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Ebstein Anomaly Pregnancy Risk — EECC MCQ

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HardCongenital Heart Disease (Adult)Ebstein Anomaly Pregnancy RiskEECC

A stable patient has symptomatic persistent AF of 6 weeks’ duration and wishes to undergo electrical cardioversion. He has not been anticoagulated. Which preparation is appropriate?

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Correct answer: A — Give therapeutic anticoagulation for three weeks or use a TOE-guided strategy

AF lasting more than 48 hours or of uncertain duration requires at least three weeks of effective anticoagulation before elective cardioversion, unless TOE excludes atrial thrombus within a protocol that includes peri- and post-procedure anticoagulation. Aspirin, a single DOAC dose, rate control alone and clopidogrel do not provide equivalent protection.

Reference: NICE NG196: Atrial fibrillation — recommendations. https://www.nice.org.uk/guidance/ng196/chapter/Recommendations