Cardioversion without prior anticoagulation

[Ivan_the_Terrible]

Because if coronavirus I do not think I will get a cardioversion for months in Britain. However I could have one next week in Russia. They would not require me to take anticoagulants for a month. Can anyone explain the difference in requirements, are we just being ultra cautious in Britain?

[Hidden]

I’m not medically trained but those who are say there is risk that the impact of the procedure could dislodge any clots which could lurking in the pipe work and that could result in a major stroke.

Not a risk I would want to take. Ask if they carry out a TOE (camera down the throat to visually detect blood clots) and if the answer is no then don’t waste your money on a return ticket!

[Ivan_the_Terrible in reply to Hidden]

I think that is what they do. Is it as safe as Rivaroxaban for a month?

[Hidden in reply to Ivan_the_Terrible]

I’m not able to answer that one. All I can say is that here, if they were both done, they would be done together. Sometimes they rely on just the anticoagulation.

[CDreamer]

I’m really confused. 10 months ago you were making a complaint to the hospital because you thought they were pushing you to have a cardioversion that you didn’t want then.

Now you want one and are prepared to go to Russia in a time of a global viral pandememic and risk a cardioversion without anticoagulation? Which has no guarantee of working. My husband had cardioversion which lasted 8 seconds.

Why the change of mind/heart? What is so urgent now that wasn’t 10 months ago?

[Ivan_the_Terrible in reply to CDreamer]

You have a very good memory. A year ago I didn't feel too bad and wanted to understand more before I had a cardioversion. Now I feel a lot worse I decided to go for one. I have a date in early April but can't believe it will happen because of Coronavirus.

As far as Coronavirus goes I'd prefer to stay in Russia for the next few months, I'd have more confidence in Vladimir Putin to keep me from infection than in Boris Johnson.

As for the complaint some members may be more sympathetic if they knew that the hospital concerned had only recently emerged from 'special measures' for cardiology and was still rated as 'needing improvement'. I have discovered that on referring me my GP should have given me the choice of going to another nearer hospital, now rated outstanding, which may have had longer waiting times. I would assuredly have chosen this hospital. The GP has apologised.

[CDreamer in reply to Ivan_the_Terrible]

Good luck I hope you fare well. So sorry you are now so symptomatic & had such a poor experience of a NHS. Hospital. I found out the hard way that it pays to do your own homework on the best available treatment & I imagine that applies wherever you Go in The World.

[Ivan_the_Terrible in reply to CDreamer]

I got to 65 resisting most things doctors pushed at me, and feeling that this worked well for me. I fear I may gave got this wrong with Atrial Fib, that I should have been more ready to make a stitch in time.

[Desanthony in reply to Ivan_the_Terrible]

You could always pay for a private CV here. It costs about £1500 or thereabouts. A cardioversion does not necessarily work for a long time. My first lasted nearly a year, the second just a couple of months and the third still working from Feb. I am now on the waiting list for an ablation and EP says I would probably need more than one but long term this could be better than more cardioversions - and any way here they will not do more than 3CV's though don't think that includes emergency ones which would be done if you went into A&E. Some hospitals ask for 1 month on anticoagulants and some just 2 weeks before CV. Hope you sort something out and don't have to travel at this time. Have you gone to another hospital and seen another cardiologist and/or EP?

By the way my ablation should be next month but again doubt whether this will happen but happy to wait.

[Ivan_the_Terrible in reply to Desanthony]

Thanks. I'm off to Russia tomorrow as I think it may be a safer place during the pandemic. It's very helpful to know the costs of private cardioversions in the UK.

[Desanthony in reply to Ivan_the_Terrible]

All the best. Let us know how you get on.

[Jalia]

Ivan, even if the hospital in the UK is being ultra cautious ( and I don't believe it is) surely this is preferable to the very real risk of a disabling stroke due to an undiscovered blood clot.

TOE procedures are carried out in this country prior to DCCV s in some circumstances when patient has not been adequately anticoagulated for whatever reason.

PS..actual cardioversions are nothing to worry about.....in case you are ! I have very recently had my 20th.

[Ivan_the_Terrible in reply to Jalia]

That's very interesting. I could certainly afford to have one or two a year in Russia, if they work force few months at a time. I'd rather have repeat cardioversion without Fleccinade than a second Cardioversion with Fleccinade.

I've a fortnight left on my Visa so no chance to have a month's anticoagulation first. Is TOE just as safe as a month's anticoagulation?

[Paulbounce]

TOE won't stop a blood clot - it will confirm if you have one ot not. If so then I'm sure the doctors would advise against having the CV. An anticoagulation aims to prevent blood clotting.

This is just my personal opinion. I would think very carefully about having a CV without being on an anticoagulation for at least 6 weeks before OR having a TOE to confirm it was safe to continue.

I went to Russia a year or so back. I paid extra to fast track the visa and from memory it came back about 5 days later. Is it worth talking to your cardio here and discussing a course of anticoagulants then fast tracking a new visa ?

Paul

[Ivan_the_Terrible in reply to Paulbounce]

Thanks. I'll try to make sure I don't pay in full until the TOE gives the all clear. I'm on my way to Russia now, travel between UK and Russia will soon be impossible.

[Steve101]

Why not pay to go private in the hospital of your choice, will still be far cheaper than flying off to Russia!

[Ivan_the_Terrible in reply to Steve101]

Hope this reply went to Steve

[Ivan_the_Terrible]

Got a flight for tomorow for 120 GBP. Cardioversion there is about 700 GBP, including three day stay in hospital. I get my teeth done there at about 10% of British prices.

[Maril1]

Cardioversion is nothing to write home about (forgive the pun!) Most if not all done by a Junior ,apparently they just have to be good on the button ( ie a good gamer - space invaders in my day!) Lost count of how many l had back in 2006/8 ,some planned ,some emergency (without thinners if you had been in afib for less than 48hrs).had one or two on the ward only took a few minutes. I remember another when the anethisist asking red or blue ? Saying wrong answer! As he put the mask over me.

[Ivan_the_Terrible in reply to Maril1]

Thanks

[pusillanimous]

I was diagnosed by chance with PAF 4 years ago. Initially the Cardiologist prescribed only a Beta Blocker, when I asked about an anticoagulant he said he would rather wait and see if I had another attack as I have very thin skin and that I must immediately go to my GP or Casualty for an ECG if I felt I was having another attack - this was tricky for me as I have no symptoms, so I just kept taking my pulse, until about 9 months after the initial diagnosis I detected the irregular pulse, I phoned my GP at once, had the ECG which confirmed the PAF attack with a HR of 110. My GP phoned the Cardio who told her to put me on Warfarin at once and he would see me in a week (I'm now on Xarelto) I had all the tests with his fancy machines and he told me I was in AF, and I could either carry on with the medicine or have a cardioversion. I said since I was there - he was in private practice at a private hospital - I might as well have the cardioversion. I was taken to the ward and had the procedure that afternoon, no problems. The point is I was only on the anticoagulant for a week before the cardioversion, and all went well.