Prevention of Thromboembolism After Cardioversion of Recent-Onset Atrial Fibrillation

September 1, 2013

Brief Is Not Always Safe^∗

Atrial fibrillation (AF) is the most common human arrhythmia causing a significant public health burden. Restoration of sinus rhythm by cardioversion of the arrhythmia, performed either electrically or pharmacologically, has been a main therapeutic option for the treatment of AF patients during the last decades. After publication of several large randomized studies showing no significant benefit of a rhythm control compared with a rate control strategy in AF patients (1,), the number of cardioversions began to decline (3). However, recent investigations reported potential advantages of rhythm control such as a survival benefit after several years (4) or a reduced progression rate to more permanent AF forms 5. As a result, the appropriate management of AF patients remains controversial, with rhythm control being the preferred strategy in several instances in everyday clinical practice (6,). Therefore, issues associated with the safety of cardioversion, which represents the cornerstone of rhythm control, are of major clinical importance. Read More