Low molecular weight heparin (parnaparin) for cardioembolic events prevention in patients with atrial fibrillation undergoing elective electrical cardioversion: A prospective cohort study

Giulia Angeloni, Silvia Alberti, Enrico Romagnoli, Alberto Banzato, Marco Formichi, Umberto Cucchini, Vittorio Pengo

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)117-123
Number of pages7
JournalInternal and Emergency Medicine
Volume6
Issue number2
DOIs
Publication statusPublished - Apr 2011

Keywords

  • Atrial fibrillation
  • Cardioembolism
  • Electrical cardioversion
  • Parnaparin

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine

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