Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2003-7-15
pubmed:abstractText
In a multicenter randomized trial, we studied a transesophageal echocardiography (TEE) guided strategy with short-term anticoagulation compared with a conventional strategy for patients with atrial fibrillation >2 days' duration and undergoing cardioversion. Composite major and minor bleeding was a predetermined secondary end point of the study. The objective of the study was to assess the incidence, location, and predictors of bleeding in the 2 treatment groups. A total of 1,222 patients were assigned to a TEE guided or conventional strategy and followed over 8 weeks. We present data on major and minor adjudicated bleeding complications for the 2 study groups during the 8-week study period. Composite major and minor bleeding complications occurred in 51 of 1,222 patients (4.2%) and were significantly lower in the TEE guided group compared with the conventional group (2.9 vs 5.5%, p = 0.025). The TEE group had fewer cancellations of cardioversion as a result of bleeding (0% vs 0.7%, p = 0.003). Major (n = 14) and minor (n = 38) bleeding complications were predominantly gastrointestinal (71.4% and 31.6%, respectively) and were associated with warfarin use. Predictors of bleeding included patient age, conventional group assignment, inpatient status, and functional status. Thus, composite major and minor bleeding complications occurred in 4.2% of the 1,222 patients and were significantly lower in the TEE guided group compared with the conventional group. Treatment variables affecting length of anticoagulant therapy in the conventional arm combined with advancing age and functional status are important concerns in patients who undergo cardioversion of atrial fibrillation.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jul
pubmed:issn
0002-9149
pubmed:author
pubmed:issnType
Print
pubmed:day
15
pubmed:volume
92
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
161-5
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:12860217-Aged, pubmed-meshheading:12860217-Aged, 80 and over, pubmed-meshheading:12860217-Anticoagulants, pubmed-meshheading:12860217-Atrial Fibrillation, pubmed-meshheading:12860217-Echocardiography, Transesophageal, pubmed-meshheading:12860217-Electric Countershock, pubmed-meshheading:12860217-Female, pubmed-meshheading:12860217-Follow-Up Studies, pubmed-meshheading:12860217-Heparin, pubmed-meshheading:12860217-Humans, pubmed-meshheading:12860217-Male, pubmed-meshheading:12860217-Middle Aged, pubmed-meshheading:12860217-Outcome Assessment (Health Care), pubmed-meshheading:12860217-Postoperative Hemorrhage, pubmed-meshheading:12860217-Predictive Value of Tests, pubmed-meshheading:12860217-Surgery, Computer-Assisted, pubmed-meshheading:12860217-Time Factors, pubmed-meshheading:12860217-Warfarin
pubmed:year
2003
pubmed:articleTitle
Bleeding complications in patients with atrial fibrillation undergoing cardioversion randomized to transesophageal echocardiographically guided and conventional anticoagulation therapies.
pubmed:affiliation
Department of Cardiovascular Medicine/Desk F15, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. kleina@ccf.org
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Randomized Controlled Trial, Multicenter Study