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Risk for clinical thromboembolism associated with conversion to sinus rhythm in patients with atrial fibrillation

M J Weigner1, T A Caulfield, P G Danias

  • 1Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Annals of Internal Medicine
|April 15, 1997
PubMed

Insights

Cardioversion for atrial fibrillation (AF) under 48 hours is safe, with a low risk of thromboembolism. These findings support current guidelines recommending early cardioversion for short-duration AF.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • Atrial fibrillation (AF) cardioversion is often assumed safe for durations under 48 hours.
  • Clinical data supporting this low thromboembolism risk assumption are lacking.

Observation:

  • A study of 375 patients with AF <48 hours found 95.2% converted to sinus rhythm.
  • Three patients (0.8%) experienced thromboembolic events (stroke, TIA, peripheral embolus) post-conversion.
  • These events occurred in patients without prior AF or thromboembolism history and with normal cardiac function.

Findings:

  • The incidence of cardioversion-related clinical thromboembolism in patients with AF <48 hours is low.
  • The observed thromboembolic event rate was 0.8% (95% CI, 0.2% to 2.4%).

Implications:

  • These data support current clinical recommendations for early cardioversion in patients with recent-onset atrial fibrillation.
  • The findings reinforce the safety of prompt cardioversion for short-duration AF.
Abstract

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