My 76 year old father had a stroke on March 30, 2004. He was treated with TPA and the clot in his brain was dissolved. He is home now recovering and is on coumadin. He has chronic atrial fibrillation which we believe began in December, 2003, after heart stents were placed. During that procedure one of the arteries in his heart burst.

After his stroke, the attending neurologist ordered a transesophegeal echocardiogram (TEE) and a blood clot around his heart was discovered. My father went to see a cardiologist last week and he scheduled him to undergo cardioversion on June 18. This is a different cardiologist than the one that performed the TEE. I am worried that the risk of stroke will be very high during this procedure since my father has the clot around his heart.

Can someone give me advice on whether my father should have the cardioversion? I talked this over with my mother, but she said I was scaring my father and that the doctor would surely know what was best for him. I asked her to at least make sure the cardiologist knows that my dad had the TEE and that a blood clot was found.

Thanks for your help.

Doug

Hi doug, I'm not a cardiologist, but I can offer some help here.

The thing, unfortunately with your dad, is that he's between a rock and a hard place. You're right that the risk of stroke during the procedure is high if he has clot in his heart, but the problem is, atrial fibrillation is a risk factor for stroke to begin with. They've clearly tried medical management with your father (i.e. reducing the rate of the heart, which is the first line treatment for afib), and it didn't work. So cardioversion is the next step.

Butterflytrans,

Thanks for your comments.

Doug