Coumadin and Aspirin re Atrial Fib

It has long been held that coumadin should not be taken with any form of salicylate.  However, some cardiologists at Yale seem to be in favor of Coumadin plus small doses of Aspirin.  This makes sense to me considering that Coumadin acts exclusively on the Vitamin K dependent clotting factors whereas Aspirin is acting on the platelettes.  Is it not conceivable that if someone is on Coumadin in preparation for conversion of atrial fibrillation, that a clot may still have formed (however incomplete) from platelette aggregation?  What are your thoughts on combined therapy.

Also, if one has enlargement of the atria does that suggest anything that could be contraindictory of having conversion with Pronestyl and/or electroconversion?    Thank you.

[CCF CARDIO MD JMF]

It is now more common to prescribe these two in combination and i almost always do this is patients with CAD and a requirement for anticoagulation.

as far as atrial enlargement, if your atria is greater than6.0 cm it does make it more difficult but by no means is contraindicated.  You are more likely to have atrial clot and your atria is less likely to respond to either chemical or electrical conversion.