Coumadin and ablation (Jackie and Newman esp)

Hi all,
I am looking for clarification regarding coumadin requirements post ablation. I think that I understand that coumadin is necessary just after the ablation to prevent blood clots. But is it really necessary 1 month post ablation if there is little or no afib? I assume that at some point in time the coumadin is used to prevent stroke due to potential afib rather than surgically induced blood clots. Is that correct and if so what data support 3 months of coumadin?
Also, if one has pulmonary stenosis after the ablation, is coumadin then taken for the rest of one's life?
My concern about coumadin centers on my reading of abstracts on medline which indicate that low vitamin K levels are associated with osteoporosis, arterialsclerosis and osteoporosis. Also, I adore veggies and prior to my coumadin regimen often ate at least 1 bunch of steamed greens at least once a day. I am trying to adjust my veggies so that I only take 6 mg of coumadin instead of adjusting my coumadin dose.
Finally, I am not sure that the local coumadin clinic has given me the correct advice. Is fish oil OK to take with comadin or not? Does anyone know?
Thanks in advance.
LynnwhoawaitsaFebruaryablationbyNatale

Lynn,

Even if one is "cured" by an ablation, afib and other heartbeat irregularities often occur in many patients during the three months after the ablation. I believe that is the reason Dr. Natale recommends coumadin during that period.

I eat tons of leafy greens. I eat four or five very large salads a week, both Greek and caesar salads, and many other food items containing vitamin K. I do get plenty of vitamin K. I offset this vitamin K with coumadin. For me, six milligrams on Mondays and Wednesdays and Fridays, and six and one-half milligrams the other four days of the week keeps me between 2.0 and 3.0 INR.

I don't know the answers to your other questions.

Newman

Also, if one has pulmonary stenosis after the ablation, is coumadin then taken for the rest of one's life?
My concern about coumadin centers on my reading of abstracts on medline which indicate that low vitamin K levels are associated with osteoporosis, arterialsclerosis and osteoporosis. Also, I adore veggies and prior to my coumadin regimen often ate at least 1 bunch of steamed greens at least once a day. I am trying to adjust my veggies so that I only take 6 mg of coumadin instead of adjusting my coumadin dose.
Finally, I am not sure that the local coumadin clinic has given me the correct advice. Is fish oil OK to take with comadin or not? Does anyone know?

If one is affib free and "cured" at the period of time post ablation designated by the Doctor, then having pulmonary stenosis with no other risk factors ,does not require continuation of coumadin therapy for the rest of your life ,once you are pronounced cured of affib-Eating veggies is ok , the idea is to keep your intake of veggies at a fairly consistent level so that once the correct dosage of coumadin is found to keep you in the inr range of 2-3 that you will not deviate very much from your veggie level that worked with the coumadin-Fish oil supposedly has some blood thinning qualities (so does vit. e, coq10, etc) but I am on coumadin and take fish oil and vit.e daily-once you take it and the coumadin dosage works it is ok-if you add them while you are taking a coumadin dosage that has been working before you added them on, then get a coumadin pt/inr test 1 or 2 weeks later to see if you need to adjust the coumadin-
jerry

My instruction for Coumadin after ablation is to take it for 3 months.
The most critical time is one week post ablation. You are at high risk of dislodging clots from the burn or ablated area. Also, the immediate risk is from the perforation site at the intraatrial septum.

After that, ideally, one will remain at least for 6 weeks if they have no afib. The docs won't give you permission to go off before 3 months because that is the standard of care and because of their liability etc.

I have a terrible time with Coumadin so I won't be taking it that long unless I go into afib again.

Regarding diet - What I've been told and what I do is to eat my normal diet and take the supplements I do and then adjust the coumadin around that. I eat leafy greens, etc. I am not going to alter a healthy diet to consume an unhealthy drug.... so far, I take a minimal amount of Coumadin - 2.5 daily and 5 mg. on weekends to stay in the 2.0 - 2.5 area.I prefer to keep mine low becuse of my hematoma propensity.
The idea is to be very consistent with what you eat...then the levels won't vary.

I continue to take fish oil - but at half the dose compared to my normal.
The only supplement I have eliminated is ginkgo biloba.

They did not advise me about supplements in Dr. Natale's office. I worked with my primary care D.O. about which supplements and doses I could continue to take.

It can take several weeks to find an appropriate level and I was instructed to do a trial for about 3 weeks prior to ablation so they would know where to start after the ablation with a dose to prevent clotting at the critical window.


Hope this helps. Good luck. February will be here before you know it!
Then you can be a member in the Cleveland Connection.

Regards, Jackie