PMID- 17098762
OWN - NLM
STAT- MEDLINE
DCOM- 20070416
LR  - 20061123
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 27
IP  - 23
DP  - 2006 Dec
TI  - The use of enoxaparin compared with unfractionated heparin for short-term 
      antithrombotic therapy in atrial fibrillation patients undergoing 
      transoesophageal echocardiography-guided cardioversion: assessment of 
      Cardioversion Using Transoesophageal Echocardiography (ACUTE) II randomized 
      multicentre study.
PG  - 2858-65
AB  - AIMS: To compare the feasibility and safety of transoesophageal 
      echocardiograpy-guided cardioversion (CV) with enoxaparin and unfractionated 
      heparin (UFH) in patients with atrial fibrillation (AF). METHODS AND RESULTS: The 
      Assessment of Cardioversion Using Transoesophageal Echocardiography (ACUTE) II 
      pilot trial compared the safety and efficacy of enoxaparin with UFH in 155 
      patients with AF who were scheduled for transoesophageal echocardiography 
      (TEE)-guided CV. Safety outcomes over a 5-week period were ischaemic stroke, 
      major or minor bleeding, and death. Efficacy outcomes were length of stay (LOS) 
      and return to normal sinus rhythm (NSR). Of the 76 patients assigned to the 
      enoxaparin group, 72 (94.7%) had a transoesophageal echocardiogram and 63 (82.9%) 
      had early CV, of which 59 (93.7%) were successful. Of the 79 UFH patients, 66 
      (83.5%) had a transoesophageal echocardiogram and 58 (73.4%) had early CV, of 
      which 54 (98.2%) were successful. There were no significant differences in 
      embolic events, bleeding, or deaths between groups. The enoxaparin group had 
      shorter median LOS compared with the UFH group [3(2-4) vs. 4(3-5)] days; 
      P<0.0001). There was also more NSR at 5 weeks in the enoxaparin group (76 vs. 
      57%; P=0.013). CONCLUSION: In the ACUTE II trial, there were no differences in 
      safety outcomes between the two strategies. However, the enoxaparin group had a 
      shorter LOS. Thus, the TEE-guided enoxaparin strategy may be considered a safe 
      and effective alternative strategy for AF. The shorter LOS may translate to lower 
      costs using the enoxaparin TEE-guided approach.
FAU - Klein, Allan L
AU  - Klein AL
AD  - University of Pittsburgh Medical Center, Scalfe Hall S-563, 200 Lothrop Street, 
      Pittsburgh, PA 15213, USA. kleina@ccf.org
FAU - Jasper, Susan E
AU  - Jasper SE
FAU - Katz, William E
AU  - Katz WE
FAU - Malouf, Joseph F
AU  - Malouf JF
FAU - Pape, Linda A
AU  - Pape LA
FAU - Stoddard, Marcus F
AU  - Stoddard MF
FAU - Apperson-Hansen, Carolyn
AU  - Apperson-Hansen C
FAU - Lieber, Elizabeth A
AU  - Lieber EA
CN  - ACUTE II Steering and Publications Committe for the ACUTE II Investigators
LA  - eng
PT  - Clinical Trial, Phase II
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20061110
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 9005-49-6 (Heparin)
SB  - IM
CIN - Eur Heart J. 2006 Dec;27(23):2742-3. PMID: 17098755
MH  - Atrial Fibrillation/*therapy
MH  - Echocardiography, Transesophageal
MH  - Electric Countershock/*methods
MH  - Enoxaparin/therapeutic use
MH  - Feasibility Studies
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Hemorrhage/chemically induced
MH  - Heparin/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Treatment Outcome
MH  - Ultrasonography, Interventional
EDAT- 2006/11/14 09:00
MHDA- 2007/04/17 09:00
CRDT- 2006/11/14 09:00
PHST- 2006/11/14 09:00 [pubmed]
PHST- 2007/04/17 09:00 [medline]
PHST- 2006/11/14 09:00 [entrez]
AID - ehl353 [pii]
AID - 10.1093/eurheartj/ehl353 [doi]
PST - ppublish
SO  - Eur Heart J. 2006 Dec;27(23):2858-65. doi: 10.1093/eurheartj/ehl353. Epub 2006 
      Nov 10.