Key result
NOAC therapy in atrial fibrillation patients undergoing elective cardioversion resulted in low rates of acute thromboembolic (0.2%) and clinically relevant bleeding (0.5%) complications.
Why the study?
What is the rate of acute thromboembolic and bleeding complications in patients with atrial fibrillation treated with NOACs undergoing elective cardioversion?
Cohort (n=1,021)
Yes
What is the rate of acute thromboembolic and bleeding complications in patients with atrial fibrillation treated with NOACs undergoing elective cardioversion?
In real-world practice, the use of NOACs in patients with atrial fibrillation undergoing elective cardioversion is associated with very low rates (<0.5%) of acute thromboembolic and bleeding complications.
NOACs were associated with low complication rates in elective AF cardioversion; hypothesis-generating and should not yet change practice.
Aims: Non-vitamin K antagonist oral anticoagulants (NOAC) have been shown to be safe and effective alternatives to warfarin for the prevention of thromboembolic complications in patients with non-valvular atrial fibrillation (AF). The aim of this study was to investigate the complications and the use of NOACs in AF patients undergoing elective cardioversion. Methods and results: This nationwide multicentre study included consecutive elective cardioversions in AF patients treated with NOACs between October 2011 and May 2016. Data on patient characteristics, antithrombotic treatment and acute (<30 days) complications were collected. One thousand twenty-one patients (mean age 64 years, 70% men) underwent 1291 elective cardioversions, of which 680 (52.7%) cardioversions were performed in patients using dabigatran, 431 (33.4%) rivaroxaban, and 159 (12.3%) apixaban. Mean CHA2DS2-VASc score was 1.8 (±1.5). A total of 3 thromboembolic events occurred after the cardioversion (0.2%): 1 patient receiving dabigatran experienced an ischaemic stroke on Day 2 and 1 rivaroxaban treated patient on Day 4. One patient receiving dabigatran experienced a transient ischaemic attack on Day 11. All 3 patients had used recommended doses of the NOAC. A total of 6 (0.5%) clinically relevant, but not serious bleeding events occurred. Only short duration of AF was associated with lower rate of AF recurrence. Conclusion: Thrombotic and bleeding complications related to NOACs were uncommon (<0.5%) in real life AF patients undergoing elective cardioversion.
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Itäinen et al. (2017) conducted a cohort in Atrial fibrillation (n=1,021). Non-vitamin K antagonist oral anticoagulants (NOACs) was evaluated on Acute (<30 days) thromboembolic complications. NOAC therapy in atrial fibrillation patients undergoing elective cardioversion resulted in low rates of acute thromboembolic (0.2%) and clinically relevant bleeding (0.5%) complications.
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