Bridge Therapy With Heparin

Have SSS, bradycardia. One episode of atrial fibrillation in November 2007 caused me to be hospitalized and have pacemaker implanted. Atrial lead displaced almost immediately and have had problems adjusting to ventricular pacing. Presently pm is set at lower rate of 30 purposely to reduce amount of ventricular pacing. According to a recent holter monitor test, my heart rate is in the 30 to 40 range over 50 % of the time. Am developing SOB.

Saw EP yesterday and have agreed to further surgery to replace the atrial lead or, if this cannot be accomplished, to switch the pm over to the right side of my chest. Will be done as out patient (day surgery).

Problem... I am on warfarin (blood thinner). Warfarin will have to be stopped about 5 days before surgery and I will have to self-inject with heparin until about the day before surgery. Doc didn't elaborate but I read on the internet that this is called "bridge therapy". Will have to attend a clinic beforehand to be instructed on self-injection.

Anyone out there have experience with bridge therapy and self-injecting with heparin??? Is it do-able? I have no one I can call on for assistance.

1 Comments

Bridging

by afibber - 2008-10-04 05:10:30

Hi,
I have had to bridge myself several times. It really is not so bad. Your doctor should write you the script with the prefilled syringes. Your injection sites should be changed daily. Be sure to ask for the kit that comes along with the Fragmin (if that is what you are going to be using). There is a video to watch, and a handy-dandy guide to help you remember where to inject the Fragmin (rotating the sites). I taped it to my bathroom mirror to help me.

It does sting a little, but the needle is not very long. It does leave bruises, that is normal. After all it is a blood thinner, but its "1/2" life is short. That is why they use it as you get off the coumadin. The coumadin stays in your system longer than the fragmin. That is why they use it. It really is not all that bad, and it is imperative that it be done, to prevent blood clots, which can lead to a stroke.

Inject yourself at the same time every day, get yourself a box of alchol wipes. Have the syringe ready, and just do it. You will find that it really isn't all that bad. Be sure to rotate the sites.

You'll do just fine. I have to start bridging myself next friday as I am having my pacemaker changed to a bi-phasic (see my posting if you like).

Be sure to ask where you can dispose of the syringes. Do not throw them in the garbage. You can always take them to your doctors office or your local hospital when you are all done and they will dispose of them for you.

I have been thru this several times. I am lucky enough to work in a hospital where I have a wealth of information.

Remember, if you don't understand anything, ASK.
Good Luck to you,
A-fibber

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Hi, I am 47 and have had a pacemaker for 7 months and I’m doing great with it.