Introduction: to asses safety of dabigatran in converting persistent atrial fibrillation (PAF) and flutter (AFL) to sinus rhythm (SR) without transesophageal evaluation (TOE).
Methods: consecutive pts with PAF and AFL were included (2012-2015). Dabigatran was used for 3 weeks before and 6 months after cardioversion. Left atrium area (LAA) and volume (LAV) were assessed in all pts. Follow-up intervals for major cardiac events (MACE): 1-3-6-12 months.
Results: the study included 82 pts (56 male) aged 63.1±10.4 y.o, (45 PAF pts /37 AFL pts). PAF group: LAA 30,3±5,3 cm²/ LAV 114,4±31,5 ml; AFL group: LAA 26,5±4,2 cm²/ LAV 97±24,9 ml; 38 pts underwent uncomplicated electric cardioversion for PAF (11 pts with AFL), 7 pts with PAF were chemically converted to SR (4 pts with AFL), 22 pts with AFL underwent successful radiofrequency ablation. The mean CHA2DS2-VASc score was 2.8±1.3 (score>3, 55%). There were 0 MACE events during the follow up period.
Conclusions: safety of cardioversion using dabigatran without need of TOE can be achieved.