February 1, 1997Annals of Internal Medicine
Cardioversion Guided by Transesophageal Echocardiography: The ACUTE Pilot Study: A Randomized, Controlled Trial
Why the study?
Does early, TEE-guided cardioversion with short-term anticoagulation therapy improve feasibility and safety compared to conventional management in patients with atrial fibrillation lasting longer than 2 days?
Population
126 patients with atrial fibrillation lasting longer than 2 days scheduled for electrical cardioversion…
Comparison
Early, transesophageal echocardiography-guided… vs Conventional therapy.
Design
RCT, Randomized
Follow-up
up to 4 weeks after cardioversion
Authors
Discussion
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Implication
Enables earlier cardioversion in AF >2 days; extends RCT evidence for TEE-guided strategy with short-term anticoagulation.
Structured PICO
Does early, TEE-guided cardioversion with short-term anticoagulation therapy improve feasibility and safety compared to conventional management in patients with atrial fibrillation lasting longer than 2 days?
P
Population
126 patients with atrial fibrillation lasting longer than 2 days scheduled for electrical cardioversion, multinational (United States, Europe, and Australia).
I
Intervention
Early, transesophageal echocardiography (TEE)-guided cardioversion with short-term anticoagulation therapy.
C
Comparator
Conventional therapy (prolonged conventional anticoagulation therapy before cardioversion).
O
Outcome
Feasibility outcome variables (frequency of cardioversion and times to cardioversion and sinus rhythm) and safety outcomes (ischemic stroke, transient ischemic attack, systemic embolization, bleeding, and detected episodes of clinical hemodynamic instability occurring as long as 4 weeks after cardioversion).safety
TEE-guided early cardioversion with short-term anticoagulation is feasible, safe, and significantly reduces the time to cardioversion compared to conventional therapy in patients with atrial fibrillation.
Cite This Study
Klein et al. (1997) studied this question.