Cardioversion & atrial fibrillation

[minniecarousel]

Things are getting much more serious for my Mom (age 93). She is currently in A-Fib and cardioversion is recommended by her cardiologist. Her symptoms are shortness of breath and weakness. Cardioversion is a procedure done in a hospital as an out-patient. She'll be put under light sedation and they "zap" her heart to get the atria of the heart working properly again. She's had this done successfully one other time. She has a pacemaker.

She has other health problems: gout, sores on her toes that won't heal. Arthritis & a current significant weight loss. Old pain from the shingles called post-herpatic neuralgia.

How do we guide her in deciding to have this procedure done? She will probably continue to have shortness of breath unless she goes for it. At what point is it: "enough is enough"?

 

[pumba]

is she on warfarin or another coumadin type drug.....if so I wouldnt do a cv on her at that age.
I asked my husband who has had CV done once and if he would have it done again and he said resounding NO......his did not work and the cardiologist said he can lead a normal life with his meds ..

 

[minniecarousel]

Yes, she's on coumadin. And cardioversion did work the one other time she had it done. The rough thing is - the shortness of breath probably won't go away without the procedure.

(but, at her age...)

 

[plyeng2ff]

I think that decesion is in the hands of your mother. She might be at the point of enough is enough already. I had the cardioversion done when I was only in my late 20s and then 3 years later in my 30s. I told the doctor the second one was the last.

 

[Dan Murphy]

Hi Julie.

When I had my A fib (actually A flutter, similar but different) last year, I did have a CV. And it worked fine. I take a beta blocker now and have no recurrence. Your mom is almost 30 years plus of me and has a number of ongoing medical concerns. I would certainly get a second, maybe third opinion.

In any case, best wishes and prayers.

And hello to you also, Marie.

 

[Disney Doll]

How did she react to the previous cardioversion? Did she have a really hard time with it or was it relatively easy for her? Everybody has different reactions to stuff like that.

What does she really want? What is her current quality of life? Would she be more active, but the weakness and SOB (acronym for Shortness Of Breath, not an insult to your dear mother!) are limiting her? Can they "tweak" her medication regime and give her some relief????

My opinion on treating the eldelry is the less invasive procedures we do, the better. I am all for conservative treatment, since sometimes the treatment causes other problems, even though it may solve the initial problem.

 

[minkydog]

How did she react to the previous cardioversion? Did she have a really hard time with it or was it relatively easy for her? Everybody has different reactions to stuff like that.

What does she really want? What is her current quality of life? Would she be more active, but the weakness and SOB (acronym for Shortness Of Breath, not an insult to your dear mother!) are limiting her? Can they "tweak" her medication regime and give her some relief????

My opinion on treating the eldelry is the less invasive procedures we do, the better. I am all for conservative treatment, since sometimes the treatment causes other problems, even though it may solve the initial problem.

Yes to this. Your mother is the one who will make that decision. Please do not try to talk her into one way or another. I know everyone has their own thoughts on what to do, but try not to influence her. Let her talk it out to you so she can get her thoughts straight. Then she can probably come to a decision. Do not fall into the trap of deciding for her, even if she says she doen't know what to do. She has to decide. Not to decide is a decision, too.

Conservative treatment in an elderly woman who has underlying health issues would be my personal course of action. But maybe your mother feels differently? Some people want to pull out all the stops right up until they breathe their last.

 

[minniecarousel]

How did she react to the previous cardioversion? Did she have a really hard time with it or was it relatively easy for her? Everybody has different reactions to stuff like that.
Her biggest complaint was in waiting for the cardiologist to come in and do the procedure! She came through last time (1-2 years ago) breathing so much better - it was immediate.
What does she really want? What is her current quality of life? Would she be more active, but the weakness and SOB (acronym for Shortness Of Breath, not an insult to your dear mother!) are limiting her? Can they "tweak" her medication regime and give her some relief????
The SOB is the toughest thing right now. Her arms & legs are so weak. She can't walk with her walker right now - too weak.
My opinion on treating the eldelry is the less invasive procedures we do, the better. I am all for conservative treatment, since sometimes the treatment causes other problems, even though it may solve the initial problem.

If she can't walk because of the SOB, her quality of life goes down. Yet, she's used the phrase "let nature take it's course"

And I am trying not to influence her. Part of me really wants her to have it done, but a little part of me thinks that maybe "it's time". I have 7 siblings, 3 who work in Healthcare. I would like to hear from them. We just found out today that the cardioversion is the preferred treatment.

Thanks for the opinions.

 

[Disney Doll]

Well, if she is alert and oriented and capable of making the decision, and her decision is to let nature take its course, then I recommend you all speak to a palliative care person or a hospice provider to prepare you and her for the days to come. I don't mean that in a bad way but these are the agencies that an help you through something like this.

I feel for you...these are tough decisions. My own parents are 82 & 84. They are currently in reasonably goods health for their age, but my mother has started a few little "niggling" things....she had a fall (no major injury believe it or not!), then a growth in her ear that needed removal and there was a quesiotnof it being cancerous (turned out benign), has macular degenration whch she says she feels her vision is declining, just had an echocardiogram to diagnose mild aortic stenosis....these are all "normal" sort of aging issues, but for a woman who had never been in a hospital except to have babies (and I am 47), these were traumatic occurrences. She keeps saying "Everything is happeneing to me" and I keep telling her that what has happened to her is minor in the grand scheme of life but I'm not convincing her of anything.

I have walked the fine line between what is "too much" and what is "not enough" a couple of times and it's not easy. So far everything has been just non-invasive testing except for the ear surgery, but that was a quick outpatinet procedure, so we've been OK.