February 11, 2010Journal of Cardiovascular Electrophysiology
Prevalence and Clinical Characteristics Associated With Left Atrial Appendage Thrombus in Fully Anticoagulated Patients Undergoing Catheter‐Directed Atrial Fibrillation Ablation
Key result
Preprocedural transesophageal echocardiogram revealed left atrial appendage thrombus in 3.6% of patients undergoing atrial fibrillation ablation despite 4 weeks of full warfarin anticoagulation.
Population
192 consecutive patients undergoing catheter-directed atrial fibrillation ablation, fully anticoagulated on…
Design
Cohort
Authors
Discussion
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Implication
Residual LAA thrombus risk despite anticoagulation in AF ablation; leaves open whether routine preprocedural TEE is warranted.
Study Design
Type
Observational (n=192)
Structured PICO
P
Population
192 consecutive patients undergoing catheter-directed atrial fibrillation (AF) ablation, fully anticoagulated on warfarin (international normalized ratio [INR] 2-3) for 4 consecutive weeks prior to echocardiogram
I
Intervention
Preprocedural transesophageal echocardiogram (TEE)
O
Outcome
Prevalence of left atrial appendage (LAA) thrombussurrogate
Despite 4 weeks of therapeutic anticoagulation with warfarin, 3.6% of patients presenting for AF ablation had LAA thrombus, supporting the routine use of preprocedural TEE regardless of LV function or LA size.
Cite This Study
Wallace et al. (2010) conducted an observational in Atrial fibrillation (n=192). Warfarin anticoagulation was evaluated on Prevalence of left atrial appendage (LAA) thrombus. Preprocedural transesophageal echocardiogram revealed left atrial appendage thrombus in 3.6% of patients undergoing atrial fibrillation ablation despite 4 weeks of full warfarin anticoagulation.