What is the clinical evidence from this study?

Study design: Observational. Population: Atrial fibrillation (n=111). Intervention: ACCP antithrombotic therapy recommendations. Primary outcome: Failure to follow at least one of ACCP's recommendations regarding anticoagulation.

What question did this study set out to answer?

To evaluate whether physicians follow consensus guidelines for anticoagulation before and after elective cardioversion in patients with atrial fibrillation.

February 12, 1996Archives of Internal Medicine

Physician Practices Regarding Anticoagulation and Cardioversion of Atrial Fibrillation

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Key result

Physician adherence to ACCP anticoagulation recommendations was inadequate, with at least one guideline failure occurring in 35% of elective cardioversion cases for atrial fibrillation.

Why the study?

Do physicians routinely follow ACCP recommendations regarding anticoagulation in elective cardioversion of atrial fibrillation?

Population

111 patients admitted to a tertiary care teaching hospital with a diagnosis of atrial fibrillation in the…

Design

Cohort

Authors

JSJohn R. SchlichtDuquesne University

Discussion

Member takes

Implication

May increase periprocedural stroke risk; leaves open whether interventions improve adherence.

Key Points

To evaluate whether physicians follow consensus guidelines for anticoagulation before and after elective cardioversion in patients with atrial fibrillation.
Retrospective chart review of patients admitted with atrial fibrillation (n=111) at a tertiary care teaching hospital during 1994.
Assessed adherence to guideline recommendations: 3 weeks of anticoagulation before cardioversion, 4 weeks after cardioversion, and a multi-day overlap of heparin and warfarin.
Of 111 patients with atrial fibrillation, 51 underwent elective cardioversion.
Physicians failed to follow at least one guideline recommendation in 35% of cases (18 of 51 patients).
Specific protocol violations included omitting 3 weeks of precardioversion anticoagulation (n=14), omitting 4 weeks of postcardioversion anticoagulation (n=6), and inadequate heparin-warfarin overlap (n=4).

Study Design

Type

Observational (n=111)

Multicenter

Structured PICO

Do physicians routinely follow ACCP recommendations regarding anticoagulation in elective cardioversion of atrial fibrillation?

Population

111 patients admitted to a tertiary care teaching hospital with a diagnosis of atrial fibrillation in the year 1994, of which 51 underwent elective cardioversion.

Intervention

Physician adherence to ACCP's Third Consensus Conference on Antithrombotic Therapy recommendations regarding anticoagulation before and following elective cardioversion.

Outcome

Adherence to ACCP recommendations regarding anticoagulation (3 weeks before and 4 weeks following cardioversion, and overlapping heparin/warfarin).

Physicians frequently fail to follow ACCP guidelines for anticoagulation around elective cardioversion for atrial fibrillation, potentially increasing stroke risk.

Cite This Study

John R. Schlicht (1996) conducted an observational in Atrial fibrillation (n=111). ACCP antithrombotic therapy recommendations was evaluated on Failure to follow at least one of ACCP's recommendations regarding anticoagulation. Physician adherence to ACCP anticoagulation recommendations was inadequate, with at least one guideline failure occurring in 35% of elective cardioversion cases for atrial fibrillation.

synapsesocial.com/papers/6a0ed6c12eca052da647d55c https://doi.org/10.1001/archinte.1996.00440030084011

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF

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Physician Practices Regarding Anticoagulation and Cardioversion of Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Physician Practices Regarding Anticoagulation and Cardioversion of Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider