What is the risk of stroke/thromboembolism with cardioversions performed without perioperative anticoagulation?
A recent Finnish observational study of 5,116 successful cardioversions in 2,481 patients with acute (< 48 h) AF showed a low incidence of stroke/thromboembolism during the 30 days following cardioversion, even without perioperative anticoagulation (0.7%). These results concur with low rates of stroke/thromboembolism in observational studies (Table 8).234,267-272 However, there is lower incidence of stroke/thromboembolism with cardioversions performed during anticoagulation (0.1% vs 0.7%; P .001), and with anticoagulation vs no anticoagulation in patients with a CHA2DS2-VASc score of $ 2 (0.2% vs 1.1%; P .001).