ATRIAL-FIBRILLATION IN THE ELDERLY - PHYSICIANS ATTITUDES TO ANTICOAGULATION

The use of warfarin and aspirin for the primary prevention of stroke i n elderly patients with atrial fibrillation (AF) is controversial. To establish current practice we circulated a questionnaire to 300 geriat ricians (G) and 300 cardiologists (C). The response rates were 47% G a nd 51% C. Most physicians prescribed warfarin in AF associated with mi tral stenosis (G vs C, 86% vs 89%, NS). Cardiologists were more likely to prescribe warfarin in AF associated with dilated cardiomyopathy (G vs C, 52% vs 86%, P<0.01). A minority would prescribe warfarin in aor tic valve disease and AF (G vs C, 37% vs 24%, P<0.05) and lone AF (G v s C, 10% vs 26%, P<0.01). Aspirin was favoured in aortic valve disease and lone AF. The cardiologists were less reluctant to use warfarin in the young and more likely to electrically cardiovert the young with c hronic AF.