Document Detail


The safety of low-molecular weight heparins for the prevention of thromboembolic events after cardioversion of atrial fibrillation.
MedLine Citation:
PMID:  12825804     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Zerrin Yigit; M Serdar Küçükoglu; Baris Okçün; Vedat Sansoy; Deniz Güzelsoy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Japanese heart journal     Volume:  44     ISSN:  0021-4868     ISO Abbreviation:  Jpn Heart J     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-06-26     Completed Date:  2003-07-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401175     Medline TA:  Jpn Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  369-77     Citation Subset:  IM    
Affiliation:
Institute of Cardiology, University of Istanbul, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
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:
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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