Rankin, A. J. and Rankin, S. H. (2017) Cardioverting acute atrial fibrillation and the risk of thromboembolism: not all patients are created equal. Clinical Medicine, 17(5), pp. 419-423. (doi: 10.7861/clinmedicine.17-5-419) (PMID:28974590)
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Abstract
Current guidelines support the well-established clinical practice that patients who present with atrial fibrillation (AF) of less than 48 hours duration should be considered for cardioversion, even in the absence of pre-existing anticoagulation. However, with increasing evidence that short runs of AF confer significant risk of stroke, on what evidence is this 48-hour rule based and is it time to adopt a new approach? We review existing evidence and suggest a novel approach to risk stratification in this setting. Overall, the risk of thromboembolism associated with acute cardioversion of patients with AF that is estimated to be of <48 hours duration is low. However, this risk varies widely depending on patient characteristics. From existing evidence, we show that using the CHA2DS2-VASc score may allow better selection of appropriate patients in order to prevent exposing specific patient groups to an unacceptably high risk of a potentially devastating complication.
Item Type: | Articles |
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Keywords: | Anticoagulants, atrial fibrillation, cardioversion, electrical cardioversion, stroke, thromboembolism. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Rankin, Dr Stephen and Rankin, Dr Alastair |
Authors: | Rankin, A. J., and Rankin, S. H. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
Journal Name: | Clinical Medicine |
Publisher: | Royal College of Physicians |
ISSN: | 1470-2118 |
ISSN (Online): | 1473-4893 |
Copyright Holders: | Copyright © 2017 Royal College of Physicians |
First Published: | First published in Clinical Medicine 17(5):419-423 |
Publisher Policy: | Reproduced in accordance with the copyright policy of the publisher |
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