February 2014 Br J Cardiol 2014;21:29–32 doi:10.5837/bjc.2014.002 Online First
Wai Kah Choo, Shona Fraser, Gareth Padfield, Gordon F Rushworth, Charlie Bloe, Peter Forsyth, Stephen J Cross, Stephen J Leslie
Abstract
Introduction
Atrial fibrillation (AF) is a common arrhythmia affecting approximately 1% of the general population, this rises to 18% in those aged 85 years and above.1 The most effective method for correcting persistent AF is direct current cardioversion (DCCV). However, DCCV is associated with an increased risk of thromboembolic events.2 Anticoagulation with warfarin reduces the risk of thromboembolism from approximately 6% to less than 1%.3
The current recommendations advise therapeutic anticoagulation for at least three weeks prior to, and four weeks after cardioversion.4 A nurse-led elective DCCV service at Raigmore Hospital was establish
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