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Related Experiment Videos

[Electrical cardioversion and thrombogenesis. Apropos a case]

N Basterra Sola1, F Olaz Preciado, F Ruiz Mateas

  • 1Servicio de Cardiología, Hospital de Navarra, Pamplona.

Revista Espanola De Cardiologia
|November 1, 1994
PubMed
Summary

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A transesophageal echocardiography before cardioversion for atrial fibrillation showed no thrombus. However, a left atrial appendage thrombus formed after the procedure despite anticoagulation, raising questions about its necessity.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology

Background:

  • Atrial fibrillation (AF) is a common arrhythmia requiring treatment.
  • Direct current cardioversion (DCCV) is a procedure to restore normal heart rhythm.
  • Transesophageal echocardiography (TEE) is used to screen for atrial thrombus before DCCV.

Observation:

  • A 73-year-old patient with AF underwent DCCV.
  • Pre-procedural TEE revealed no evidence of atrial thrombus.
  • Post-procedural TEE detected a new thrombus in the left atrial appendage.

Findings:

  • Thrombus formation occurred in the left atrial appendage after DCCV.
  • The thrombus developed despite the patient receiving oral anticoagulation therapy.
  • This case challenges the standard protocol regarding pre-cardioversion anticoagulation.

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Implications:

  • The findings suggest a potential need to re-evaluate the role and timing of oral anticoagulation in AF patients undergoing DCCV.
  • Further research is warranted to understand the mechanisms of post-cardioversion thrombus formation.
  • This case highlights the importance of vigilant monitoring even after successful cardioversion.