Abstract
Systemic thromboembolism is a severe complication in patients undergoing electrical cardioversion (ECV) for atrial fibrillation (AF). Vitamin K antagonists greatly reduce the risk of thromboembolic events, but the administration scheme before ECV is troublesome as difficulties in reaching and maintaining the target therapeutic range for 3 weeks often delay the restoration and likelihood of maintaining sinus rhythm. Low molecular weight heparins (LMWHs) do not need dose adjustment, and may be preferable in this clinical setting. In this multicentre study, the LMWH parnaparin was used at a dose of 85 anti-factor Xa U/kg b. i. d. 2 weeks before and 3 weeks after ECV of AF. In an intention to treat analysis of 102 patients, there was no systemic thromboembolism or major bleeding (0%, 95% CI 0-3. 6). Two clinically relevant non-major bleeds (2. 5%, 95% CI 0. 7-8. 8) and three minor bleeds (3. 8%, 95% CI 1. 3-10. 6) were recorded. No heparin-induced thrombocytopenia or other major adverse events were recorded. Parnaparin appears effective and safe for thromboprophylaxis of elective ECV in patients with AF.
| Original language | English |
|---|---|
| Pages (from-to) | 117-123 |
| Number of pages | 7 |
| Journal | Internal and Emergency Medicine |
| Volume | 6 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Apr 2011 |
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Keywords
- Atrial fibrillation
- Cardioembolism
- Electrical cardioversion
- Parnaparin
ASJC Scopus subject areas
- Emergency Medicine
- Internal Medicine
Cite this
Low molecular weight heparin (parnaparin) for cardioembolic events prevention in patients with atrial fibrillation undergoing elective electrical cardioversion : A prospective cohort study. / Angeloni, Giulia; Alberti, Silvia; Romagnoli, Enrico; Banzato, Alberto; Formichi, Marco; Cucchini, Umberto; Pengo, Vittorio.
In: Internal and Emergency Medicine, Vol. 6, No. 2, 04.2011, p. 117-123.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Low molecular weight heparin (parnaparin) for cardioembolic events prevention in patients with atrial fibrillation undergoing elective electrical cardioversion
T2 - A prospective cohort study
AU - Angeloni, Giulia
AU - Alberti, Silvia
AU - Romagnoli, Enrico
AU - Banzato, Alberto
AU - Formichi, Marco
AU - Cucchini, Umberto
AU - Pengo, Vittorio
PY - 2011/4
Y1 - 2011/4
N2 - Systemic thromboembolism is a severe complication in patients undergoing electrical cardioversion (ECV) for atrial fibrillation (AF). Vitamin K antagonists greatly reduce the risk of thromboembolic events, but the administration scheme before ECV is troublesome as difficulties in reaching and maintaining the target therapeutic range for 3 weeks often delay the restoration and likelihood of maintaining sinus rhythm. Low molecular weight heparins (LMWHs) do not need dose adjustment, and may be preferable in this clinical setting. In this multicentre study, the LMWH parnaparin was used at a dose of 85 anti-factor Xa U/kg b. i. d. 2 weeks before and 3 weeks after ECV of AF. In an intention to treat analysis of 102 patients, there was no systemic thromboembolism or major bleeding (0%, 95% CI 0-3. 6). Two clinically relevant non-major bleeds (2. 5%, 95% CI 0. 7-8. 8) and three minor bleeds (3. 8%, 95% CI 1. 3-10. 6) were recorded. No heparin-induced thrombocytopenia or other major adverse events were recorded. Parnaparin appears effective and safe for thromboprophylaxis of elective ECV in patients with AF.
AB - Systemic thromboembolism is a severe complication in patients undergoing electrical cardioversion (ECV) for atrial fibrillation (AF). Vitamin K antagonists greatly reduce the risk of thromboembolic events, but the administration scheme before ECV is troublesome as difficulties in reaching and maintaining the target therapeutic range for 3 weeks often delay the restoration and likelihood of maintaining sinus rhythm. Low molecular weight heparins (LMWHs) do not need dose adjustment, and may be preferable in this clinical setting. In this multicentre study, the LMWH parnaparin was used at a dose of 85 anti-factor Xa U/kg b. i. d. 2 weeks before and 3 weeks after ECV of AF. In an intention to treat analysis of 102 patients, there was no systemic thromboembolism or major bleeding (0%, 95% CI 0-3. 6). Two clinically relevant non-major bleeds (2. 5%, 95% CI 0. 7-8. 8) and three minor bleeds (3. 8%, 95% CI 1. 3-10. 6) were recorded. No heparin-induced thrombocytopenia or other major adverse events were recorded. Parnaparin appears effective and safe for thromboprophylaxis of elective ECV in patients with AF.
KW - Atrial fibrillation
KW - Cardioembolism
KW - Electrical cardioversion
KW - Parnaparin
UR - http://www.scopus.com/inward/record.url?scp=79953025433&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79953025433&partnerID=8YFLogxK
U2 - 10.1007/s11739-010-0479-1
DO - 10.1007/s11739-010-0479-1
M3 - Article
VL - 6
SP - 117
EP - 123
JO - Internal and Emergency Medicine
JF - Internal and Emergency Medicine
SN - 1828-0447
IS - 2
ER -