Embolic complications of direct current cardioversion of atrial arrhythmias: association with low intensity of anticoagulation at the time of cardioversion
Mark M. Gallagher, MD*,*,
Brian J. Hennessy, MB ,
Nils Edvardsson, MD ,
Ceara M. Hart, MB ,
Muriel S. Shannon, MD||,
Owen A. Obel, MB*,
Naab M. Al-Saady, PhD* and
A. John Camm, MD*
* Department of Cardiological Sciences, St. George’s Hospital Medical School, London, United Kingdom
Department of Haematology, Northwick Park Hospital, London, United Kingdom
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden
Department of Cardiology, Cork University Hospital, Cork, Ireland
|| Department of Haematology, St. George’s Hospital Medical School, London, United Kingdom
View larger version (50K):
[in a new window]
|
Figure 1 Embolic and other complications within 28 days of direct current (DC) cardioversion. A small number of patients with recent-onset atrial fibrillation were receiving long-term warfarin therapy, most for paroxysmal arrhythmias or because of prosthetic valves. Arrhythmias of unknown duration were assumed to have a duration of >2 days.
|
|
View larger version (56K):
[in a new window]
|
Figure 2 Shows the international normalized ratio (INR) on the day of cardioversion in 1,533 cases in which cardioversion was preceded by warfarin therapy, and the INR was checked on the day of cardioversion or on the preceding day. The majority of values <1.5 relate to cardioversion via intracardiac electrodes.
|
|
View larger version (24K):
[in a new window]
|
Figure 3 Relation between the international normalized ratio (INR) on the day of cardioversion and the risk of thromboembolism. Confidence intervals were calculated by assuming a Poisson distribution.
|
|
|
