Safety of electrical cardioversion in patients with previous embolic events

Abdou Elhendy, Federico Gentile, Bijoy K. Khandheria, Kent R. Bailey, Kelli N. Burger, James B. Seward

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

• Objective:To assess thromboembolic complications in cardioversions in patients with atrial fibrillation or flutter and a previous embolic event. • Patients and Methods: The study population consisted of 104 patients with previous embolic events who under-went 128 electrical cardioversions for termination of atrial fibrillation or flutter. The primary outcome measure was successful cardioversion. • Results: Anticoagulants were administered in 118 procedures (92%). Cardioversion was successful in 108 (84%) of the 128 procedures. Only 1 embolic event occurred within 30 days after cardioversion (incidence, 0.9 % of successful procedures; 95 % confidence interval, 0.02%5.3%). The single embolic event was a transient neurologic deficit occurring 22 days after cardioversion in a patient with previous atrial fibrillation. This patient had a subtherapeutic level of anticoagulation. Transesophageal echocardiography revealed no spontaneous echo contrast or thrombi before the procedure. No thromboembolism was noted in patients who had therapeutic anticoagulation or in those with failed cardioversion. • Conclusion: Patients with previous embolism are not at additional risk of thromboembolic complications after cardioversion if anticoagulation is adequate.

Original languageEnglish (US)
Article number62383
Pages (from-to)364-368
Number of pages5
JournalMayo Clinic proceedings
Volume76
Issue number4
DOIs
StatePublished - 2001

ASJC Scopus subject areas

  • General Medicine

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