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Review
. 2019 Sep 30;55(10):660.
doi: 10.3390/medicina55100660.

Management of Direct Oral Anticoagulants in Patients with Atrial Fibrillation Undergoing Cardioversion

Giuseppe Coppola  1 , Girolamo Manno  2 , Antonino Mignano  3 , Mirko Luparelli  4 , Antonino Zarcone  5 , Giuseppina Novo  6 , Egle Corrado  7
Affiliations
Review

Management of Direct Oral Anticoagulants in Patients with Atrial Fibrillation Undergoing Cardioversion

Giuseppe Coppola et al. Medicina (Kaunas). .

Abstract

Atrial fibrillation the most common cardiac arrhythmia. Its incidence rises steadily with each decade, becoming a real "epidemic phenomenon". Cardioversion is defined as a rhythm control strategy which, if successful, restores normal sinus rhythm. This, whether obtained with synchronized shock or with drugs, involves a periprocedural risk of stroke and systemic embolism which is reduced by adequate anticoagulant therapy in the weeks before or by the exclusion of left atrial thrombi. Direct oral anticoagulants are safe, manageable, and provide rapid onset of oral anticoagulation; they are an important alternative to heparin/warfarin from all points of view, with a considerable reduction in bleedings and increase in the safety and quality of life of patients.

Keywords: atrial fibrillation (AF); direct oral anticoagulants (DOACs); electrical cardioversion (EC).

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Suggested flow chart for atrial fibrillation (AF) cardioversion on the basis of the current European Society of Cardiology (ESC) Guidelines. Transesophageal echocardiogram (TEE), anticoagulant therapy (OAT), left atrial appendage (LAA), sinus rhythm (SR).
Figure 2
Figure 2
Summary of X-VeRT, ENSURE-AF, and EMANATE trials results.
See this image and copyright information in PMC

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