Cardioversion of recent-onset atrial fibrillation: current evidence, practical considerations, and controversies in a complex clinical scenario.

Cardioversion of recent-onset atrial fibrillation: current evidence, practical considerations, and controversies in a complex clinical scenario. Kardiol Pol. 2020 Oct 06;: Authors: Boriani G, Bonini N, Albini A, Venturelli A, Imberti JF, Vitolo M Abstract Atrial fibrillation (AF) represents the most common arrhythmia and it is associated with increased morbidity and mortality carrying high social costs. Because of its high prevalence, AF is usually managed not only by cardiologists, but also by general practitioners or in the emergency departments. Conventional classification of AF includes "recent-onset AF" defined as an arrhythmia episode of < 48 hours (h) in duration. In patients with a definite duration of AF of less than 24 h and with a very low-risk profile (CHA2DS2VASC 0 in male, 1 in female) the thromboembolic risk seems low and the standard 4-weeks anticoagulation is now considered an optional treatment. Cardioversion (electrical or pharmacological) in recent-onset AF represents a valid rhythm approach strategy. Electrical CV is usually reserved for hemodynamically unstable patient and performed with biphasic waveform shocks. Pharmacological CV is preferred in hemodynamically stable patients. Several antiarrhythmics drugs have been studied but some questions still remain unresolved mainly due to the lack of randomized clinical trials and prospective studies. Current guidelines do not uniformly agree on which drug to use f...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research