Low-Molecular-Weight Heparin in Transesophageal Echocardiography–Guided Cardioversion of Atrial Fibrillation
| Autor: | John A. Pieper, Anna M. Wodlinger |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
medicine.medical_specialty
Heart disease medicine.drug_class medicine.medical_treatment Electric Countershock Low molecular weight heparin Cardioversion Thromboembolism Internal medicine Atrial Fibrillation medicine Humans Pharmacology (medical) Sinus rhythm Clinical Trials as Topic business.industry Anticoagulant Cardiac arrhythmia Atrial fibrillation Heparin Heparin Low-Molecular-Weight medicine.disease Treatment Outcome Anesthesia Cardiology business Echocardiography Transesophageal medicine.drug |
| Zdroj: | Pharmacotherapy. 23:57-63 |
| ISSN: | 0277-0008 |
| DOI: | 10.1592/phco.23.1.57.31917 |
| Popis: | Atrial fibrillation is the most common sustained cardiac arrhythmia and is associated with thromboembolic events and hemodynamic impairment that results in considerable morbidity, mortality, and cost. Cardioversion to sinus rhythm is a common approach to the treatment of these patients. However, cardioversion is associated with the risk of thromboembolism. Current guidelines recommend that patients receive anticoagulants for 3-4 weeks before and 4 weeks after cardioversion. With the development of transesophageal echocardiography (TEE), the risk of thromboembolism and alternative anticoagulation strategies have been evaluated in patients with atrial fibrillation. Administration of low-molecular-weight heparin (LMWH) in conjunction with TEE offers several advantages over unfractionated heparin. Limited data suggest that LMWH in this setting is as effective, is safer, and may be more cost-effective than unfractionated heparin. Ongoing research will identify definitively the optimal strategy for pericardioversion anticoagulation. |
| Databáze: | OpenAIRE |
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