| The safety of low-molecular weight heparins for the prevention of thromboembolic events after cardioversion of atrial fibrillation. | |
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MedLine Citation:
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PMID: 12825804 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Transesophageal echocardiography (TEE) guided early cardioversion (CV) in conjunction with short-term anticoagulation has been shown to be safe, and an alternative to prolonged conventional anticoagulation therapy. Recently, low molecular weight heparins (LMWHs) have been used successfully as an alternative to standard heparin therapy obviating the need for hospitalization and APTT monitoring. The aim of this study was to determine the feasibility and safety of TEE guided early cardioversion in conjunction with short-term LMWH use in patients with nonvalvular atrial fibrillation (NVAF). The study group consisted of 172 consecutive patients with NVAF. Before TEE, 90 patients received LMWH (Dalteparin 2 x 5,000U) and 82 patients received standard heparin (UFH) (5,000U bolus followed by infusion to raise APTT to 1.5 times control). TEE was performed and the left atrium and left atrial appendage were examined thoroughly for the presence of thrombus. One patient from each group was excluded due to detection of a left atrial thrombus by TEE. Immediately after TEE, CV was attempted and warfarin was initiated. All patients received warfarin for one month after CV. In the LMWH group, 89 of 90 patients (98.9%) were successfully cardioverted. CV was successful in 97.5% of the patients in the UFH group. None of the patients experienced thromboembolic events during the four weeks after CV. TEE guided early CV in conjunction with short-term LMWH treatment is as safe as UFH for the prevention of thromboembolic events after CV. |
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Authors:
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Zerrin Yigit; M Serdar Küçükoglu; Baris Okçün; Vedat Sansoy; Deniz Güzelsoy |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Japanese heart journal Volume: 44 ISSN: 0021-4868 ISO Abbreviation: Jpn Heart J Publication Date: 2003 May |
Date Detail:
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Created Date: 2003-06-26 Completed Date: 2003-07-08 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0401175 Medline TA: Jpn Heart J Country: Japan |
Other Details:
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Languages: eng Pagination: 369-77 Citation Subset: IM |
Affiliation:
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Institute of Cardiology, University of Istanbul, Istanbul, Turkey. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Atrial Fibrillation / therapy*, ultrasonography Echocardiography, Transesophageal Electric Countershock* Feasibility Studies Female Fibrinolytic Agents / therapeutic use* Heparin, Low-Molecular-Weight / therapeutic use* Humans Male Middle Aged Thromboembolism / prevention & control* |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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