Rivaroxaban in atrial fibrillation cardioversion: insights from the X-VeRT trial

Future Cardiology
Mohamed Farag, Diana A Gorog

Abstract

ABSTRACT  Vitamin K antagonists (VKAs) have traditionally been the standard of care for the thromboprophylactic anticoagulation of patients with nonvalvular atrial fibrillation (NVAF) undergoing cardioversion. X-VeRT was the first prospective trial to explore the safety and efficacy of one of the non-VKA oral anticoagulants, rivaroxaban, compared with dose-adjusted VKA as thromboprophylaxis in patients with NVAF scheduled to undergo cardioversion. The protocol allowed either early (1-5 days) or delayed (3-8 weeks) cardioversion to be performed. Rivaroxaban use (20 mg once daily or 15 mg if creatinine clearance was 30-49 ml/min) was associated with a similar incidence of adverse cardiovascular events and bleeding as VKA use; however, rivaroxaban significantly reduced the time to cardioversion in those undergoing delayed cardioversion. Thus, rivaroxaban is a safe alternative to VKAs for thromboprophylaxis in patients with NVAF undergoing elective cardioversion.

References

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Mar 19, 2013·Journal of the American College of Cardiology·Jonathan P PicciniUNKNOWN ROCKET AF Steering Committee & Investigators
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