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Low stroke risk after elective cardioversion of atrial fibrillation: an analysis of the Flec-SL trial

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Low stroke risk after elective cardioversion of atrial fibrillation: an analysis of the Flec-SL trial. / Apostolakis, Stavros; Haeusler, Karl Georg; Oeff, Michael; Treszl, Andras; Andresen, Dietrich; Borggrefe, Martin; Lip, Gregory Y H; Meinertz, Thomas; Parade, Ulrich; Samol, Alexander; Steinbeck, Gerhard; Wegscheider, Karl; Breithardt, Günter; Kirchhof, Paulus.

In: INT J CARDIOL, Vol. 168, No. 4, 09.10.2013, p. 3977-81.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Apostolakis, S, Haeusler, KG, Oeff, M, Treszl, A, Andresen, D, Borggrefe, M, Lip, GYH, Meinertz, T, Parade, U, Samol, A, Steinbeck, G, Wegscheider, K, Breithardt, G & Kirchhof, P 2013, 'Low stroke risk after elective cardioversion of atrial fibrillation: an analysis of the Flec-SL trial', INT J CARDIOL, vol. 168, no. 4, pp. 3977-81. https://doi.org/10.1016/j.ijcard.2013.06.090

APA

Apostolakis, S., Haeusler, K. G., Oeff, M., Treszl, A., Andresen, D., Borggrefe, M., Lip, G. Y. H., Meinertz, T., Parade, U., Samol, A., Steinbeck, G., Wegscheider, K., Breithardt, G., & Kirchhof, P. (2013). Low stroke risk after elective cardioversion of atrial fibrillation: an analysis of the Flec-SL trial. INT J CARDIOL, 168(4), 3977-81. https://doi.org/10.1016/j.ijcard.2013.06.090

Vancouver

Apostolakis S, Haeusler KG, Oeff M, Treszl A, Andresen D, Borggrefe M et al. Low stroke risk after elective cardioversion of atrial fibrillation: an analysis of the Flec-SL trial. INT J CARDIOL. 2013 Oct 9;168(4):3977-81. https://doi.org/10.1016/j.ijcard.2013.06.090

Bibtex

@article{5e04007f390d4c388659c92bf1eacd28,
title = "Low stroke risk after elective cardioversion of atrial fibrillation: an analysis of the Flec-SL trial",
abstract = "BACKGROUND: Current recommendations for anticoagulation management during cardioversion are largely based on historical data and expert consensus.METHODS AND RESULTS: To characterize current practice of anticoagulation during and after elective cardioversion for AF and the risk of stroke and bleeding events, all patients enrolled into the Flec-SL trial were analyzed for stroke/transient ischemic attack and major bleeds after cardioversion. Flec-SL (ISRCTN62728743, NCT00215774) enrolled 635 patients (mean age 63.7 ± 10.9, 66% male). 629 (99.1%) patients received periprocedural anticoagulation, 556 (87.6%) were adequately anticoagulated following current recommendations. 202 (31.8%) patients underwent transesophageal echocardiography-guided cardioversion. Electrical cardioversion was used in 508 patients (80.0%), pharmacological cardioversion in 127 (20%). Six patients suffered from stroke (n = 5) or transient ischemic attack (3 TIAs in 1 patient, event rate 0.9%, 95% CI 0.4-2.1), five others from major bleeds (event rate 0.8%, 95% CI 0.3-1.9), consistent with the low reported event rates in prior studies. Three strokes occurred in the first 5 days after cardioversion. Events were independent of type of cardioversion or the use of TEE to exclude thrombi.CONCLUSION: Strokes are rare in this large, prospectively followed cohort of patients undergoing cardioversion for AF and receiving antithrombotic therapy following local routine. These results support adherence to current recommendations for anticoagulation during cardioversion of AF.",
author = "Stavros Apostolakis and Haeusler, {Karl Georg} and Michael Oeff and Andras Treszl and Dietrich Andresen and Martin Borggrefe and Lip, {Gregory Y H} and Thomas Meinertz and Ulrich Parade and Alexander Samol and Gerhard Steinbeck and Karl Wegscheider and G{\"u}nter Breithardt and Paulus Kirchhof",
note = "{\textcopyright} 2013.",
year = "2013",
month = oct,
day = "9",
doi = "10.1016/j.ijcard.2013.06.090",
language = "English",
volume = "168",
pages = "3977--81",
journal = "INT J CARDIOL",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "4",

}

RIS

TY - JOUR

T1 - Low stroke risk after elective cardioversion of atrial fibrillation: an analysis of the Flec-SL trial

AU - Apostolakis, Stavros

AU - Haeusler, Karl Georg

AU - Oeff, Michael

AU - Treszl, Andras

AU - Andresen, Dietrich

AU - Borggrefe, Martin

AU - Lip, Gregory Y H

AU - Meinertz, Thomas

AU - Parade, Ulrich

AU - Samol, Alexander

AU - Steinbeck, Gerhard

AU - Wegscheider, Karl

AU - Breithardt, Günter

AU - Kirchhof, Paulus

N1 - © 2013.

PY - 2013/10/9

Y1 - 2013/10/9

N2 - BACKGROUND: Current recommendations for anticoagulation management during cardioversion are largely based on historical data and expert consensus.METHODS AND RESULTS: To characterize current practice of anticoagulation during and after elective cardioversion for AF and the risk of stroke and bleeding events, all patients enrolled into the Flec-SL trial were analyzed for stroke/transient ischemic attack and major bleeds after cardioversion. Flec-SL (ISRCTN62728743, NCT00215774) enrolled 635 patients (mean age 63.7 ± 10.9, 66% male). 629 (99.1%) patients received periprocedural anticoagulation, 556 (87.6%) were adequately anticoagulated following current recommendations. 202 (31.8%) patients underwent transesophageal echocardiography-guided cardioversion. Electrical cardioversion was used in 508 patients (80.0%), pharmacological cardioversion in 127 (20%). Six patients suffered from stroke (n = 5) or transient ischemic attack (3 TIAs in 1 patient, event rate 0.9%, 95% CI 0.4-2.1), five others from major bleeds (event rate 0.8%, 95% CI 0.3-1.9), consistent with the low reported event rates in prior studies. Three strokes occurred in the first 5 days after cardioversion. Events were independent of type of cardioversion or the use of TEE to exclude thrombi.CONCLUSION: Strokes are rare in this large, prospectively followed cohort of patients undergoing cardioversion for AF and receiving antithrombotic therapy following local routine. These results support adherence to current recommendations for anticoagulation during cardioversion of AF.

AB - BACKGROUND: Current recommendations for anticoagulation management during cardioversion are largely based on historical data and expert consensus.METHODS AND RESULTS: To characterize current practice of anticoagulation during and after elective cardioversion for AF and the risk of stroke and bleeding events, all patients enrolled into the Flec-SL trial were analyzed for stroke/transient ischemic attack and major bleeds after cardioversion. Flec-SL (ISRCTN62728743, NCT00215774) enrolled 635 patients (mean age 63.7 ± 10.9, 66% male). 629 (99.1%) patients received periprocedural anticoagulation, 556 (87.6%) were adequately anticoagulated following current recommendations. 202 (31.8%) patients underwent transesophageal echocardiography-guided cardioversion. Electrical cardioversion was used in 508 patients (80.0%), pharmacological cardioversion in 127 (20%). Six patients suffered from stroke (n = 5) or transient ischemic attack (3 TIAs in 1 patient, event rate 0.9%, 95% CI 0.4-2.1), five others from major bleeds (event rate 0.8%, 95% CI 0.3-1.9), consistent with the low reported event rates in prior studies. Three strokes occurred in the first 5 days after cardioversion. Events were independent of type of cardioversion or the use of TEE to exclude thrombi.CONCLUSION: Strokes are rare in this large, prospectively followed cohort of patients undergoing cardioversion for AF and receiving antithrombotic therapy following local routine. These results support adherence to current recommendations for anticoagulation during cardioversion of AF.

U2 - 10.1016/j.ijcard.2013.06.090

DO - 10.1016/j.ijcard.2013.06.090

M3 - SCORING: Journal article

C2 - 23871349

VL - 168

SP - 3977

EP - 3981

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

IS - 4

ER -