Michael B. Jacobs, MD
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To the Editors: The article addressing the question of which subgroups of patients with atrial fibrillation need anticoagulation by Albers and colleagues (1) is a welcome addition to the medical literature. However, the implied advice about managing patients with paroxysmal atrial fibrillation may be misleading. Atwood (2) states that, "Unlike patients with chronic atrial fibrillation, patients with acute atrial fibrillation of less than 3 days duration do not require anticoagulant therapy before cardioversion." (Here, I equate each new paroxysm of atrial fibrillation with "acute atrial fibrillation.") In support of this statement, he cites an article by Bjerkelund and Orning (3);
Jacobs MB. Anticoagulation before Cardioversion for Atrial Fibrillation. Ann Intern Med. 1992;116:698–699. doi: 10.7326/0003-4819-116-8-698_2
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Published: Ann Intern Med. 1992;116(8):698-699.
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