Evidence map›Paper›PMID 33715143›Full record

SynthesisCJEM2021

Thromboembolic events following cardioversion of acute atrial fibrillation and flutter: a systematic review and meta-analysis.

Brenton M Wong, Jeffrey J Perry, Wei Cheng, Bo Zheng, Kevin Guo, Monica Taljaard, Allan C Skanes, Ian G Stiell

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in CJEM, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Guideline
  3. Article
  4. Modern management of acute atrial fibrillation and atrial flutter.Clinical and experimental emergency medicine · 2024
    Article
  5. Review
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Brenton M WongDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID http://orcid.org/0000-0003-2585-7484
Jeffrey J PerryDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Wei ChengClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Bo ZhengDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Kevin GuoDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Monica TaljaardClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Allan C SkanesDivision of Cardiology, Western University, London, ON, Canada.
Ian G StiellDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada. istiell@ohri.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent studies have presented concerning data on the safety of cardioversion for acute atrial fibrillation and flutter. We conducted this meta-analysis to evaluate the effect of oral anticoagulation use on thromboembolic events post-cardioversion of low-risk acute atrial fibrillation and flutter patients of < 48 h in duration.

methodsWe searched MEDLINE, Embase, and Cochrane from inception through February 6, 2020 for studies reporting thromboembolic events post-cardioversion of acute atrial fibrillation and flutter. Main outcome was thromboembolic events within 30 days post-cardioversion. Primary analysis compared thromboembolic events based on oral anticoagulation use versus no oral anticoagulation use. Secondary analysis was based on baseline thromboembolic risk. We performed meta-analyses where 2 or more studies were available, by applying the DerSimonian-Laird random-effects model. Risk of bias was assessed with the Quality in Prognostic Studies tool.

resultsOf 717 titles screened, 20 studies met inclusion criteria. Primary analysis of seven studies with low risk of bias demonstrated insufficient evidence regarding the risk of thromboembolic events associated with oral anticoagulation use (RR = 0.82 where RR < 1 suggests decreased risk with oral anticoagulation use; 95% CI 0.27 to 2.47; I

conclusionPrimary analysis revealed insufficient evidence regarding the effect of oral anticoagulation use on thromboembolic events post-cardioversion of low-risk acute atrial fibrillation and flutter, though the event rate is low in contemporary practice. Our findings can better inform patient-centered decision-making when considering 4-week oral anticoagulation use for acute atrial fibrillation and flutter patients.

Indexed as

Atrial FibrillationThromboembolismAdministration, OralAnticoagulantsElectric CountershockHumansPrognosisAnticoagulantsAtrial fibrillationCardioversionMeta-analysisThromboembolism

Identifiers

PMID33715143

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.