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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Diagnosis and Management of Left Atrium Appendage Thrombosis in Atrial Fibrillation Patients Undergoing Cardioversion

Enrico Melillo1, Giuseppe Palmiero2, Adele Ferro3

  • 1Department of Cardiology, AO dei Colli, Monaldi Hospital, 80131 Naples, Italy. doc.emelillo88@gmail.com.

Medicina (Kaunas, Lithuania)
|August 24, 2019
PubMed

Insights

Atrial fibrillation patients undergoing cardioversion need anticoagulation to prevent stroke. Transesophageal echocardiography helps detect left atrial appendage thrombus, guiding treatment decisions for safer rhythm restoration.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology

Background:

  • Atrial fibrillation is the most common cardiac arrhythmia.
  • It significantly increases stroke and thromboembolic complication risks.
  • Rhythm control via cardioversion is recommended for symptomatic patients.

Purpose of the Study:

  • To review left atrial appendage (LAA) thrombosis epidemiology and risk factors.
  • To discuss the role of echocardiography in cardioversion decision-making.
  • To evaluate anticoagulant efficacy in LAA thrombosis detection and treatment.

Main Methods:

  • Literature review on atrial fibrillation, cardioversion, and LAA thrombosis.
  • Analysis of echocardiography's role in pre-cardioversion assessment.
  • Review of studies on anticoagulant therapy for LAA thrombosis.

Main Results:

  • LAA thrombosis is a key concern before cardioversion, necessitating anticoagulation.
  • Transesophageal echocardiography is crucial for excluding LAA thrombus.
  • Anticoagulant regimens vary in efficacy for LAA thrombosis management.

Conclusions:

  • Effective anticoagulation and echocardiographic assessment are vital for safe cardioversion in atrial fibrillation.
  • Understanding LAA thrombosis risk factors and management is essential.
  • Further research on optimal anticoagulant strategies is warranted.

Keywords:
atrial fibrillationcardioversionleft atrial appendage thrombosisoral anticoagulation therapytransesophageal echocardiography

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