CHAPTER 36 RISK OF STROKE IN ATRIAL FIBRILLATION CARDIOVERSION

Risk for Clinical Thromboembolism Associated with Conversion to Sinus Rhythm in Patients with Atrial Fibrillation Lasting Less Than 48 Hours

Weigner MJ, Caulfield TA, Danias PG, et al. Ann Intern Med. 1997;126(8):615–620

BACKGROUND

Atrial fibrillation (AFib) is the most common arrhythmia and a common reason for presentation to the ED. Rhythm control with cardioversion is recommended but carries an estimated 5% to 7% risk of thromboembolism. Before this study, the risk of thromboembolism in a patient who presented less than 48 hours after onset was assumed to be low; however, some studies had suggested that up to 14% of patients with AFib <3 days developed cardiac thrombus.

OBJECTIVES

To determine the incidence of cardioversion-related thromboembolism in patients presenting with onset of AFib less than 48 hours.

METHODS

Prospective, observational cohort conducted at two US academic medical centers from 1990 to 1996.

Patients

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