The Living Guidelines: Prevention of thromboembolism in patients with atrial fibrillation undergoing cardioversion: Polling Results for CLASS I Guidelines
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Class I Guidelines
1. For patients with AF of 48-h duration or longer, or when the duration of AF is unknown, anticoagulation (INR 2.0 to 3.0) is recommended for at least 3 week prior to and 4 wk after cardioversion, regardless of the method (electrical or pharmacological) used to restore sinus rhythm. (Level of Evidence: B) [1]
<Poll>
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class I Recommendation 1 for prevention of thromboembolism in patients with atrial fibrillation undergoing cardioversion should be:
CLASS I
CLASS IIa
CLASS IIb
CLASS III
</poll>
2. For patients with AF of more than 48-h duration requiring immediate cardioversion because of hemodynamic instability, heparin should be administered concurrently (unless contraindicated) by an initial intravenous bolus injection followed by a continuous infusion in a dose adjusted to prolong the activated partial thromboplastin time to 1.5 to 2 times the reference control value. Thereafter, oral anticoagulation (INR 2.0 to 3.0) should be provided for at least 4 wk, as for patients undergoing elective cardioversion. Limited data support subcutaneous administration of low molecular weight heparin in this indication. (Level of Evidence: C) [1]
<Poll>
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class I Recommendation 2 for prevention of thromboembolism in patients with atrial fibrillation undergoing cardioversion should be:
CLASS I
CLASS IIa
CLASS IIb
CLASS III
</poll>
3. For patients with AF of less than 48-h duration associated with hemodynamic instability (angina pectoris, acute MI, cardiogenic shock, or pulmonary edema), cardioversion should be performed immediately without delay for prior initiation of anticoagulation. (Level of Evidence: C) [1]
<Poll>
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class I Recommendation 3 for prevention of thromboembolism in patients with atrial fibrillation undergoing cardioversion should be:
CLASS I
CLASS IIa
CLASS IIb
CLASS III
</poll>
References
- ↑ 1.0 1.1 1.2 Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Le Heuzey JY, Kay GN, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann S. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation- Executive Summary: executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidlines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006; 114: 700-752. PMID 16908781