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Updated: Jan 31, 2026
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
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Comparing the delay with different anticoagulants before elective electrical cardioversion for atrial
Christopher Wall1, Tania Jankowski1, Vinci Naruka1
1Department of Cardiology, William Harvey Hospital, Ashford, Kent, United Kingdom.
Plos One
|January 4, 2019
Summary
Direct oral anticoagulants (DOACs) significantly reduce the time to cardioversion for atrial fibrillation compared to warfarin. Patients on DOACs also showed improved success rates in maintaining sinus rhythm post-procedure.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Atrial fibrillation necessitates cardioversion to restore normal heart rhythm.
- Anticoagulation is crucial before cardioversion to prevent thromboembolic events.
- Direct oral anticoagulants (DOACs) have emerged as alternatives to warfarin.
Purpose of the Study:
- To evaluate the impact of DOACs versus warfarin on outcomes of elective electrical cardioversion for atrial fibrillation.
- To compare the time to cardioversion, success rates, and rhythm maintenance between different anticoagulant groups.
Main Methods:
- Retrospective analysis of 1,374 patients undergoing cardioversion from January 2013 to September 2017.
- Comparison of time from referral to cardioversion, cardioversion success, and sinus rhythm at 12 weeks.
- Statistical analysis using Kruskal-Wallis, Mann-Whitney-U, and z-testing.
Main Results:
- DOACs (apixaban, rivaroxaban) significantly reduced the delay to cardioversion by at least 2 weeks compared to warfarin.
- Patients on DOACs had a higher probability of achieving and maintaining sinus rhythm at 12 weeks post-cardioversion.
- No significant difference in adverse events was observed between DOACs and warfarin groups.
Conclusions:
- DOACs offer a significant advantage by shortening the time to cardioversion for atrial fibrillation patients.
- Warfarin use was associated with lower success rates in achieving and maintaining sinus rhythm compared to DOACs.
- DOACs represent an effective and potentially superior anticoagulant strategy for cardioversion procedures.
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