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[Atrial fibrillation]
1Service de cardiologie, Hôpital Habib Thameur, Montfleury, Tunis, Tunisie.
Insights
Transesophageal echocardiography (TOE) screens for cardiac thrombus in atrial fibrillation patients before cardioversion. A peak systolic velocity over 0.25 m/s predicts maintaining sinus rhythm post-procedure.
Area of Science:
- Cardiology
- Echocardiography
Background:
- Atrial fibrillation (AF) poses a risk of cardiac thrombus formation.
- Transesophageal echocardiography (TOE) is crucial for detecting thrombi before cardioversion.
- Predicting the maintenance of sinus rhythm after cardioversion is clinically significant.
Purpose of the Study:
- To establish indications for TOE in AF patients undergoing cardioversion.
- To identify echographic predictors for maintaining sinus rhythm post-cardioversion.
Main Methods:
- Prospective screening of 40 AF patients undergoing cardioversion.
- Pre-procedure transthoracic and transesophageal echocardiography to assess for atrial thrombus.
- Follow-up at one, three, and six months to evaluate rhythm status.
Main Results:
- All 40 patients successfully underwent cardioversion.
- A peak systolic velocity > 0.25 m/s was the sole echographic predictor of sustained sinus rhythm.
- 28 patients maintained sinus rhythm, while 12 reverted to AF.
Conclusions:
- Peak systolic velocity measured by echocardiography is a key predictor of successful cardioversion outcomes in AF patients.
- This finding aids in the echographic prognosis for maintaining sinus rhythm after AF cardioversion.
Abstract:
The aim of transesophageal echocardiography (TOE) in atrial fibrillation milieu is to search a cardiac chamber thrombus. In order to establish the indications of TOE and to raise new issues for the echographic prognosis of maintain of sinus rhythm, 40 patients with atrial fibrillation who underwent cardioversion were prospectively screened. All patients had transthoracic and transesophageal echocardiography before procedure to control the absence or disappearing of atrial thrombus (N = 7). All 40 patients underwent a successful cardioversion. Follow-up was done after one, three and six months for both success group (N = 28) and refibrillation group (N = 12). Our study provides evidence that the only predictive echographic factor of maintain of a good result (sinus rhythm) after cardioversion was a systolic velocity peak > 0.25 metir/sec.