2014Atrial fibrillationArrhythmias & devices1504 patients

X-VeRT

Therapy group: Anticoagulation · Therapy: Rivaroxaban vs vitamin K antagonists for cardioversion

Rivaroxaban showed efficacy and safety comparable to vitamin K antagonists in atrial fibrillation patients undergoing elective cardioversion, allowing quicker cardioversion.

Published in Eur Heart J (2014)

Question: Is rivaroxaban an effective and safe alternative to vitamin K antagonists (VKAs) in patients with atrial fibrillation undergoing elective cardioversion?
Design: Prospective, randomized, open-label, parallel-group, active-controlled multicenter trial that assigned 1504 patients in a 2:1 ratio. Investigators chose either an early (1-5 days after randomization) or delayed (3-8 weeks) cardioversion strategy.
Population: Patients with nonvalvular atrial fibrillation scheduled for elective cardioversion.
Intervention: Rivaroxaban 20 mg once daily (15 mg if creatinine clearance was 30-49 mL/min).
Control: Dose-adjusted VKAs.
Primary outcome: Composite of stroke, transient ischaemic attack, peripheral embolism, myocardial infarction, and cardiovascular death; the primary safety outcome was major bleeding.
Results: The primary efficacy outcome occurred in 5 of 978 patients (0.51%) on rivaroxaban and 5 of 492 (1.02%) on VKA (risk ratio 0.50; 95% CI 0.15-1.73). Time to cardioversion was significantly shorter with rivaroxaban (P < 0.001).
Safety: Major bleeding occurred in 6 patients (0.6%) on rivaroxaban and 4 (0.8%) on VKA (risk ratio 0.76; 95% CI 0.21-2.67).
Conclusion: Oral rivaroxaban appeared to be an effective and safe alternative to VKAs and may allow prompt cardioversion.
Why it matters: It was the first prospective randomized trial of a direct oral anticoagulant in elective cardioversion for atrial fibrillation, supporting its use as an alternative to VKAs without delaying the procedure.

Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.

Generated on October 14, 2026

Sources

Original publication on PubMed (PMID 25182247) ↗Rivaroxaban vs. vitamin K antagonists for cardioversion in atrial fibrillation.
Journal article (DOI) ↗
ClinicalTrials.gov record (NCT01674647) ↗

Videos explaining it

EHJ Today - X-VERT Trial

ESC · European Society of Cardiology ↗10:37Video page

Source: European Society of Cardiology · YouTube
Date: 20 Oct 2014
Audio: English
Subtitles: MultilingualYouTube
Audio transl.: None

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