[Assessment of results of transesophageal echocardiography in patients with atrial flutter]

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Type I atrial flutter (AF) is often associated with coronary heart disease and cardiosclerosis.
• Transesophageal electric cardiac stimulation (TEECS) is a method for restoring sinus rhythm.
• Pre-procedure echocardiography is crucial for assessing atrial function.

Purpose of the Study:

• To evaluate the effectiveness of TEECS in patients with type I atrial flutter.
• To investigate the impact of left atrium appendage ejection velocity on cardioversion outcomes.
• To identify predictors of successful TEECS and potential complications.

Main Methods:

• 89 patients with type I atrial flutter underwent TEECS.
• Patients were divided into two groups based on left atrium appendage ejection velocity (≤40 cm/s vs. >40 cm/s).
• Transthoracic and transesophageal echocardiography were performed prior to cardioversion.

Main Results:

• Group I (low ejection velocity) experienced longer AF duration, more hypertension, and frequent relapses post-TEECS.
• Group II (high ejection velocity) showed better cardioversion success rates and fewer transient arrhythmias.
• Absence of spontaneous contrast and specific intra-atrial hemodynamic patterns were noted in Group II.

Conclusions:

• Left atrium appendage ejection velocity is a significant predictor of TEECS success in atrial flutter.
• Higher ejection velocity is associated with improved cardioversion outcomes and reduced relapse rates.
• These findings may allow for a shortened anticoagulant preparation period before TEECS in select patients.