Transesophageal Echocardiography Can Detect Atrial Fibrillation Masked by a Pacemaker: A Case Series

Atrial fibrillation is a major risk factor for cerebral infarction. Moreover, new-onset atrial fibrillation is detected at a higher rate following pacemaker implantation. Three patients presented to the hospital with large-vessel occlusion and underwent mechanical thrombectomy. Atrial fibrillation was not detected via electrocardiogram in any of the cases. Transesophageal echocardiography was able to reveal movements localized in the left atrial appendage and corresponding reductions in blood-flow velocity through these structures that suggested atrial fibrillation. Our findings suggest that transesophageal echocardiography has emerged as a valuable diagnostic tool for detecting movements localized in the left atrial appendage that may indicate fibrillation.