Safety of electrical cardioversion in patients with atrial fibrillation

Federico Gentile, Abdou Elhendy, Bijoy K. Khandheria, James B. Seward, Christine M. Lohse, Win Kuang Shen, Kent R Bailey, Samantha C. Montgomery, Kelli N. Burger, A. Jamil Tajik

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Abstract

Objectives: To determine the incidence of thromboembolic complications after electively performed electrical cardioversion in patients with atrial fibrillation and to assess the clinical variables associated with an increased risk of thromboembolism after cardioversion. Patients and Methods: This is a retrospective analysis of 834 successful electrical cardioversions performed in 717 patients from 1990 through 1994. Outcome measures included embolic complications at 1-month follow-up after cardioversion and logistic regression models to measure the associations among clinical, anticoagulation, and thromboembolic events and to identify independent predictors of these events. Results: The rate of embolic events after cardioversion was low (0.9%;95% confidence interval, 0.4%-1.8%). Patients with a therapeutic international normalized ratio had no embolic events. Adequate anticoagulation was independently associated with reduced risk of thromboembolism. Hypertension and diabetes mellitus were independently associated with increased risk of embolization. Conclusion: Adequate anticoagulation reduced the risk of embolization after cardioversion. Diabetes mellitus and hypertension are independently associated with increased risk of embolization early after cardioversion.

Original languageEnglish (US)
Pages (from-to)897-904
Number of pages8
JournalMayo Clinic Proceedings
Volume77
Issue number9
StatePublished - 2002

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Electric Countershock
Atrial Fibrillation
Safety
Thromboembolism
Diabetes Mellitus
Logistic Models
Hypertension
International Normalized Ratio
Outcome Assessment (Health Care)
Confidence Intervals
Incidence

ASJC Scopus subject areas

  • Medicine(all)

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Gentile, F., Elhendy, A., Khandheria, B. K., Seward, J. B., Lohse, C. M., Shen, W. K., ... Tajik, A. J. (2002). Safety of electrical cardioversion in patients with atrial fibrillation. Mayo Clinic Proceedings, 77(9), 897-904.

Safety of electrical cardioversion in patients with atrial fibrillation. / Gentile, Federico; Elhendy, Abdou; Khandheria, Bijoy K.; Seward, James B.; Lohse, Christine M.; Shen, Win Kuang; Bailey, Kent R; Montgomery, Samantha C.; Burger, Kelli N.; Tajik, A. Jamil.

In: Mayo Clinic Proceedings, Vol. 77, No. 9, 2002, p. 897-904.

Research output: Contribution to journalArticle

Gentile, F, Elhendy, A, Khandheria, BK, Seward, JB, Lohse, CM, Shen, WK, Bailey, KR, Montgomery, SC, Burger, KN & Tajik, AJ 2002, 'Safety of electrical cardioversion in patients with atrial fibrillation', Mayo Clinic Proceedings, vol. 77, no. 9, pp. 897-904.
Gentile F, Elhendy A, Khandheria BK, Seward JB, Lohse CM, Shen WK et al. Safety of electrical cardioversion in patients with atrial fibrillation. Mayo Clinic Proceedings. 2002;77(9):897-904.
Gentile, Federico ; Elhendy, Abdou ; Khandheria, Bijoy K. ; Seward, James B. ; Lohse, Christine M. ; Shen, Win Kuang ; Bailey, Kent R ; Montgomery, Samantha C. ; Burger, Kelli N. ; Tajik, A. Jamil. / Safety of electrical cardioversion in patients with atrial fibrillation. In: Mayo Clinic Proceedings. 2002 ; Vol. 77, No. 9. pp. 897-904.
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AU - Lohse, Christine M.

AU - Shen, Win Kuang

AU - Bailey, Kent R

AU - Montgomery, Samantha C.

AU - Burger, Kelli N.

AU - Tajik, A. Jamil

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N2 - Objectives: To determine the incidence of thromboembolic complications after electively performed electrical cardioversion in patients with atrial fibrillation and to assess the clinical variables associated with an increased risk of thromboembolism after cardioversion. Patients and Methods: This is a retrospective analysis of 834 successful electrical cardioversions performed in 717 patients from 1990 through 1994. Outcome measures included embolic complications at 1-month follow-up after cardioversion and logistic regression models to measure the associations among clinical, anticoagulation, and thromboembolic events and to identify independent predictors of these events. Results: The rate of embolic events after cardioversion was low (0.9%;95% confidence interval, 0.4%-1.8%). Patients with a therapeutic international normalized ratio had no embolic events. Adequate anticoagulation was independently associated with reduced risk of thromboembolism. Hypertension and diabetes mellitus were independently associated with increased risk of embolization. Conclusion: Adequate anticoagulation reduced the risk of embolization after cardioversion. Diabetes mellitus and hypertension are independently associated with increased risk of embolization early after cardioversion.

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