Came onto to this late.

First of all, atrial fibrillation confers a five fold increase in risk of stroke and studies with other blood thinners, including asprin, just don't hold up when compared to the efficacy of coumadin. With that said, it is a difficult and dangerous drug and must be monitored carefully on a monthly basis and is affected by vit k rich foods. However, should you have to stay on a blood thinner (if the cardioversion does not work) there is another alternative that has been out in europe for a long time and is making its way here. http://www.drugdevelopment-technolog...ojects/exanta/

Exanta does not need the monthly monitoring and is not affected by vit k rich foods. Thus, it is not prone to flucuations that are inherent to a drug such as coumadin since it is a direct thrombin inhibitor. It has been well studied in atrial fibrillation and stroke prevention.

As for catheter ablation of atrial fibrialltion, it is stilll in the investigational phase. It is only reserved for those patients who have failed cardioversion and rate control with drugs (high rate atrial fibrilllation where the heart rate is left to tick along at a very fast rate can lead to atrial fibrillation cardiomyopathy). In addition, unlike av nodal rentrant tachycardia or wolf parkinson white syndrome and other arrythmias, in atrial fibrillation it is hard to map out the focus or origin of the abnormal electrical signals. I think the clinical trials out there have ablated the pulmonary vein (felt to be the source of much of the focus of atrial fibrillation) and or ablated the av node which still requireds a person to be on a blood thinner (only helps with rate control) and the subsequent need for a pacemaker.

Let's hope the cardioversion works. If not, I know quite a few active patients with atrial fibrillation on coumadin.