Internal and Emergency Medicine

, Volume 6, Issue 2, pp 117–123

Low molecular weight heparin (parnaparin) for cardioembolic events prevention in patients with atrial fibrillation undergoing elective electrical cardioversion: a prospective cohort study

  • Giulia Angeloni
  • Silvia Alberti
  • Enrico Romagnoli
  • Alberto Banzato
  • Marco Formichi
  • Umberto Cucchini
  • Vittorio Pengo
IM - Original


Systemic thromboembolism is a severe complication in patients undergoing electrical cardioversion (ECV) for atrial fibrillation (AF). Vitamin K antagonists greatly reduce the risk of thromboembolic events, but the administration scheme before ECV is troublesome as difficulties in reaching and maintaining the target therapeutic range for 3 weeks often delay the restoration and likelihood of maintaining sinus rhythm. Low molecular weight heparins (LMWHs) do not need dose adjustment, and may be preferable in this clinical setting. In this multicentre study, the LMWH parnaparin was used at a dose of 85 anti-factor Xa U/kg b.i.d. 2 weeks before and 3 weeks after ECV of AF. In an intention to treat analysis of 102 patients, there was no systemic thromboembolism or major bleeding (0%, 95% CI 0–3.6). Two clinically relevant non-major bleeds (2.5%, 95% CI 0.7–8.8) and three minor bleeds (3.8%, 95% CI 1.3–10.6) were recorded. No heparin-induced thrombocytopenia or other major adverse events were recorded. Parnaparin appears effective and safe for thromboprophylaxis of elective ECV in patients with AF.


Atrial fibrillation Electrical cardioversion Cardioembolism Parnaparin 


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Copyright information

© SIMI 2010

Authors and Affiliations

  • Giulia Angeloni
    • 1
    • 2
  • Silvia Alberti
    • 3
  • Enrico Romagnoli
    • 2
  • Alberto Banzato
    • 4
  • Marco Formichi
    • 5
  • Umberto Cucchini
    • 6
  • Vittorio Pengo
    • 6
  1. 1.Department of Heart and Vessels, Careggi HospitalUniversity of FlorenceFlorenceItaly
  2. 2.Department of Cardiovascular DiseasesSacred Heart Catholic UniversityRomeItaly
  3. 3.Research LaboratorySacred Heart Catholic UniversityRomeItaly
  4. 4.Cardiologia OncologicaVeneto Region Institute of OncologyPaduaItaly
  5. 5.Department of CardiologyCivil HospitalEsteItaly
  6. 6.Clinical Cardiology, Thrombosis CentreUniversity of Padua School of MedicinePaduaItaly

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