Kalashnykova O. Efficiency and safety of electrical cardioversion in patients with atrial fibrillation

Dissertation is dedicated to assessment of efficiency and safety of electrical cardioversion (ECV) in patients with persistent non-valvular atrial fibrillation (NVAF). The study inсluded 133 patients with persistent NVAF, who underwent transoesophageal echocardiography (TOE) before ECV. Clinical examination, transthoracic echocardiography (TTE), TOE have been done in all patients after 4 weeks of effective oral anticoagulant (OAC) therapy. ECV was performed in all patients, there were no cases of ECV-related thromboembolism. According to the study all patients with high cardiovascular risk need to be screened for AF using pulse-taking followed by an electrocardiogram in spite of the age. After 4 weeks of effective OAC therapy TOE should be performed with visualization of both atrial appendages in all patients with NVAF before ECV. Duration of OAC therapy before ECV should be determined by thrombus organization. TOE detection of organized atrial appendage thrombi in effectively anticoagulated patients with NVAF is not an obstacle in making decision of rhythm control therapy. TOE should be done as well as CHA2DS2-VASc score assessment for low-risk thromboembolism identification in all patients with NVAF