Restoring sinus rhythm after atrial fibrillation in patients with implanted occlusion devices raises safety concerns. A single-center ambispective cohort study published in Frontiers in Cardiovascular Medicine evaluated the safety and efficacy of direct current cardioversion (DCCV) following left atrial appendage occlusion (LAAO).

The study included 196 adults (mean age 72 years; 51% men) who underwent LAAO, with 95 receiving DCCV as part of a combined procedural approach with radiofrequency catheter ablation. Over 12 months, there were no DCCV-related deaths, device dislodgment, or embolic events. The incidence of safety outcomes was 3.2% in the DCCV group and 6.9% in the non-DCCV group (P = .238).

Efficacy outcomes, including cardiovascular death, stroke, and systemic embolism, occurred at similar rates in both groups. Post-procedural TEE showed slight increases in device diameter at 45° and 90°, but these changes had no adverse effects.

These findings support the safety of performing DCCV after LAAO, indicating that it does not increase procedural or thromboembolic complications in patients with atrial fibrillation.