Pranas Šerpytis, Rasa Palšauskaitė, Giedrius Navickas, Tomas Tamošiūnas, Rokas Šerpytis, Viktoras Skromovas, Dimitrijus Kačiūrinas, Eglė Butkutė

Abstract

Atrial fibrillation (AF) is the most common arrhythmia. One of the AF medical treatment option is electrical cardiovertion. This procedure may cause ischaemic thromboembolic complications, therefore patients have to use anticoagulants. The main aim of our study was to establish the safety of new anticoagulant dabigatran in electrical cardioversion. Methods and results: we analyzed 424 patients with atrial fibrillation who received electrical cardioversion. Patients were divided into two groups: I group (n=204) – patients who received warfarin and had INR range 2-3 for 3 weeks; II group (n=210) – patients who received dabigatran 150 mg twice a day for 21 days before cardioversion. I group patients average age was 58±11 years, 78% of them had hypertension and 18% diabetes. II group patients average age was 60±12 years, 80% had hypertension and 21% diabetes. Precardioversion transesophageal echocardiography was performed in dabigatran group patients. No intracardiac thrombus were observed. In warfarin group sinus rhythm was converted in 189 patients (92,6%), whereas in dabigatran group 205 patients (97,6%) accordingly. There were no thromboembolic or bleeding complications observed in both groups. Conclusions: dabigatran is a safe medication before cardioversion and the transesophageal echocardiography is not indicated.

Keyword(s): atrial fibrillation; electrical cardioversion; anticoagulants; warfarin; dabigatran.
DOI: 10.5200/sm-hs.2016.111
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