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Evolution of left atrial thrombus with anticoagulant therapy-follow-up by transesophageal echocardiography
1Department of Internal Medicine, Seoul National University College of Medicine, Korea.
Insights
Anticoagulant therapy can help dissolve or reduce the size of left atrial thrombus in patients with atrial fibrillation. This study tracked thrombus changes using transesophageal echocardiography during treatment.
Area of Science:
- Cardiology
- Internal Medicine
- Vascular Medicine
Background:
- Atrial fibrillation is a significant risk factor for systemic embolism.
- Anticoagulant therapy is proven to prevent embolism, but its effect on existing left atrial thrombus is unclear.
Purpose of the Study:
- To investigate the resolution or reduction in size of left atrial thrombus in patients undergoing anticoagulation therapy.
- To assess the impact of transesophageal echocardiography-guided anticoagulation on left atrial thrombus.
Main Methods:
- Transesophageal echocardiography was used to identify left atrial thrombus in 13 patients.
- Patients received anticoagulation therapy and were followed for 15 months with repeated transesophageal echocardiography.
Main Results:
- In 9 patients with adequate anticoagulation (INR > 2.0), left atrial thrombus resolved in 3.
- The average size of the thrombus decreased significantly (p < 0.05) from 2.2 cm to 0.9 cm.
Conclusions:
- Adequate anticoagulation therapy can lead to the dissolution or size reduction of left atrial thrombus.
- This finding supports the use of anticoagulation for managing left atrial thrombus in atrial fibrillation patients.
Objectives:
Atrial fibrillation is an important risk factor for systemic embolism. A number of clinical studies demonstrated the beneficial effect of anticoagulant therapy for the prevention of embolism. But there has been no study on the fate of left atrial thrombus demonstrated by transesophageal echocardiography in the course of anticoagulation therapy.
Methods:
Thirteen patients, demonstrated to have left atrial thrombus by transesophageal echocardiography were followed with anticoagulation therapy. Repeated transesophageal echocardiography was done 15 months after 1st study.
Results:
Among 9 patients with adequate anticoagulation effect (INR > 2.0), left atrial thrombus disappeared in 3 patients. The size of thrombus decreased from 2.2 +/- 0.8cm to 0.9 +/- 1.0cm (p < 0.05 by paired Student's t-test).
Conclusions:
Left atrial thrombus could dissolve or decrease in size with adequate anticoagulation.