years now and have done well to keep my INR (Protime) between 2-3.  Occasionally it had gone above 3 but that is usually when I am on an antibiotic or my meds have changed.  I call the coumadin clinic very time I have a medicine change.  It makes things much esier for me and them.  

I have also had 4 ablations and one shoulder surgery and have had ample practice with Lovenox.  I  go on it 5 days before each procedure and 5 days after.  I do have to admit, I had a tough time with the very first shot.  As you know, you drop coumadin and start Lovenox (which is a lower molecular weight heparin).  My first kit came with a book and a DVD telling my excaty what to do.  I just piched up my belly just to the side of my belly button and pushed in the needle. Remember to switch sides with each injection.  After the first injection, it is much easier to do.  The shots do not hurt.  The needles are very small in diameter.

After each of my the surgeries, I went back to the coumadin clinic the next day to start checking my INR (protime) and taking coumadin again according to their directions.  In some cases I went every day for 3-4 days and then skip a couple of days all working to stablize my INR above 2.  When that was done, I was off the Lovenox.

If you are having a difficulty with maintaining your INR (protime) ask for a list of foods high in vitamin K.  That has helped me a lot.  When I am high, I eat more broccoli.  When I am low, I do not eat anything in the dark green leafy vegetable family for a day or two.

I wish you  luck with your procedure and Lovenox.
ksig

[Snoodles]

Thanks so much for your in-put!  Did you also have to have your protime 2 or 3 for four weeks before the procedure?  That is what is killing us!  I am also worried about having no reduction in the atrial fib. beats for so long.
  Medicare will only pay for a protime test once a week.  Scares me also.
      

[ksig]

Hi, Snoodles
I have always kept my protime between 2-3 at all times for the last 4 yrs.  The last time I had Lovenox was one year ago and I was at 2.6 when I started the Lovenox.  At that time I quit taking coumadin until after the procedure.  The day after the procedure, I started up on coumadin and continued to taking the Lovenox until I was therapeutic again (between 2-3 INR).  

You stated that you were worried about the AFib.  I assume you were referring to AFib while you are off coumadin and on Lovenox.  I wouldn't worry about that.  There really is not chance of you developing a clot while you are on Lovenox.  

Again, if you are having trouble stabilizing between 2-3, contact your coumadin clinic or EP and ask them for a list of foods to eat and to stay away from.  The more vitamin K you consume, the harder it is to stay therapeutic.  For that matter, "google" vitamin K foods for a list and don't eat too much of them.  If you follow that advice you will probably stay between 2-3.

ksig

[Snoodles]

I can't thank you enough for your help!  I have been left totally in the dark.  The Dr's should give you a list of the Vit. K foods when one goes on coumadin!  They just told me I had to be within 2 and 3 on the Protime for 4 weeks, and then take Lovenox!  What did I know about it?  Please pray that tomorrow the Protime will be within range.  Then I will have 2 weeks in--I just want to get it over with!
   Thanks Again!
Snoodles