Thromboembolic complications after electrical cardioversion in patients with atrial flutter.
OBJECTIVE
To determine the incidence of thromboembolic complications after cardioversion in patients with atrial flutter.


METHODS
We reviewed 615 electrical cardioversions performed electively in 493 patients with atrial flutter. Embolic complications were evaluated during the 30 days after cardioversion. Follow-up data were obtained by follow-up visits and by contacting the treating physician.


RESULTS
Anticoagulants had been administered in 415 cardioversions (67%). Cardioversion was successful in 570 procedures (93%). Three embolic events (in 3 patients) occurred in the 30 days after 550 successful cardioversions with completed follow-up (0.6% of successful procedures; 95% confidence interval, 0.1% to 1.6%). Two of the 3 patients had not been anticoagulated, whereas the third patient had subtherapeutic oral anticoagulation. No embolic event occurred in procedures performed with adequate anticoagulation. The incidence of embolism in patients regardless of subtherapeutic anticoagulation was 1% (3 of 303 successful cardioversions).


CONCLUSIONS
We observed a low (0.6%) incidence of postcardioversion thromboembolic complications in patients with atrial flutter. Embolic events did not occur in patients with adequate anticoagulation.
Elhendy
A
A
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Gentile
F
F
Khandheria
B K
BK
Gersh
B J
BJ
Bailey
K R
KR
Montgomery
S C
SC
Seward
J B
JB
Tajik
A J
AJ
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001282:Atrial Flutter / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D004554:Electric Countershock / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D014463:Ultrasonography
D000925:Anticoagulants; D006493:Heparin