SynthesisJournal of thrombosis and thrombolysis2018
Direct oral anti-coagulants compared to vitamin-K antagonists in cardioversion of atrial fibrillation: an updated meta-analysis.
Synthesis in Journal of thrombosis and thrombolysis, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 23 citations in OpenAlex.
- Practical Recommendations for Anticoagulation in Patients With Atrial Fibrillation.European journal of clinical investigation · 2026Review
- Spotlight on the 2024 ESC/EACTS management of atrial fibrillation guidelines: 10 novel key aspects.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Review
- Is It Safe (and When) to Stop Oral Anticoagulation After Ablation for Atrial fibrillation? (Do We Have Enough Evidence to Solve the Dilemma?).Cardiovascular drugs and therapy · 2021Article
- Non Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients Scheduled for Electrical Cardioversion: A Real-Life Propensity Score Matched Study.Journal of blood medicine · 2021Article
- Management of Direct Oral Anticoagulants in Patients with Atrial Fibrillation Undergoing Cardioversion.Medicina (Kaunas, Lithuania) · 2019Review
- Oral Anticoagulation and Antiarrhythmic Drug Therapy for Atrial Fibrillation.The Journal of innovations in cardiac rhythm management · 2018Review
- Non-vitamin K antagonist oral anticoagulants in cardioversion of atrial fibrillation: a network meta-analysis.Journal of thrombosis and thrombolysis · 2018Article
- Stroke due to Left Atrial Appendage Thrombus after Pulmonary Vein Isolation despite Novel Oral Anticoagulant: A Case Report.Case reports in neurologyArticle
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pharmacological or electrical cardioversion allows immediate symptoms improvement in the setting of paroxysmal or persistent atrial fibrillation (AF), although the periprocedural risk of systemic embolism should be considered. Recently, there was a great interest on the safety and efficacy of direct oral anticoagulants (DOACs) when used for the cardioversion of non-valvular AF. We performed a random-effects meta-analysis of patients undergoing both electrical and pharmacologic cardioversion for non-valvular AF in the RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE AF-TIMI 48, X-VeRT, ENSURE-AF, and EMANATE trials. We assessed Mantel-Haenszel pooled estimates of risk ratios (RRs) and 95% confidence intervals (CIs) for stroke/systemic embolism (SSE) and major bleeding (MB) at follow-up. A total of 8564 patients have been included in the analysis. When compared with patients receiving vitamin-K antagonists (VKAs), patients receiving DOACs had a lower risk of SSE (RR 0.70, 95% CI 0.33-1.546, P = 0.34), as well as of MB (RR 0.86;,95% CI 0.47-1.58, P = 0.62), although both were non-significant. Funnel plot analysis showed, however, lower RRs with more recent ad hoc studies in comparison with registrational studies, even though statistical significance was not reached. DOACs are as effective and as safe as VKAs for thromboembolic prevention in non-valvular AF in the setting of cardioversion. There are differences, although non-significant, between registrational studies and studies enrolling exclusively patients undergoing cardioversion of AF.
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Registered trials
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