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European Journal of Echocardiography 2004 5(4):239-242; doi:10.1016/j.euje.2004.04.008
© 2004 by European Society of Cardiology
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Copyright © 2004, The European Society of Cardiology

Subtherapeutic anticoagulation: the bane of conventional anticoagulation for cardioversion of atrial fibrillation

J.A Sallach and A.L Klein*

The Cleveland Clinic Foundation, Department of Cardiology, 9500 Euclid Avenue, Desk F15, Cleveland, OH 44195-5001, USA

Received 27 April 2004; .

kleina@ccf.org

* Corresponding author. Tel.: +1-216-444-3932; fax: +1-216-445-2309.

The first 150 words of the full text of this article appear below.

Please see page 257 for the article by Corrado et al. (doi: 10.1016/S1525-2167(03)00075-1) to which this editorial pertains.

Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice, affecting slightly less than 1% of the general population.1 Patients with AF suffer from a decrease in functional capacity secondary to a combination of palpitations, dyspnea, myocardial ischemia, congestive heart failure and hypotension.2,3 In addition, unorganized atrial electrical and mechanical activity result in blood stasis and the formation of atrial thrombi placing the patient at risk of systemic thromboembolism.4 It is therefore important, if feasible, to attempt cardioversion (CV) to normal sinus rhythm (NSR) in these patients.

The most concerning complication of CV in AF is systemic thromboembolism, and more specifically stroke. In 1960, Goldman reported a 1.5% embolization event rate in 400 AF patients undergoing chemical CV who had not received anticoagulation.5 This study proposed for . . . [Full Text of this Article]


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Related articles in Eur J Echocardiogr:

Prevalence of atrial thrombi in patients with atrial fibrillation/flutter and subtherapeutic anticoagulation prior to cardioversion
G Corrado, S Beretta, L Sormani, G Tadeo, G Foglia-Manzillo, L.M Tagliagambe, and M Santarone
Eur J Echocardiogr 2004 5: 257-261. [Abstract] [FREE Full Text]