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October 1, 2017ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam)Open Access

Cardioverting acute atrial fibrillation and the risk of thromboembolism: not all patients are created equal

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Key result

While the overall risk of thromboembolism after cardioversion for acute atrial fibrillation (<48 hours) is low, risk varies widely and the CHA2DS2-VASc score may improve patient selection.

Why the study?

Does risk stratification using the CHA2DS2-VASc score improve patient selection for acute cardioversion in atrial fibrillation of <48 hours duration to prevent thromboembolism?

Population

Patients presenting with atrial fibrillation (AF) of less than 48 hours duration

Design

Review

Authors

ARAlastair J. RankinUniversity of GlasgowSRStephen RankinUniversity of Glasgow

Discussion

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Implication

May support CHA2DS2-VASc-guided selection for acute AF cardioversion; leaves open need for prospective validation.

Structured PICO

Does risk stratification using the CHA2DS2-VASc score improve patient selection for acute cardioversion in atrial fibrillation of <48 hours duration to prevent thromboembolism?

P
Population
Patients presenting with atrial fibrillation (AF) of less than 48 hours duration
I
Intervention
Cardioversion with risk stratification using the CHA2DS2-VASc score
O
Outcome
Thromboembolismhard clinical

Using the CHA2DS2-VASc score for risk stratification in patients with acute AF (<48 hours) may help identify those at unacceptably high risk of thromboembolism following cardioversion, challenging the blanket 48-hour rule.

Cite This Study

Rankin et al. (2017) conducted a review in Acute atrial fibrillation (<48 hours duration). Cardioversion was evaluated on Thromboembolism. While the overall risk of thromboembolism after cardioversion for acute atrial fibrillation (<48 hours) is low, risk varies widely and the CHA2DS2-VASc score may improve patient selection.

synapsesocial.com/papers/6a4c4247028ea97264ab766bhttps://doi.org/10.7861/clinmedicine.17-5-419

Topics

Atrial fibrillationAnticoagulation in AFPersistent AF management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Thromboembolic risk in 16 274 atrial fibrillation patients undergoing direct current cardioversion with and without oral anticoagulant therapy2014 · 131 citations
  2. 2Thirty‐day Outcomes of Emergency Department Patients Undergoing Electrical Cardioversion for Atrial Fibrillation or Flutter2010 · 66 citations
  3. 3A Comparison of Rate Control and Rhythm Control in Patients with Recurrent Persistent Atrial Fibrillation2002 · 2,376 citations
  4. 4Delayed rhythm control of atrial fibrillation may be a cause of failure to prevent recurrences: reasons for change to active antiarrhythmic treatment at the time of the first detected episode2007 · 152 citations
  5. 5Higher risk of death and stroke in patients with persistent vs. paroxysmal atrial fibrillation: results from the ROCKET-AF Trial2014 · 361 citations