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Article: Bleeding and thromboembolic risks of internal cardioversion for persistent atrial fibrillation

TitleBleeding and thromboembolic risks of internal cardioversion for persistent atrial fibrillation
Authors
Issue Date2002
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
Citation
Pace - Pacing And Clinical Electrophysiology, 2002, v. 25 n. 12, p. 1752-1755 How to Cite?
AbstractAlthough internal cardioversion is an effective method for converting AF the thromboembolic risk and bleeding complication of this procedure remains unclear. Retrospective analysis of the thromboembolic events and bleeding complications was performed in 114 consecutive patients (mean age 63 ± 10 years, 91 men) who underwent internal cardioversion for persistent AF (mean AF duration 31 ± 42 months). All patients received therapeutic warfarin for 3 weeks prior to the procedure, which was then replaced by periprocedural heparin therapy during internal cardioversion. The mean INR value before the internal cardioversion was 1.3 ± 0.2. A total of 992 R wave synchronized shocks were delivered (mean 8.7 shocks/patients) without ventricular proarrhythmia. Successful internal cardioversion of AF was achieved in 100 (88%) patients. Two (2%) patients developed major bleeding complications with pericardial effusion after the procedure. Both of them subsided with conservative treatment. Minor bleeding with wound hematoma occurred in 8 (7%) of 114 after the procedure. Overall, there was no significant difference in the risk of procedure related complication between the use of heparin infusion and subcutaneous LMWH injection (6/78 [13%] vs 3/36 [8%], P = 0.9). No thromboembolic event was observed after 4 weeks of follow-up. In conclusion, the risk of thromboembolism after discontinuation of anticoagulation before the procedure is low in patients with persistent AF underwent internal cardioversion. However, the use of periprocedural heparin therapy was associated with an increase risk of procedure related bleeding complications.
Persistent Identifierhttp://hdl.handle.net/10722/162646
ISSN
2015 Impact Factor: 1.156
2015 SCImago Journal Rankings: 0.662
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_US
dc.contributor.authorLau, CPen_US
dc.date.accessioned2012-09-05T05:22:02Z-
dc.date.available2012-09-05T05:22:02Z-
dc.date.issued2002en_US
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2002, v. 25 n. 12, p. 1752-1755en_US
dc.identifier.issn0147-8389en_US
dc.identifier.urihttp://hdl.handle.net/10722/162646-
dc.description.abstractAlthough internal cardioversion is an effective method for converting AF the thromboembolic risk and bleeding complication of this procedure remains unclear. Retrospective analysis of the thromboembolic events and bleeding complications was performed in 114 consecutive patients (mean age 63 ± 10 years, 91 men) who underwent internal cardioversion for persistent AF (mean AF duration 31 ± 42 months). All patients received therapeutic warfarin for 3 weeks prior to the procedure, which was then replaced by periprocedural heparin therapy during internal cardioversion. The mean INR value before the internal cardioversion was 1.3 ± 0.2. A total of 992 R wave synchronized shocks were delivered (mean 8.7 shocks/patients) without ventricular proarrhythmia. Successful internal cardioversion of AF was achieved in 100 (88%) patients. Two (2%) patients developed major bleeding complications with pericardial effusion after the procedure. Both of them subsided with conservative treatment. Minor bleeding with wound hematoma occurred in 8 (7%) of 114 after the procedure. Overall, there was no significant difference in the risk of procedure related complication between the use of heparin infusion and subcutaneous LMWH injection (6/78 [13%] vs 3/36 [8%], P = 0.9). No thromboembolic event was observed after 4 weeks of follow-up. In conclusion, the risk of thromboembolism after discontinuation of anticoagulation before the procedure is low in patients with persistent AF underwent internal cardioversion. However, the use of periprocedural heparin therapy was associated with an increase risk of procedure related bleeding complications.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1en_US
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiologyen_US
dc.subject.meshAnticoagulants - Therapeutic Useen_US
dc.subject.meshAtrial Fibrillation - Complications - Therapyen_US
dc.subject.meshElectric Countershock - Adverse Effects - Methodsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHemorrhage - Etiology - Prevention & Controlen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshThromboembolism - Etiology - Prevention & Controlen_US
dc.subject.meshWarfarin - Therapeutic Useen_US
dc.titleBleeding and thromboembolic risks of internal cardioversion for persistent atrial fibrillationen_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1460-9592.2002.01752.x-
dc.identifier.pmid12520677-
dc.identifier.scopuseid_2-s2.0-0036918871en_US
dc.identifier.hkuros100803-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036918871&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume25en_US
dc.identifier.issue12en_US
dc.identifier.spage1752en_US
dc.identifier.epage1755en_US
dc.identifier.isiWOS:000180096800014-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US

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