Bleeding and thromboembolic risks of internal cardioversion for persistent atrial fibrillation

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Internal cardioversion is a common treatment for atrial fibrillation (AF).
• Thromboembolic and bleeding risks associated with internal cardioversion require further clarification.

Purpose of the Study:

• To retrospectively analyze thromboembolic events and bleeding complications in patients undergoing internal cardioversion for persistent AF.
• To evaluate the safety of periprocedural anticoagulation strategies.

Main Methods:

• Retrospective analysis of 114 consecutive patients with persistent AF undergoing internal cardioversion.
• Patients received warfarin followed by periprocedural heparin therapy.
• Monitoring for thromboembolic events and bleeding complications.

Main Results:

• Successful internal cardioversion achieved in 88% of patients.
• Major bleeding complications (pericardial effusion) occurred in 2% of patients.
• No thromboembolic events were observed within 4 weeks of follow-up.
• Periprocedural heparin therapy was associated with an increased risk of bleeding complications.

Conclusions:

• The risk of thromboembolism after discontinuing anticoagulation before internal cardioversion for persistent AF is low.
• Periprocedural heparin therapy in conjunction with internal cardioversion increases the risk of bleeding complications.