2001
ACUTE TRIAL
Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation
multicenter, prospective, randomized controlled trial
Objective: To compare conventional anticoagulation strategy with the transesophageal echocardiography to guide short-term anticoagulant therapy in patients with atrial fibrillation prescribed with electrical cardioversion
1222 patients
Inclusion criteria: Patients aged ≥18 years who had atrial fibrillation of more than 2 days duration or who had atrial flutter with history of atrial fibrillation.
M
0.8
TEE-guided cardioversion (n=619)
PRIMARY OUTCOME
Conventional treatment (n=603)
Composite of cerebrovascular acci- dent, transient ischemic attack, and peripheral embolism at 8 weeks % RR 1.62; 95% CI, 0.39 to 6.76; P=0.50
SECONDARY OUTCOME
Hemorrhagic events%
0.5
2.9
5.5
RR 0.53; 95% CI, 0.30 to 0.93; P=0.03
Deaths from all causes %
2.4
1.0
RR 2.44; 95% CI, 0.95 to 6.24; P=0.06
Sinus rhythm restored
71.1
within 8 weeks %
65.2
RR 1.09; 95% CI, 1.01 to 1.18; P=0.03
27.4
Functional status at 8
weeks-DASI score P=0.50
26.7
Conclusion: The use of transesophageal echocardiography to guide the management of atrial fibrillation may be considered a clinically effective alternative strategy to conventional therapy for patients in whom elective cardioversion is planned.
AL Klein et al. NEJM 2001; 344:1411-1420 |Visualmed
