Antithrombotic treatment management in low stroke risk patients undergoing cardioversion of atrial fibrillation & lt;48 h duration: results of an EHRA survey

AbstractData supporting the safety of cardioversion (CV) of atrial fibrillation (AF) without anticoagulation in patients with AF duration<48  h are scarce. Observational studies suggest that the risk of stroke in these patients is very low when the definite duration of the AF episode is of<48  h and the clinical risk profile as estimated through the CHA2DS2VASc score is low (a score of 0 for men and 1 for women). As the recent 2020 European Society of Cardiology (ESC) guidelines indication for this clinical scenario is based mainly on consensus, we sent out a survey to assess the current clinical practice on anticoagulation prior to and post-CV in patients with AF<24 –48 h duration and low stroke risk across centres in Europe. Of the 136 respondents, half were affiliated to university hospitals (68/136; 50%). Non-university hospitals (50/136; 36%) and private hospitals (2/136; 1.4%) accounted over a third of respondents. The main findings of our survey were (i) heterogeneity in the anticoagulation management both before and post-CV in low stroke-risk patients with AF<48  h, (ii) higher utilization of periprocedural low-molecular-weight heparin than of non-vitamin K antagonist oral anticoagulant, (iii) higher utilization of pre-CV transoesophageal echocardiography for electrical CV than for pharmacological CV regardless of the duration of AF, (iv) high adherence t o a 4-week post-CV oral anticoagulant (OAC) therapy, mainly for electrical CV, and finally, ...
Source: Europace - Category: Cardiology Source Type: research