Anticoagulation for cardioversion of atrial arrhythmias
We would advocate 3 weeks of anticoagulation prior to, and 4 weeks post-cardioversion (either electrical or chemical) for patients in chronic atrial fibrillation or flutter. In selected cases it seems reasonable to use transoesophageal echocardiography to exclude preformed thrombus and negate the ne...
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| Veröffentlicht in: | European heart journal 1998-04, Vol.19 (4), p.548-552 |
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| container_title | European heart journal |
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| creator | Mayet, J. More, R.S. Sutton, G.C. |
| description | We would advocate 3 weeks of anticoagulation prior to, and 4 weeks post-cardioversion (either electrical or chemical) for patients in chronic atrial fibrillation or flutter. In selected cases it seems reasonable to use transoesophageal echocardiography to exclude preformed thrombus and negate the need for 3 weeks of prior anticoagulation. For patients presenting acutely with atrial fibrillation or flutter we suggest anticoagulating with heparin immediately on presentation and for those who do not spontaneously revert to sinus rhythm, using transoesophageal echocardiography to exclude atrial thrombi prior to cardioversion. Oral anticoagulation should be continued for 4 weeks post-procedure. If transoesophageal echocardiography is not readily available an alternative strategy would be to anticoagulate the patient for 3 weeks and thereafter readmit them for elective cardioversion, continuing the anticoagulation for a further 4 weeks after the procedure. |
| doi_str_mv | 10.1053/euhj.1997.0509 |
| format | Article |
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In selected cases it seems reasonable to use transoesophageal echocardiography to exclude preformed thrombus and negate the need for 3 weeks of prior anticoagulation. For patients presenting acutely with atrial fibrillation or flutter we suggest anticoagulating with heparin immediately on presentation and for those who do not spontaneously revert to sinus rhythm, using transoesophageal echocardiography to exclude atrial thrombi prior to cardioversion. Oral anticoagulation should be continued for 4 weeks post-procedure. If transoesophageal echocardiography is not readily available an alternative strategy would be to anticoagulate the patient for 3 weeks and thereafter readmit them for elective cardioversion, continuing the anticoagulation for a further 4 weeks after the procedure.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1053/euhj.1997.0509</identifier><identifier>PMID: 9597402</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Acute Disease ; Anticoagulants - administration & dosage ; anticoagulation ; atrial fibrillation ; Atrial Fibrillation - drug therapy ; Atrial Fibrillation - therapy ; atrial flutter ; Biological and medical sciences ; Blood. Blood coagulation. Reticuloendothelial system ; cardioversion ; Chronic Disease ; Electric Countershock - adverse effects ; Female ; Humans ; Male ; Medical sciences ; Pharmacology. Drug treatments ; Randomized Controlled Trials as Topic ; supraventricular tachycardia ; Thromboembolism - etiology ; Thromboembolism - prevention & control ; Treatment Outcome</subject><ispartof>European heart journal, 1998-04, Vol.19 (4), p.548-552</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c397t-70c51c3d9cd868b05b83cd928c6ecb7f2c2d38fbbce57695788915408ecdaef03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2216401$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9597402$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mayet, J.</creatorcontrib><creatorcontrib>More, R.S.</creatorcontrib><creatorcontrib>Sutton, G.C.</creatorcontrib><title>Anticoagulation for cardioversion of atrial arrhythmias</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>We would advocate 3 weeks of anticoagulation prior to, and 4 weeks post-cardioversion (either electrical or chemical) for patients in chronic atrial fibrillation or flutter. In selected cases it seems reasonable to use transoesophageal echocardiography to exclude preformed thrombus and negate the need for 3 weeks of prior anticoagulation. For patients presenting acutely with atrial fibrillation or flutter we suggest anticoagulating with heparin immediately on presentation and for those who do not spontaneously revert to sinus rhythm, using transoesophageal echocardiography to exclude atrial thrombi prior to cardioversion. Oral anticoagulation should be continued for 4 weeks post-procedure. If transoesophageal echocardiography is not readily available an alternative strategy would be to anticoagulate the patient for 3 weeks and thereafter readmit them for elective cardioversion, continuing the anticoagulation for a further 4 weeks after the procedure.</description><subject>Acute Disease</subject><subject>Anticoagulants - administration & dosage</subject><subject>anticoagulation</subject><subject>atrial fibrillation</subject><subject>Atrial Fibrillation - drug therapy</subject><subject>Atrial Fibrillation - therapy</subject><subject>atrial flutter</subject><subject>Biological and medical sciences</subject><subject>Blood. Blood coagulation. Reticuloendothelial system</subject><subject>cardioversion</subject><subject>Chronic Disease</subject><subject>Electric Countershock - adverse effects</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Pharmacology. Drug treatments</subject><subject>Randomized Controlled Trials as Topic</subject><subject>supraventricular tachycardia</subject><subject>Thromboembolism - etiology</subject><subject>Thromboembolism - prevention & control</subject><subject>Treatment Outcome</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kEtLw0AURgdRaq1u3QlZiLvEO0nmtSy-KlR0oVDcDJPJxE7No84kYv-9CQ1dXbjfuR_cg9AlhggDSW5Nt95EWAgWAQFxhKaYxHEoaEqO0RSwICGlfHWKzrzfAACnmE7QRBDBUoiniM3r1upGfXWlam1TB0XjAq1cbptf4_ywaYpAtc6qMlDOrXfturLKn6OTQpXeXIxzhj4eH97vFuHy9en5br4MdSJYGzLQBOskFzrnlGdAMp7oXMRcU6MzVsQ6zhNeZJk2hFFBGOcCkxS40bkyBSQzdLPv3brmpzO-lZX12pSlqk3TeckEZ6L_tgejPahd470zhdw6Wym3kxjkYEoOpuRgSg6m-oOrsbnLKpMf8FFNn1-PufJalYVTtbb-gMUxpingHgv3mPWt-TvEyn1LyhJG5GL1Ke-BwcubWEqR_ANUS4Ep</recordid><startdate>19980401</startdate><enddate>19980401</enddate><creator>Mayet, J.</creator><creator>More, R.S.</creator><creator>Sutton, G.C.</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980401</creationdate><title>Anticoagulation for cardioversion of atrial arrhythmias</title><author>Mayet, J. ; More, R.S. ; Sutton, G.C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c397t-70c51c3d9cd868b05b83cd928c6ecb7f2c2d38fbbce57695788915408ecdaef03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Acute Disease</topic><topic>Anticoagulants - administration & dosage</topic><topic>anticoagulation</topic><topic>atrial fibrillation</topic><topic>Atrial Fibrillation - drug therapy</topic><topic>Atrial Fibrillation - therapy</topic><topic>atrial flutter</topic><topic>Biological and medical sciences</topic><topic>Blood. Blood coagulation. Reticuloendothelial system</topic><topic>cardioversion</topic><topic>Chronic Disease</topic><topic>Electric Countershock - adverse effects</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Pharmacology. Drug treatments</topic><topic>Randomized Controlled Trials as Topic</topic><topic>supraventricular tachycardia</topic><topic>Thromboembolism - etiology</topic><topic>Thromboembolism - prevention & control</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mayet, J.</creatorcontrib><creatorcontrib>More, R.S.</creatorcontrib><creatorcontrib>Sutton, G.C.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mayet, J.</au><au>More, R.S.</au><au>Sutton, G.C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anticoagulation for cardioversion of atrial arrhythmias</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>1998-04-01</date><risdate>1998</risdate><volume>19</volume><issue>4</issue><spage>548</spage><epage>552</epage><pages>548-552</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>We would advocate 3 weeks of anticoagulation prior to, and 4 weeks post-cardioversion (either electrical or chemical) for patients in chronic atrial fibrillation or flutter. In selected cases it seems reasonable to use transoesophageal echocardiography to exclude preformed thrombus and negate the need for 3 weeks of prior anticoagulation. For patients presenting acutely with atrial fibrillation or flutter we suggest anticoagulating with heparin immediately on presentation and for those who do not spontaneously revert to sinus rhythm, using transoesophageal echocardiography to exclude atrial thrombi prior to cardioversion. Oral anticoagulation should be continued for 4 weeks post-procedure. If transoesophageal echocardiography is not readily available an alternative strategy would be to anticoagulate the patient for 3 weeks and thereafter readmit them for elective cardioversion, continuing the anticoagulation for a further 4 weeks after the procedure.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>9597402</pmid><doi>10.1053/euhj.1997.0509</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0195-668X |
| ispartof | European heart journal, 1998-04, Vol.19 (4), p.548-552 |
| issn | 0195-668X 1522-9645 |
| language | eng |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals |
| subjects | Acute Disease Anticoagulants - administration & dosage anticoagulation atrial fibrillation Atrial Fibrillation - drug therapy Atrial Fibrillation - therapy atrial flutter Biological and medical sciences Blood. Blood coagulation. Reticuloendothelial system cardioversion Chronic Disease Electric Countershock - adverse effects Female Humans Male Medical sciences Pharmacology. Drug treatments Randomized Controlled Trials as Topic supraventricular tachycardia Thromboembolism - etiology Thromboembolism - prevention & control Treatment Outcome |
| title | Anticoagulation for cardioversion of atrial arrhythmias |
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