Int J Arrhythm.  2016 Mar;17(1):46-50. 10.18501/arrhythmia.2016.007.

Use of NOAC in Cardioversion

• Kim JB

• KMID: 2308908
• DOI: http://doi.org/10.18501/arrhythmia.2016.007

Abstract

Cardioversion increases the risk for stroke or systemic embolic events, and patients scheduled for cardioversions need several weeks of anticoagulant treatment to prevent these adverse events. Anticoagulant therapy should be considered as a balancing act between the risk of stroke and the risk of life-threatening bleeding. The efficacy of non-vitamin K antagonist oral anticoagulants (NOACs) was found to be equal to, or even superior, to warfarin for the prevention of stroke, systemic embolism, and other outcomes in patients with atrial fibrillation, when all risk factors were considered. There have been few studies independently looking at the efficacy and safety profile of NOACs in cardioversion. The efficacy of both rivaroxaban and dabigatran in preventing stroke or major systemic embolic events post-cardioversion was found to be similar to that of warfarin. The efficacy of apixaban could not be compared based on the available data because of the limited number of procedures performed. However, all three NOACs were found to be safe for use in cardioversion when compared to warfarin.

Keyword

Atrial Fibrillation; Cardioversion; Oral Anticoagulation

MeSH Terms

Anticoagulants
Atrial Fibrillation
Dabigatran
Electric Countershock*
Embolism
Hemorrhage
Humans
Risk Factors
Rivaroxaban
Stroke
Warfarin
Anticoagulants
Dabigatran
Rivaroxaban
Warfarin