title: Rivaroxaban in atrial fibrillation cardioversion: insights from the X-VeRT trial.
abstract: ABSTRACT  Vitamin K antagonists (VKAs) have traditionally been the standard of care for the thromboprophylactic anticoagulation of patients with nonvalvular atrial fibrillation (NVAF) undergoing cardioversion. X-VeRT was the first prospective trial to explore the safety and efficacy of one of the non-VKA oral anticoagulants, rivaroxaban, compared with dose-adjusted VKA as thromboprophylaxis in patients with NVAF scheduled to undergo cardioversion. The protocol allowed either early (1-5 days) or delayed (3-8 weeks) cardioversion to be performed. Rivaroxaban use (20 mg once daily or 15 mg if creatinine clearance was 30-49 ml/min) was associated with a similar incidence of adverse cardiovascular events and bleeding as VKA use; however, rivaroxaban significantly reduced the time to cardioversion in those undergoing delayed cardioversion. Thus, rivaroxaban is a safe alternative to VKAs for thromboprophylaxis in patients with NVAF undergoing elective cardioversion.
authors.affiliation: Department of Cardiology, East & North Hertfordshire NHS Trust, Hertfordshire, UK.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Farag
authors.forename: Diana A
authors.initials: DA
authors.lastname: Gorog
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications* / Q000628:therapy*; D004334:Drug Administration Schedule; D004554:Electric Countershock; D065427:Factor Xa Inhibitors / Q000627:therapeutic use*; D006801:Humans; D000069552:Rivaroxaban / Q000627:therapeutic use*; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D065427:Factor Xa Inhibitors; D000069552:Rivaroxaban
keywords: atrial fibrillation; cardioversion; oral anticoagulants; rivaroxaban; warfarin