Vol 14, No 3 (2019)
Original paper
Published online: 2019-07-04
Sinus rhythm recovery in patients with atrial fibrillation treated with non-vitamin K antagonist oral anticoagulants is safe without transoesophageal echocardiography evaluation — a preliminary report
DOI: 10.5603/FC.2019.0054
Folia Cardiologica 2019;14(3):230-234.
Abstract
Introduction. Atrial fibrillation (AF) is the most common type of supraventricular arrhythmia. Electrical cardioversion is a non-pharmacological method of restoring sinus rhythm in AF patients. The role of transoesophageal echocardiography (TEE) in patients subjected to electrical cardioversion has not yet been fully established. The objective of this study was to assess the safety of electrical cardioversion procedures in AF patients who had received novel oral anticoagulants for at least 21 days prior to the procedure, and in whom electrical cardioversion was carried out without previous TEE examination.
Material and methods. The study population consisted of 132 patients receiving non-vitamin K antagonist oral anticoagulants (NOACs) and subjected to electrical cardioversion procedures at a district hospital cardiology department. Patients with valvular AF and patients receiving NOACs in an irregular fashion were excluded from the study. The incidence of thromboembolic and haemorrhagic complications was assessed over a 30-day follow-up period.
Results. In a group of 132 patients treated with NOACs, rivaroxaban was used in 65 (49.2%) patients, dabigatran was used in 62 (47.0%) patients, and apixaban was used in five (3.8%) patients. No thromboembolic or haemorrhagic complications were observed in the study group over the hospitalisation period or the 30-day follow-up period.
Conclusions. NOACs are effective and safe in the premedication of AF patients prior to electrical cardioversion procedures. Electrical cardioversion without prior TEE is a safe method of managing patients receiving regular premedication with NOACs for at least 21 days before a sinus rhythm restoration procedure.
Keywords: TEEelectrical cardioversionNOAC
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