TY - JOUR
T1 - Transesophageal echocardiography and cardioversion trends in patients with atrial fibrillation
T2 - A 10-year survey
AU - Yarmohammadi, Hirad
AU - Klosterman, Tristan
AU - Grewal, Gaganpreet
AU - Alraies, M. Chadi
AU - Lindsay, Bruce D.
AU - Bhargava, Mandeep
AU - Tang, W. H Wilson
AU - Klein, Allan L.
PY - 2012/9
Y1 - 2012/9
N2 - Background: Transesophageal echocardiography (TEE) has long been used to assess for left atrial thrombus (LAT) in patients undergoing direct-current cardioversion (DCC) for atrial fibrillation or flutter. However, little is known about its recent trends and current applications. Methods: In this retrospective study, 3,191 serial transesophageal echocardiographic studies in 2,705 unique patients (mean age, 66 ± 13 years; 68% men) with atrial fibrillation or atrial flutter who underwent TEE before DCC from 1999 to 2008 were identified using the Cleveland Clinic echocardiography database. Clinical data and information on the presence of spontaneous echocardiographic contrast, sludge, or LAT before DCC were obtained as well as the total number of transesophageal echocardiographic studies and DCC procedures performed in outpatient or inpatient settings. Results: Increasing trends of TEE-guided DCC were observed over the past 10 years (25% in 1999, 34% in 2008). TEE-guided DCC was also performed more often in the outpatient setting (21% in 1999, 37% in 2008). There was no yearly difference for the prevalence of LAT or sludge (8% overall; P = .12). Conclusions: Over the past 10 years, trends have suggested that the application of TEE-guided DCC compared with the conventional approach have consistently grown and that more DCC procedures are done in the outpatient setting. Given the high LAT or sludge detection rate of 8%, TEE-guided DCC has continued to be an important part of atrial fibrillation management.
AB - Background: Transesophageal echocardiography (TEE) has long been used to assess for left atrial thrombus (LAT) in patients undergoing direct-current cardioversion (DCC) for atrial fibrillation or flutter. However, little is known about its recent trends and current applications. Methods: In this retrospective study, 3,191 serial transesophageal echocardiographic studies in 2,705 unique patients (mean age, 66 ± 13 years; 68% men) with atrial fibrillation or atrial flutter who underwent TEE before DCC from 1999 to 2008 were identified using the Cleveland Clinic echocardiography database. Clinical data and information on the presence of spontaneous echocardiographic contrast, sludge, or LAT before DCC were obtained as well as the total number of transesophageal echocardiographic studies and DCC procedures performed in outpatient or inpatient settings. Results: Increasing trends of TEE-guided DCC were observed over the past 10 years (25% in 1999, 34% in 2008). TEE-guided DCC was also performed more often in the outpatient setting (21% in 1999, 37% in 2008). There was no yearly difference for the prevalence of LAT or sludge (8% overall; P = .12). Conclusions: Over the past 10 years, trends have suggested that the application of TEE-guided DCC compared with the conventional approach have consistently grown and that more DCC procedures are done in the outpatient setting. Given the high LAT or sludge detection rate of 8%, TEE-guided DCC has continued to be an important part of atrial fibrillation management.
KW - Atrial fibrillation
KW - Direct current cardioversion
KW - Transesophageal echocardiography
KW - Trends
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U2 - 10.1016/j.echo.2012.05.015
DO - 10.1016/j.echo.2012.05.015
M3 - Article
C2 - 22742868
AN - SCOPUS:84865202989
SN - 0894-7317
VL - 25
SP - 962
EP - 968
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 9
ER -