Cardioversion from atrial fibrillation without prolonged anticoagulation with use of transesophageal echocardiography to exclude the presence of atrial thrombi
Article Abstract:
Individuals suffering from prolonged atrial fibrillation can be successfully treated without receiving long-term anticoagulant therapy if transesophageal echocardiography shows that they have no blood clots in their heart. Clot formation is a complication of atrial fibrillation and most patients are treated with anticoagulants for weeks before their fibrillation is converted to normal heart rhythm. Ninety-four patients with prolonged atrial fibrillation were given a conventional echocardiogram and a transesophageal echocardiogram. Twelve patients had atrial blood clots, and 86% of the clots were detected only by transesophageal echocardiography. No atrial blood clots were detected by transesophageal echocardiography in 82 patients, and 95% of these patients were successfully converted to normal heart rhythm without long-term anticoagulation.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1993
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Accuracy of transesophageal echocardiography for identifying left atrial thrombi: a prospective, intraoperative study
Article Abstract:
Transesophageal echocardiography may be used to accurately detect the presence of blood clots in the left atrium of the heart or to rule out their presence. Transesophageal echocardiography (TEE) allows viewing of the back of the heart by placing probes in the esophagus. Researchers performed TEE on 231 patients scheduled to undergo heart surgery to repair or replace the mitral valve, or to remove a tumor in the left atrium. TEE detected 14 patients with blood clots in the left atrium, and this was confirmed in 12 patients during surgery. The accuracy rate was 86%. The two incorrect diagnoses were confirmed by only one observer, rather than by both observers. TEE correctly ruled out left atrial blood clots for 217 patients, as confirmed during surgery.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1995
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Strategies for cardioversion of atrial fibrillation -- time for a change?
Article Abstract:
Transesophageal echocardiography can be used to determine whether patients with atrial fibrillation have a blood clot in their heart before they are defibrillated. If not, they would not require three weeks of anticoagulation before defibrillation.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2001
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