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Safety of electrical cardioversion in patients with atrial fibrillation
Federico Gentile1, Abdou Elhendy, Buoy K Khandheria
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
Insights
Electrical cardioversion for atrial fibrillation has a low risk of thromboembolism. Adequate anticoagulation is key, while hypertension and diabetes increase risks.
Area of Science:
- Cardiology
- Thrombosis Research
- Medical Interventions
Background:
- Atrial fibrillation is a common arrhythmia.
- Electrical cardioversion is a treatment option for atrial fibrillation.
- Thromboembolic complications are a concern after cardioversion.
Purpose of the Study:
- To determine the incidence of thromboembolic complications after elective electrical cardioversion in atrial fibrillation patients.
- To identify clinical variables associated with increased thromboembolism risk post-cardioversion.
Main Methods:
- Retrospective analysis of 834 successful electrical cardioversions in 717 patients (1990-1994).
- Outcome measures included embolic complications at 1-month follow-up.
- Logistic regression models identified predictors of thromboembolic events.
Main Results:
- Low rate of embolic events (0.9%).
- No embolic events in patients with therapeutic international normalized ratio.
- Adequate anticoagulation was linked to reduced thromboembolism risk.
- Hypertension and diabetes mellitus were independently associated with increased embolization risk.
Conclusions:
- Adequate anticoagulation significantly reduces embolization risk post-cardioversion.
- Hypertension and diabetes mellitus are independent risk factors for early embolization after cardioversion.
Objectives:
To determine the incidence of thromboembolic complications after electively performed electrical cardioversion in patients with atrial fibrillation and to assess the clinical variables associated with an increased risk of thromboembolism after cardioversion.
Patients And Methods:
This is a retrospective analysis of 834 successful electrical cardioversions performed in 717 patients from 1990 through 1994. Outcome measures included embolic complications at 1-month follow-up after cardioversion and logistic regression models to measure the associations among clinical, anticoagulation, and thromboembolic events and to identify independent predictors of these events.
Results:
The rate of embolic events after cardioversion was low (0.9%; 95% confidence interval, 0.4%-1.8%). Patients with a therapeutic international normalized ratio had no embolic events. Adequate anticoagulation was independently associated with reduced risk of thromboembolism. Hypertension and diabetes mellitus were independently associated with increased risk of embolization.
Conclusion:
Adequate anticoagulation reduced the risk of embolization after cardioversion. Diabetes mellitus and hypertension are independently associated with increased risk of embolization early after cardioversion.