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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Published on: February 26, 2013

Cardioversion in patients with left ventricular thrombus is not associated with increased thromboembolic risk

Sripal Bangalore1, Luiza Petre, Bengt Herweg

  • 1Division of Cardiology, Department of Medicine, St Luke's-Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons, New York, New York 10025, USA.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|April 4, 2006
PubMed

Insights

Systemic embolism was not observed after cardioversion in patients with left ventricular (LV) thrombus. This study suggests cardioversion may be safe in this population, warranting further investigation.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Echocardiography

Background:

  • Systemic embolization risk after cardioversion is known for atrial thrombus but limited for left ventricular (LV) thrombus.
  • Hesitancy to perform cardioversion in patients with LV thrombus exists due to potential thromboembolic risks.
  • Limited data necessitates further research into cardioversion safety in LV thrombus patients.

Purpose of the Study:

  • To determine the incidence of systemic embolism following cardioversion in patients diagnosed with left ventricular (LV) thrombus.
  • To evaluate the safety and efficacy of cardioversion in a population with known LV thrombus.
  • To provide data on thromboembolic events in patients undergoing cardioversion for arrhythmias with coexisting LV thrombus.

Main Methods:

  • Retrospective review of transthoracic and transesophageal echocardiograms (1996-2001) to identify patients with LV thrombus.
  • Analysis of medical records for patients who underwent cardioversion within three weeks of echocardiographic diagnosis.
  • Assessment of clinical outcomes, including embolic events, during hospitalization and up to one year of follow-up.

Main Results:

  • Twenty-one patients with LV thrombus (mean age 66 years, ejection fraction 22%) underwent cardioversion.
  • Cardioversion was performed for atrial fibrillation (38%) and ventricular tachyarrhythmia (62%), with varying urgency.
  • No patient experienced a clinically apparent embolic event, including stroke, during the follow-up period.

Conclusions:

  • Cardioversion in patients with echocardiographically confirmed left ventricular (LV) thrombus was not associated with systemic embolism.
  • The findings suggest that cardioversion may be a safe procedure in this patient group.
  • Further prospective studies are recommended to confirm the safety and efficacy of cardioversion in patients with LV thrombus.
Abstract

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