L.I. Vasilyeva, O.S. Kalashnykova, V.G. Dzyak.Efficiency and safety of electrical cardioversion in patients with atrial fibrillation

The aim – to assess the efficiency and safety of electrical cardioversion (ECV) in patients with persistent atrial fibrillation (AF).

Materials and methods. 133 consecutive patients with non-valvular persistent AF undergoing ECV were included in the study.

Results. TEE was performed in all patients after 4 weeks of effective anticoagulant therapy. Both left and right atrial appendages thrombi were present in 63 (47.4 %) patients, left atrial appendage thrombi – in 40 (30.1 %) patients and right atrial appendage thrombi – in 10 (7.5 %) patients, 20 (15 %) patients were without thrombi. In 58 (51.3 %) patients thrombi were organized, in 55 (48.7 %) patients thrombi were non-organized. ECV was performed in patients with organized thrombi and in patients without thrombi. Procedure was delayed in patients with non-organized thrombi in atrial appendages until thrombus organization detected by TEE. Duration of anticoagulant therapy was 8 weeks in 43 (32.3 %), 12 weeks in 9 (6.8 %), 16 weeks in 2 (1.5 %) and 20 weeks in one (0.8 %) patient. There were no cases of ECV-related thromboembolism.

Conclusions. For individual definition of readiness for ECV in patients with non-valvular AF TOE with visualization of both atrial appendages should be done after 4 weeks of effective anticoagulant therapy for thrombus detection and studying their structure.

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