A Case Report of an Ischemic Stroke after Electrical Shock of Atrial Fibrillation Under Apixaban

This article discusses the case of a patient with ischemic stroke following a cardioversion of Atrial Fibrillation under treatment with Apixaban 5 mg twice daily. Adherence to anticoagulant therapy and normal trans-thoracic ultrasound do not eliminate the possibility of an atrial thrombus, which may contraindicate or delay the cardioversion procedure. The use of transesophageal echocardiography in this case is discussed, to avoid the occurrence of thromboembolic events. This study indicates the need for further studies whether for flutter ablations or cardioversions under oral anticoagulants.