Cardioversion at 90+ necessary or not? An English friend has her elderly (English) parents living with her, here in Italy.

[paolina]

Her father has been diagnosed with Atrial Fibrillation and her GP has arranged for him to have a cardioversion next month, as she "doesn't like giving Warfarin to elderly patients because of the risk of falling and bleeding". I was a bit perplexed when told this as I at 69 was told I would have to stay on warfarin indefinitely and would have thought that my friends father would have been better staying on it especially as he has never had a fall. Not being an expert I don't like to stress my feelings on the subject too strpmgly. I did think it was a bit much to put this old gentleman through this procedure anyhow especially as his daughter is quite happy to take him for INR tests weekly. I have passed on to her information from AFA etc (she's not on the internet). Pauline

[BobD Volunteer]

The whole Chadsvasc v Hasbled balance does change markedly as you get past a certain age so I tend to understand the doctor's point of view even though I haven't all the facts. Many of us may pass that point if we live long enough.lol

Bob

[rosyG]

This point about age and warfarin was raised at our last patient support meeting and the consultant said elderly patients should be given warfarin as long as their HasBled score (see AFA website) is ok. The risk of stroke is higher than a bleed for a fall unless there are other clinical factors ( considered in HasBled)

Regarding cardioversion- I would have thought it depends on whether the symptoms are very troubling

[paolina in reply to rosyG]

That's what I thought. Re the cardioversion, apparently he has had one episode a few months ago and is in very good health, he did have a by-pass a few years ago so I don't know if that has anything to do with it. Like in England different areas have different things and I do know that where I live it's unusual for over 80's to be offered a cardioversion after one episode. I feel quite sorry for him even if it is Day Hospital it is all in a foriegn language. Pauline