Key result
Pre-cardioversion TOE offers limited benefit in well-anticoagulated patients but remains essential for high-risk or early cases.
Why the study?
The role and appropriate use of transoesophageal echocardiography before cardioversion in atrial fibrillation patients with adequate anticoagulation remains uncertain and variable across institutions.
What is the appropriate role of transoesophageal echocardiography before cardioversion in patients with atrial fibrillation?
Population
Patients with atrial fibrillation undergoing cardioversion
Comparison
TOE-guided cardioversion strategy vs routine TOE before cardioversion
Design
Review article
Authors
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Supports anticoagulation as standard peri-cardioversion care; reinforces guideline-directed stroke prevention in symptomatic AF.
What is the appropriate role of transoesophageal echocardiography before cardioversion in patients with atrial fibrillation?
Routine TOE before cardioversion is not justified in patients with adequate and uninterrupted anticoagulation, and should be reserved for those with uncertain anticoagulation status, high thromboembolic risk, or when early cardioversion is needed.
Roberto Cemin (2026) conducted a review in Atrial fibrillation. Transoesophageal echocardiography (TOE) vs. Routine cardioversion without TOE was evaluated. Transoesophageal echocardiography before cardioversion provides limited benefit in well-anticoagulated patients but remains valuable when anticoagulation is inadequate or early cardioversion is needed.
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