Cardioversion on Reduced Dose Direct Oral Anticoagulants (DOACs) - Are we Confident?

Electrical cardioversion is commonly performed in patients with symptomatic or hemodynamically unstable atrial fibrillation (AF). The associated risk of a periprocedural embolic event following cardioversion has significantly decreased from an estimated 5-7% to approximately 1% with the use of uninterrupted anticoagulation. The introduction of direct oral anticoagulants (DOACs) over the past decade has greatly simplified periprocedural anticoagulation management by eliminating the need for intravenous heparin and avoiding delay and/or need for transesophageal echocardiography in patients with subtherapeutic or variable INR levels with vitamin K antagonist (VKA) treatment.

Source: Heart Rhythm - July 8, 2019 Category: Cardiology Authors: Eran Leshem, Patricia Tung, Peter Noseworthy, Peter Zimetbaum Source Type: research