Long-Term Predictors of Thromboembolic Events in Nonvalvular Atrial Fibrillation Patients Undergoing Electrical Cardioversion

Background:Patients with nonvalvular atrial fibrillation (AF) who undergo electrical cardioversion (ECV) tend to be younger and have less comorbidity. Long-term anticoagulation after ECV should be based on thromboembolic risk. We sought to study the long-term incidence of thromboembolic events (TE),...

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Bibliographic Details
Published in:Circulation Journal 2016/02/25, Vol.80(3), pp.605-612
Main Authors: García-Fernández, Amaya, Marín, Francisco, Roldán, Vanessa, Gómez-Sansano, José M, Hernández-Romero, Diana, Valdés, Mariano, Martinez-Martinez, Juan G, Sogorb-Garri, Francisco, Lip, Gregory YH
Format: Article
Language:English
Subjects:
Aged
Anticoagulants
Anticoagulants - administration & dosage
Anticoagulants - adverse effects
Atrial fibrillation
Atrial Fibrillation - complications
Atrial Fibrillation - epidemiology
Atrial Fibrillation - therapy
Cardioversion
Electric Countershock
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Risk Factors
Thromboembolism
Thromboembolism - epidemiology
Thromboembolism - etiology
Thromboembolism - prevention & control
Time Factors
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Summary:Background:Patients with nonvalvular atrial fibrillation (AF) who undergo electrical cardioversion (ECV) tend to be younger and have less comorbidity. Long-term anticoagulation after ECV should be based on thromboembolic risk. We sought to study the long-term incidence of thromboembolic events (TE), factors related to TE and compare the predictive value of the CHADS2and CHA2DS2-VASc scores in this particular population.Methods and Results:From January 2008 to June 2012, 571 ECV were performed in 406 consecutive patients with nonvalvular AF. Risk factors for TE and factors related to anticoagulation therapy after ECV were registered. During a follow-up of approximately 2 years, the annual incidence of TE was 1.9%. Factors associated with TE were: poor quality anticoagulation control (hazard ratio [HR]: 2.91; 95% confidence interval [CI]: 1.10–7.80; P=0.03), cessation of anticoagulation after ECV (HR: 8.80; 95% CI: 3.11–25.10; P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-15-0992