scholarly journals Mechanical concordance between left atrium and left atrial appendage in nonvalvular atrial fibrillation: can it be exploited to avoid transesophageal echocardiography prior to electrical cardioversion during Covid-19 pandemic?

2021 ◽  
Author(s):  
Andrea Sonaglioni ◽  
Michele Lombardo ◽  
Gian Luigi Nicolosi ◽  
Gian Franco Gensini ◽  
Giuseppe Ambrosio
Keyword(s):  
Atrial Fibrillation ◽  
Transesophageal Echocardiography ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Electrical Cardioversion ◽  
Atrial Appendage ◽  
Nonvalvular Atrial Fibrillation

scholarly journals Clinical Efficacy and Safety Comparison of Rivaroxaban and Dabigatran for Nonvalvular Atrial Fibrillation Patients Undergoing Percutaneous Left Atrial Appendage Closure Operation

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaoye Li ◽  
Xiaochun Zhang ◽  
Qinchun Jin ◽  
Ying Xue ◽  
Wenjing Lu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Transesophageal Echocardiography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Average Length ◽  
Atrial Appendage ◽  
Target Range ◽  
Efficacy And Safety ◽  
Left Atrial Appendage Closure ◽  
Nonvalvular Atrial Fibrillation

Objective: Due to the clinical complexity of warfarin, novel oral anticoagulation (NOAC) has been a feasible and safe alternative anticoagulant approach during left atrial appendage closure (LAAC). This study was designed to compare the efficacy and safety of rivaroxaban and dabigatran for nonvalvular atrial fibrillation patients undergoing percutaneous LAAC.Methods: One single and prospective cohort study was performed among patients who received anticoagulation with dabigatran or rivaroxaban. All patients were medicated with a 3-month course of NOAC to facilitate device endothelialization, followed by dual antiplatelet therapy until 6 months, then lifelong aspirin after discharge. Repeated transesophageal echocardiography was scheduled to evaluate thrombosis formation on occluders and thrombus dissolution ability.Results: A total of 262 consecutive patients were initially enrolled. A final number of 250 patients were analyzed; two patients were excluded due to procedure failure and 10 patients had a loss of follow-up; 97 were from the dabigatran group and 153 from the rivaroxaban group. Three patients (1.9%) in the rivaroxaban group and eight (8.2%) in the dabigatran group were experiencing device-related thrombosis (DRT) events during follow-ups. Cumulative Kaplan–Meier estimates showed that the incidence of DRT was lower under rivaroxaban medication during the 6-month follow-ups (p = 0.038*, OR = 3.843, 95%CI: 0.991–14.836). The transesophageal echocardiography (TEE) results showed that the average length and width of DRT in the rivaroxaban group was significantly lower compared with that in the dabigatran group (2.16 vs. 1.60 mm, p = 0.017*, and 1.71 vs. 1.30 mm, p = 0.003*, respectively). The thrombosis dissolved after the switch from dabigatran or rivaroxaban to warfarin within the target range, represented by the average length and width of thrombus with the cooperation of secondary TEE for the dabigatran and rivaroxaban groups (0.64 vs. 0.40 mm, p = 0.206, and 0.43 vs. 0.27 mm, p = 0.082, respectively). No significant difference was found between the two groups with respect to the levels of coagulation parameters, cardiac function, and bleeding events.Conclusion: Compared to dabigatran, post-procedural rivaroxaban anticoagulation might be advantageous in preventing DRT complications expected after LAAC, without increasing the risk of hemorrhage.

PREDICTING VALUE OF LEFT ATRIAL APPENDAGE THROMBUS IN NONVALVULAR ATRIAL FIBRILLATION PATIENTS BY CHADS2 AND CHADS2-VAS’SCORE AND BY TRANSTHORACIC ECHOCARDIOGRAPHIC PARAMETERS

2012 ◽  
pp. 36-42
Author(s):  
Thuc Quang Bui ◽  
Dien Bien Vu ◽  
Nguyen Son Pham
Keyword(s):  
Atrial Fibrillation ◽  
Transesophageal Echocardiography ◽  
Key Words ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Nonvalvular Atrial Fibrillation ◽  
Left Atrial Appendage Thrombus ◽  
Echocardiographic Parameters ◽  
And Function

Objectives: To evaluate size and function of left atrium and left atrial appendage (LAA) by using transthoracic and transesophageal echocardiography in nonvalvular atrial fibrillation (NVAF) patients. Method: 127 NVAF patients (mean age 65,8 ± 10,0 years) were assessed by using CHADS2 and CHADS2-VAS score, transthoracic and transesophageal echocardiographic parameters. Results: CHADS2 ≥3, CHADS2-VAS ≥ 4 and LAVI ≥ 38ml/m2, diagnosis of LAA thrombus has been expected in turn with Se=67% and Sp=70%, Se=67% and Sp=71% and Se=80% and Sp=60%; With LEVF/LAVI ≤1,5, risk of LAA thrombus was OR=13,3; 95% CI (1,8 – 98,5) with p=0,001. Conclusion: CHADS2, CHADS2-VAS, LAVI and ratio LVEF/LAVI are predictors of LAA thrombus in NVAF patients. Key words: CHADS 2, CHADS 2 -VAS, left atrial appendage thrombus, thromboembolism, nonvalvular atrial fibrillation

scholarly journals Application of Transesophageal Echocardiography in Observing Left Atrial and Left Atrial Appendage Before Radiofrequency Ablation in Patients with AF

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Yiyi Ma ◽  
Xiaoming Liu
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Transesophageal Echocardiography ◽  
Left Atrium ◽  
Left Atrial ◽  
Detection Rate ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Detection Methods ◽  
Examination Method

Objective: To report and explain the significance of transesophageal echocardiography(TEE) in the observation of left atrium and left atrial appendage before radiofrequency ablation in patients with AF. Methods: 25 patients with AF were selected as the review objects who received echocardiography in our hospital during June 2018 to June 2019. They had routinely received transthoracic echocardiography (TTE) before preparing for radiofrequency ablation. Then TEE was selected to observe and compare the effect of two detection methods on left atrial and left auricular thrombosis. Results: TEE examinations were given to patients with atrial fibrillation before radiofrequency ablation. Compared with TTE examinations, the detection rate of left atrium and left atrial appendage thrombosis was significantly improved. The two detection methods are different and comparable(P<0.05), which is of great significance in clinical application. Conclusion: The use of TEE has significantly improved the detection rate of left atrial and left atrial appendage thrombosis in patients with AF, and has become an important examination method before the implementation of radiofrequency ablation.

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