Abstract:
BACKGROUND:Direct oral anticoagulants (DOACs) have emerged as the preferred choice of oral anticoagulation in patients with atrial fibrillation. Randomized trials have demonstrated the efficacy and safety of DOAC in patients undergoing electrical cardioversion (ECV); however, there is limited real-world data. OBJECTIVE:To evaluate the outcome of patients undergoing an elective ECV for atrial tachyarrhythmia in a tertiary referral center who were treated with DOAC or vitamin K antagonist (VKA) without routine trans esophageal echocardiography (TEE). METHODS:This was a retrospective single-center cohort study of consecutive patients undergoing an elective ECV for atrial tachyarrhythmia from January 2013 to February 2020. The primary endpoints were thromboembolism (composite of stroke, transient ischemic attack or systemic embolism) and major bleeding events within 60 days. RESULTS:A total of 1431 ECV procedures were performed in 920 patients. One-third of the procedures were performed under DOAC (N = 488, 34%) and the remainder of the procedures was performed under VKA (N = 943, 66%). There were no differences between groups with regard to demographic variables (mean age 62.4 ± 11.7, 72% men) and mean CHA2DS2-VASc score (2.3 ± 1.6); however, the VKA group had a higher proportion of patients with co-morbidity. Thromboembolism occurred in 0.41% in the DOAC group versus 0.64% in the VKA group (P = 0.72). Major bleeding events occurred in 0.41% in the DOAC group versus 0.11% in the VKA group (P = 0.27). CONCLUSION:In a real-world population, the rates of thromboembolism and major bleeding events were low after elective ECV in patients using DOAC or VKA, even without routine TEE.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
de Heide J,de Wit A,Bhagwandien RE,Assaf A,Gros-Bisdom J,van der Meer KC,Wijchers SA,Zijlstra F,Szili-Torok T,Lenzen MJ,Yap SCdoi
10.1016/j.ijcard.2020.10.070subject
Has Abstractpub_date
2020-11-02 00:00:00eissn
0167-5273issn
1874-1754pii
S0167-5273(20)34061-4pub_type
杂志文章abstract:BACKGROUND:The pathogenesis of aortic valve stenosis may involve inflammation and we have previously demonstrated Chlamydophila pneumoniae (C. pneumoniae) DNA in stenotic aortic heart valves. Dissemination of these bacteria is probably mediated by alveolar macrophages. Bacterial DNA alone does not indicate whether the ...
journal_title:International journal of cardiology
pub_type: 杂志文章
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abstract:BACKGROUND:Left ventricular (LV) global longitudinal strain (GLS) can detect an early dysfunction in arterial hypertension. We investigated regional LV patterns of longitudinal strain (LS) and base-to-apex behaviour in newly diagnosed, never-treated hypertensive patients (HTN) without LV hypertrophy. METHODS:180 HTN a...
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journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章,多中心研究
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journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
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journal_title:International journal of cardiology
pub_type: 信件
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pub_type: 信件
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更新日期:2010-02-04 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章,评审
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journal_title:International journal of cardiology
pub_type: 杂志文章
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