[Use and clinical implications of anticoagulation maintenance after a successful cardioversion]

Abstract

Patients and method: We studied the use of anticoagulation following cardioversion due to persistent atrial fibrillation in 422 patients with low or moderate risk of embolism, as well as its benefit during a follow-up of one year.

Results: Oral anticoagulation was maintained after the first month in 80% of patients who showed sinus rhythm and in 43% after 12 months. Its maintenance in patients in sinus rhythm was related to a trend to lower incidence of embolic events (2.8% vs. 0.7%; p=0.37). The incidence of major bleeding in patients who remained on oral anticoagulation was 4.9%, and age ≥75 years (OR 5.3; p=0.02) was the only independently related factor.

Conclusions: Anticoagulation is frequently maintained to long-term in patients without high risk of embolism but it seems that this treatment doe not have a favorable risk profile with a CHADS(2)=0 or 1 older than ≥75.