A 60-year-old woman on ICU has been in AF for 72 hours with a rapid ventricular rate. The team considers DC cardioversion. She has no echocardiography...

Question

A 60-year-old woman on ICU has been in AF for 72 hours with a rapid ventricular rate. The team considers DC cardioversion. She has no echocardiography available and has not been anticoagulated. What is the risk of cardioversing AF that has been present for >48 hours without prior anticoagulation?

Accepted Answer

Significant risk of thromboembolism (stroke) - thrombus may have formed in the left atrial appendage, and cardioversion-induced return of atrial contraction can dislodge it

Answer

No risk - cardioversion is always safe

Answer

Risk of pneumothorax only

Answer

Risk of pacemaker malfunction

Answer

Risk of developing permanent AF

uk-fficm MCQ (SBA): Cardioversion - Thromboembolic Risk

A 60-year-old woman on ICU has been in AF for 72 hours with a rapid ventricular rate. The team considers DC cardioversion. She has no echocardiography available and has not been anticoagulated. What is the risk of cardioversing AF that has been present for >48 hours without prior anticoagulation?