What question did this study set out to answer?

The aim is to assess the prevalence of left atrial appendage thrombus on transoesophageal echocardiography prior to atrial fibrillation ablation in anticoagulated patients.

June 11, 2018EP EuropaceOpen Access

Prevalence of left atrial appendage thrombus detected by transoesophageal echocardiography before catheter ablation of atrial fibrillation in patients anticoagulated with non-vitamin K antagonist oral anticoagulants

View Full Paper

Ask AI

Bookmark

Why the study?

What is the prevalence of left atrial appendage thrombus detected by routine transoesophageal echocardiography before atrial fibrillation ablation in patients on oral anticoagulation?

Population

668 consecutive patients scheduled for atrial fibrillation ablation, on oral anticoagulation for at least 4…

Design

Cohort

Authors

WAWael AlqarawiKing Saud University DBDavid H. BirnieElectrophysiology SSStewart SpenceUniversity of Ottawa

Discussion

Member takes

Implication

Low LAAT prevalence supports selective over routine pre-ablation TOE in anticoagulated patients; leaves open prospective validation of risk-based strategies.

Key Points

The aim is to assess the prevalence of left atrial appendage thrombus on transoesophageal echocardiography prior to atrial fibrillation ablation in anticoagulated patients.
Included 668 patients undergoing atrial fibrillation ablation from January 2009 to December 2016.
All patients were on oral anticoagulation for at least 4 weeks prior to transoesophageal echocardiography.
Transoesophageal echocardiographies were performed 3-5 days before the scheduled ablation.
Detected 3 cases of left atrial appendage thrombus (3/943, 0.3%), all among patients on Warfarin with persistent AF.
No cases of thrombus were found in patients with paroxysmal AF or those on non-vitamin K antagonist oral anticoagulants.
The prevalence is significantly lower than the previously reported 4.4%.

Structured PICO

What is the prevalence of left atrial appendage thrombus detected by routine transoesophageal echocardiography before atrial fibrillation ablation in patients on oral anticoagulation?

Population

668 consecutive patients (undergoing 943 AF ablation procedures) scheduled for atrial fibrillation (AF) ablation, on oral anticoagulation for at least 4 weeks prior to TOE. Mean age 64 ± 11 years, 72% male, average CHADS2 score 1.0 ± 1.0, 72% paroxysmal AF.

Intervention

Transoesophageal echocardiography (TOE) performed 3-5 days prior to scheduled AF ablation

Outcome

Prevalence of left atrial appendage thrombus (LAAT) on TOEsurrogate

The prevalence of left atrial appendage thrombus in anticoagulated patients undergoing TOE before AF ablation is extremely low (0.3%), suggesting a risk-based approach may be preferable to routine TOE screening.

Cite This Study

Alqarawi et al. (2018) studied this question.

synapsesocial.com/papers/6a21345ec4e60624665acbd1 https://doi.org/10.1093/europace/euy129

Topics

Left atrial appendage closure Atrial fibrillation Persistent AF management Anticoagulation in AF AF ablation outcomes

View Full Paper

Ask AI

Bookmark

Implication

Low LAAT prevalence supports selective over routine pre-ablation TOE in anticoagulated patients; leaves open prospective validation of risk-based strategies.

Prevalence of left atrial appendage thrombus detected by transoesophageal echocardiography before catheter ablation of atrial fibrillation in patients anticoagulated with non-vitamin K antagonist oral anticoagulants

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Prevalence of left atrial appendage thrombus detected by transoesophageal echocardiography before catheter ablation of atrial fibrillation in patients anticoagulated with non-vitamin K antagonist oral anticoagulants

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider