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Stroke after electrical cardioversion: Dabigatran vs warfarin

Mar 15, 2011 12:10 EDT


A study published earlier this year in Circulation reports no statistical difference in stroke rate in patients randomized to anticoagulation treatment with dabigatran vs warfarin following electrical cardioversion. But the incidence of stroke—even following a relatively simple procedure, such as cardioversion—is sobering. 

See:

Nagarakanti R, Ezekowitz MD, Oldgren J, et al. Dabigatran versus warfarin in patients with atrial fibrillation: an analysis of patients undergoing cardioversion. Circulation. 2011; 123:131-136. Available here.

RE-LY: Stroke risk at AF cardioversion similar on dabigatran or warfarin





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Your comments
Stroke after electrical cardioversion: Dabigatran vs warfarin
# 1 of 2
March 19, 2011 07:22 (EDT)
josgreg

Cardioversion can be used for the treatment of the following conditions:

  • Patients having an arrhythmia causing troublesome symptoms like dizziness, shortness of breath, extreme fatigue and chest discomfort.
  • Patients having Atrial Fibrillation, which is a condition in which the electrical signals travel through the upper chambers of your heart in a fast and disorganized way causing the atria to quiver instead of contract. Atrial Fibrillation is the most common type of arrhythmia treated with cardioversion.
    http://www.heart-consult.com/articles/what-cardioversion
# 2 of 2
March 26, 2011 01:10 (EDT)
Usdin

thank you for this analysis.

Dabigatran is not yet recommended in France for  stroke prophylaxis in Atrial Fibrillation.

However my main concern when  availiable will be :

How to be sure that the patient is well anticoagulated under Dabigatran? how can I be sure that the patient took during at least 3 weeks the exact dosage of Two tablets (150 or 110mg) daily?

Depending of this doubt the prescription of TEE will be more frequent and this has to be discussed in Benefice/risk and the cost of treatment with Dabigatran.

Best regards 

dr Usdin.

Neuilly  France 

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Who's Talking
Samuel Z Goldhaber, MD
Professor of Medicine
Harvard Medical School
Director, Venous Thromboembolism Research Group
Co-Director, Anticoagulation Management Service
Cardiovascular Division
Brigham and Women's Hospital
Boston, MA