Why the study?
Does anticoagulation after cardioversion prevent thromboembolism in patients with a negative TEE?
Does anticoagulation after cardioversion prevent thromboembolism in patients with a negative TEE?
The authors suggest continuing anticoagulation for at least one week to one month after cardioversion, even after a negative TEE, due to the risk of early cardioversion-related embolism.
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Suggests extended post-cardioversion anticoagulation despite negative TEE; hypothesis-generating and should not yet change practice.
As in the report of Manning et al,2 anticoagulation management was not uniform in the present series,' reflecting physician judgements regarding the requirement for and contraindications to anticoagulation. Our study did not address the optimal duration of anticoagulation after cardioversion, which may depend on the time course of atrial function after cardioversion6 and the likelihood of arrhythmia recurrence. Most cases of cardioversion-related embolism occur in the first week after cardioversion.'78 Although the minimum anticoagulation duration of 24 hours after cardioversion recommended by Manning et al may provide some benefit, it appears prudent to continue anticoagulation after cardioversion for at least one week and as long as one month, until further data are available.
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Manning et al. (1994) studied this question.
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