A new risk model of assessing left atrial appendage thrombus in patients with atrial fibrillation – Using multiple clinical and transesophageal echocardiography parameters

2020 ◽  
Vol 314 ◽  
pp. 60-63
Author(s):  
Lu Chen ◽  
Ashley Zinda ◽  
Nicholas Rossi ◽  
Xiu-Jie Han ◽  
Steve Sprankle ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Transesophageal Echocardiography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Risk Model ◽  
Atrial Appendage ◽  
Left Atrial Appendage Thrombus

scholarly journals Endoscopic Ultrasound for the Detection of Left Atrial Appendage Thrombus: A Useful Technique in Patients with Transesophageal Echocardiography Contraindication

2016 ◽  
Vol 2016 ◽  
pp. 1-2
Author(s):  
Manuel Marina-Breysse ◽  
Alfonso Jurado-Román ◽  
Bartolomé López-Viedma ◽  
Jesús Piqueras-Flores ◽  
María T. López-Lluva
Keyword(s):  
Atrial Fibrillation ◽  
Transesophageal Echocardiography ◽  
Endoscopic Ultrasound ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Thrombus ◽  
Therapeutic Technique ◽  
Esophageal Bleeding ◽  
Rule Out

Endoscopic ultrasound is a diagnostic and therapeutic technique used in specialized centers for patients that have undergone digestive procedures. This technique enables highly precise real-time imaging of the digestive tract wall and surrounding organs. Endoscopic ultrasound is also useful in patients with cardiovascular diseases such as atrial fibrillation. In patients with contraindication for transesophageal echocardiography due to high risk of esophageal bleeding or complications that may require immediate intervention, endoscopic ultrasound may be a safer option for visualizing atrial chambers to rule out the presence of left atrial appendage thrombi before cardioversion.

scholarly journals Intracardiac Versus Transesophageal Echocardiography for diagnosis of Left Atrial Appendage Thrombosis in Atrial Fibrillation: a Meta-analysis

2021 ◽  
Author(s):  
Guijun He ◽  
Hanxion Liu ◽  
Xiaoyu Huang ◽  
Xiaoqi Deng ◽  
Guosu Yang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Transesophageal Echocardiography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Meta Analysis ◽  
Atrial Appendage ◽  
Cochrane Library ◽  
Left Atrial Appendage Thrombus ◽  
Suitable Alternative ◽  
Significant Difference

Abstract Introduction: Left atrial appendage (LAA) thrombus in patients with atrial fibrillation is usually detected by transesophageal echocardiography (TEE). Intracardiac echocardiography (ICE) can be a suitable alternative to detect thrombosis. We performed a meta-analysis of all studies that compared ICE vs. TEE for LAA thrombosis.Methods: We searched PubMed, Cochrane Library, and Embase for published abstracts and manuscripts until June 1, 2020. Studies reporting clinical outcomes comparing TEE vs. ICE for LAA thrombus in human subjects aged ≥ 18 years were included. Two investigators independently extracted the data and an individual quality assessment was performed. The analysis was performed using RevMan 5.3, STATA 15, and Meta-Disc 1.4.Results: Eight eligible studies consisting of 1108 patients (TEE = 558 vs. ICE = 550) were included. The average sensitivity of ICE and TEE to diagnose left atrial appendage thrombus was 1.0 (95% CI: 0.91-1.00) vs 0.68 (95% CI: 0.49-0.83),and specificity of ICE and TEE to diagnosis of left atrial appendage thrombus was 1.0 (95% CI: 0.99-1.00) vs 0.98 (95% CI: 0.96-0.99) . The AUC of ICE and TEE were 0.9846 (SEAUC = 0.0196) and 0.9655 (SEAUC = 0.0401), and the Q * statistics were 0.9462 (SEQ * = 0.0406) and 0.9127 (SEQ * = 0.0616), respectively. Z test was performed on Q * statistics (Z = 0.45, P> 0.05), there was no significant difference between ICE and TEE.Conclusion: ICE and TEE have similar diagnostic efficacy for left atrial appendage thrombosis, but ICE has higher sensitivity and specificity, which has certain advantages over TEE and has clinical application prospects.

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

P3731The improvement in left atrial strain among patients undergoing percutaneous left atrial appendage closure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Ijuin ◽  
A Hamadanchi ◽  
F Haertel ◽  
L Baez ◽  
C Schulze ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Transesophageal Echocardiography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Lateral Wall ◽  
Bleeding Risk ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure ◽  
Left Atrial Strain

Abstract Background Percutaneous left atrial appendage closure (LAAC) is being established as an alternative option for atrial fibrillation (AF) patients with high bleeding risk. Few studies reported the influence of percutaneous LAAC on left atrial (LA) performance, but most of the studies demonstrated no remarkable changes in their parameters after the procedure. Method The study included 95 patients (age: 75±6.7 years, 67% male) whom underwent percutaneous LAAC in a single center between September 2012 and November 2018. LA strain was evaluated at three different time intervals by transesophageal echocardiography (baseline, 45 days and 180 days after procedure). All data were analyzed using a dedicated. 70 patients had atrial fibrillation whereas 25 were in sinus rhythm. Analysis was performed for peak atrial longitudinal strain (PALS) and peak atrial contraction strain (PACS) from segment of lateral wall in mid-esophageal 4 chamber view. The validity of lateral wall left atrial analysis was recently shown by our group. PACS was obtained in patients with sinus rhythm during exams. Results Compared to baseline, PALS was significantly increased after 45 days (12.4±8.4% vs 16.0±10.7%, p=0.001) and remained stable after 180 days (13.8±9.0% vs 17.0±12.4%, p=0.098). Even in only patients with atrial fibrillation during exams, it was increased (10.8±7.7% vs 13.4±7.1%, p=0.012 and 8.5±5.1% vs 13.9±8.1%, p=0.014). Similarly, compared with the baseline, PACS was significantly increased after 45 days and 180 days (5.8±3.9% vs 10.6±7.6%, p=0.001 and 4.5±2.6% vs 7.9±3.1%, p=0.036). The Changes in PALS and PACS Conclusion Our study has demonstrated for the first time the improvement in LA strain following LAAC within 45 days of implantation by transesophageal echocardiography and these values were maintained at least for 6 months. Further appraisal is warranted for confirmation of these preliminary findings.

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