When no anticoagulation is used after cardioversion of acute atrial fibrillation, patients with conventional risk factors for thromboembolism are at increased risk for stroke and other thromboembolic events, according to results from a large retrospective study. The researchers who conducted the FinCV study concluded that their data support a European Society of Cardiology guideline issued in 2010 recommending anticoagulation therapy during and after cardioversion in patients with acute AF and risk factors for stroke. The specific therapy recommended is heparin peri-cardioversion followed by long-term anticoagulation with a vitamin K antagonist.
In FinCV, researchers followed clinical outcomes from successful cardioversions (n=5,116) in patients treated for AF lasting less than 48 hours before treatment. The patients were identified from the discharge registries at three hospitals in Finland. Emergency clinic admission records and databases were then used to review all patients (aged older than 18 years) with acute AF who underwent cardioversion during the study period from 2003 to 2010. Further analysis was conducted on the patients (n=2,481, 63.7% men) who did not receive anticoagulation therapy during or after treatment. The primary outcome of interest was definite thromboembolic event — defined as confirmed stroke caused by cerebral infarction or confirmed systemic embolism — within 30 days after index cardioversion.
The full article is located at Healio