INR cutoff for pacer/AICD's

[Gas you down]

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had a bit of an argument with a cardiologist today...pt's inr was 2.6. i mentioned him not stopping his coumadin and the inr, when he abruptly cut me off with the old "i'm the surgeon i don't care what the inr is, we never stop it!" in a very pompous jackass sort of way. i proceeded to say that he was acting like an ass. then i followed with the fact that for the past month his inr was up and down like a yo-yo, and the 2.6 was 4 days ago. we needed coags and depending on what they were, we might proceed.
so it came back inr 4. i know 2-3 would have been acceptable based on the quick lit search i did before i spoke to him. do you guys have a firm cutoff? >3? >3.5> 4? it seems to me there is a large gray area

 

[aneftp]

2.0 is our cutoff.

 

[Gaseous Clay]

Some people are clueless. About a month ago, I informed our spine surgeon that doing a SCS on a patient who just took their Xarelto yesterday is not a good idea. After looking stuff up himself, he was at least very appreciative towards me.

 

[somedumbDO]

2.0 is our cut off too.... u don't like it do the sedation yourself "surgeon" aka cardiologist...