Document Detail


Anticoagulation for cardioversion of atrial arrhythmias.
MedLine Citation:
PMID:  9597402     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We would advocate 3 weeks of anticoagulation prior to, and 4 weeks post-cardioversion (either electrical or chemical) for patients in chronic atrial fibrillation or flutter. In selected cases it seems reasonable to use transoesophageal echocardiography to exclude preformed thrombus and negate the need for 3 weeks of prior anticoagulation. For patients presenting acutely with atrial fibrillation or flutter we suggest anticoagulating with heparin immediately on presentation and for those who do not spontaneously revert to sinus rhythm, using transoesophageal echocardiography to exclude atrial thrombi prior to cardioversion. Oral anticoagulation should be continued for 4 weeks post-procedure. If transoesophageal echocardiography is not readily available an alternative strategy would be to anticoagulate the patient for 3 weeks and thereafter readmit them for elective cardioversion, continuing the anticoagulation for a further 4 weeks after the procedure.
Authors:
J Mayet; R S More; G C Sutton
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European heart journal     Volume:  19     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-07-22     Completed Date:  1998-07-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  548-52     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Hillingdon Hospital, London, U.K.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Anticoagulants / administration & dosage*
Atrial Fibrillation / drug therapy*,  therapy
Chronic Disease
Electric Countershock* / adverse effects
Female
Humans
Male
Randomized Controlled Trials as Topic
Thromboembolism / etiology,  prevention & control*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants
Comments/Corrections
Comment In:
Eur Heart J. 1999 Feb;20(4):317   [PMID:  10099928 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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