Abstract:
:Atrial fibrillation is the most common sustained cardiac arrhythmia and is associated with thromboembolic events and hemodynamic impairment that results in considerable morbidity, mortality, and cost. Cardioversion to sinus rhythm is a common approach to the treatment of these patients. However, cardioversion is associated with the risk of thromboembolism. Current guidelines recommend that patients receive anticoagulants for 3-4 weeks before and 4 weeks after cardioversion. With the development of transesophageal echocardiography (TEE), the risk of thromboembolism and alternative anticoagulation strategies have been evaluated in patients with atrial fibrillation. Administration of low-molecular-weight heparin (LMWH) in conjunction with TEE offers several advantages over unfractionated heparin. Limited data suggest that LMWH in this setting is as effective, is safer, and may be more cost-effective than unfractionated heparin. Ongoing research will identify definitively the optimal strategy for pericardioversion anticoagulation.
journal_name
Pharmacotherapyjournal_title
Pharmacotherapyauthors
Wodlinger AM,Pieper JAdoi
10.1592/phco.23.1.57.31917subject
Has Abstractpub_date
2003-01-01 00:00:00pages
57-63issue
1eissn
0277-0008issn
1875-9114journal_volume
23pub_type
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