PJmomrunner
Well-known member
My mom is on ACT for ventricular tachycardia and is scheduled for replacement of her pacemaker on Friday. As of today she is off Coumadin with no bridging. Scary?
Off ACT starting Today for Friday procedure...
- Thread starter PJmomrunner
- Start date
Help Support Valve Replacement Forums:
Very scary.
Very scary.
Five full days is just not right, but I'm not the least bit surprised.
My neighbor is on Coumadin for similar reasons. For the old colon check-up he was told five days before and five days after !!
After my wife's sister died not too long ago from a Coumadin screw-up, I am even more upset when these doctors tell patients to do this.
Rich
Very scary.
Five full days is just not right, but I'm not the least bit surprised.
My neighbor is on Coumadin for similar reasons. For the old colon check-up he was told five days before and five days after !!
After my wife's sister died not too long ago from a Coumadin screw-up, I am even more upset when these doctors tell patients to do this.
Rich
ALCapshaw2
Well-known member
Who is doing the surgery to replace the pacemaker? A HEART Doctor? and he doesn't know about BRIDGING?
YIKES!
But why didn't your mom raise the question?
Has she not read any of the posts about Bridging?
Sometimes WE, the Patients, have to be our own advocate and stand up in the face of IGNORANCE, even, or especially, with Medical PROFESSIONALS !
'AL Capshaw'
YIKES!
But why didn't your mom raise the question?
Has she not read any of the posts about Bridging?
Sometimes WE, the Patients, have to be our own advocate and stand up in the face of IGNORANCE, even, or especially, with Medical PROFESSIONALS !
'AL Capshaw'
Marty
Well-known member
To hold or bridge?
To hold or bridge?
I do not want to be the devil's advocate but I must say that in my home area many of the top cardiologists hold rather than bridge. I asked my cardiologist, who is considered tops in his field, about this. He said he has never had trouble with a hold in his 25 years of practise. Having said this, please note, if I need any procedures I will bridge.
To hold or bridge?
I do not want to be the devil's advocate but I must say that in my home area many of the top cardiologists hold rather than bridge. I asked my cardiologist, who is considered tops in his field, about this. He said he has never had trouble with a hold in his 25 years of practise. Having said this, please note, if I need any procedures I will bridge.
Ross
Well-known member
When I had my GI bleed, I was worried about no coumadin and no bridge. My Cardio said the risks are minimal, but I'd have to have the bleeding stopeed before bridging anyhow. I was without anything for 3 or 4 days. Now the length of time he's telling you, I think I'd demaned to be bridged.
PJmomrunner
Well-known member
I did quite a bit of reading after I posted the question and I can't offer any links or sources but the gist of what I've gleaned is that the risk of a bleeding complication, while very low, is higher in a patient on LMWH or UFH (bridging) than the risk of thromboembolism in a patient who is not anticoagulated (for God's sake don't quote me, but it's something like 3% vs .3%)...BUT...the risk of thromboembolism while bridging is zero.
So I guess I understand where the doctors like Marty's are coming from because they probably see a lot more bleeding problems (even though they are rare) than they do TE's, but to me the low risk of a bleeding event is preferable to the even lower risk of a TE event ('cuz of that addage about not being able to replace brain cells). Al, my mom is a different story. She would rather trust her doctor--you know, the one who's going to operate on her--and I'm going to have to respect that.
Ross, everything I found that advocates holding says to hold four days prior to the procedure. I also found at least a couple references that said a pacemaker implant can be done fully coagulated. Yet another approach is to let the INR dwindle to 1.5 and be partially anticoagulated.
Thanks for being here, guys, please keep my mom in mind on Friday.
So I guess I understand where the doctors like Marty's are coming from because they probably see a lot more bleeding problems (even though they are rare) than they do TE's, but to me the low risk of a bleeding event is preferable to the even lower risk of a TE event ('cuz of that addage about not being able to replace brain cells). Al, my mom is a different story. She would rather trust her doctor--you know, the one who's going to operate on her--and I'm going to have to respect that.
Ross, everything I found that advocates holding says to hold four days prior to the procedure. I also found at least a couple references that said a pacemaker implant can be done fully coagulated. Yet another approach is to let the INR dwindle to 1.5 and be partially anticoagulated.
Thanks for being here, guys, please keep my mom in mind on Friday.
Ross
Well-known member
I just can't advocate having a major stroke and being a living vegetable, regardless of what they say, it's not their life.
G
Guest
I have never heard that warfarin was a recommended treatment for ventricular tachycardia. I am wondering if warfarin was doing her any good or just increasing her risk of bleeding.
PJmomrunner
Well-known member
Al, my mistake...she has atrial tachycardia...and bradycardia (hence the pacemaker--"Tachy-Brady Syndrome")
PJmomrunner
Well-known member
Incidentally, I talked to my mom about this just this morning and she is going to ask her doctor if he ever uses bridging and what his thinking is about the risk bleeding versus the risk of thromboembolic events. I hadn't said anything to her about any of this, I just asked how they were handling her coumadin and said nothing after she said they were taking her off 5 days in advance.
She had a devil of a time when the pacemaker was first implanted--the lead wires got away from the doctor doing the procedure and they had to retrieve them so the procedure took a lot longer than it should have and was very worrisome. Consequently, I knew she'd be nervous about a second go-around and didn't want to compound her concern with making a fuss about their having taken her off coumadin. I should have known better--she was awake all night worrying anyway, just because I'd asked and she knew I must be worried about it!
She had a devil of a time when the pacemaker was first implanted--the lead wires got away from the doctor doing the procedure and they had to retrieve them so the procedure took a lot longer than it should have and was very worrisome. Consequently, I knew she'd be nervous about a second go-around and didn't want to compound her concern with making a fuss about their having taken her off coumadin. I should have known better--she was awake all night worrying anyway, just because I'd asked and she knew I must be worried about it!
