Optimal Anticoagulation Strategy for Cardioversion in Atrial Fibrillation

For many patients with symptomatic atrial fibrillation, cardioversion is performed to restore sinus rhythm and relieve symptoms. Cardioversion carries a distinct risk for thromboembolism which has been described to be in the order of magnitude of 1 to 3 %. For almost five decades, vitamin K antagoni...

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Veröffentlicht in:Arrhythmia & electrophysiology review 2015-05, Vol.4 (1), p.44-46
Hauptverfasser: Bushoven, Philipp, Linzbach, Sven, Vamos, Mate, Hohnloser, Stefan H
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container_title Arrhythmia & electrophysiology review
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creator Bushoven, Philipp
Linzbach, Sven
Vamos, Mate
Hohnloser, Stefan H
description For many patients with symptomatic atrial fibrillation, cardioversion is performed to restore sinus rhythm and relieve symptoms. Cardioversion carries a distinct risk for thromboembolism which has been described to be in the order of magnitude of 1 to 3 %. For almost five decades, vitamin K antagonist therapy has been the mainstay of therapy to prevent thromboembolism around the time of cardioversion although not a single prospective trial has formally established its efficacy and safety. Currently, three new direct oral anticoagulants are approved for stroke prevention in patients with non-valvular atrial fibrillation. For all three, there are data regarding its usefulness during the time of electrical or pharmacological cardioversion. Due to the ease of handling, their efficacy regarding stroke prevention, and their safety with respect to bleeding complications, the new direct oral anticoagulants are endorsed as the preferred therapy over vitamin K antagonists for stroke prevention in non-valvular atrial fibrillation including the clinical setting of elective cardioversion.
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subjects Anticoagulants
Cardiac arrhythmia
Cardioversion
Diagnostic Electrophysiology & Ablation
Embolisms
Mortality
Patients
Prevention
Stroke
Thromboembolism
title Optimal Anticoagulation Strategy for Cardioversion in Atrial Fibrillation
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