Key result
Cardioversion without routine TEE shows similar 30-day thromboembolism risk vs TEE-guided cardioversion.
Why the study?
Does routine transesophageal echocardiography prior to elective electrical cardioversion reduce thromboembolic events (ischemic stroke or systemic embolism) within 30 days in patients with atrial fibrillation or atrial flutter receiving at least 3 weeks of anticoagulation?
Observational (n=420)
Does routine transesophageal echocardiography prior to elective electrical cardioversion reduce thromboembolic events (ischemic stroke or systemic embolism) within 30 days in patients with atrial fibrillation or atrial flutter receiving at least 3 weeks of anticoagulation?
Answers are grounded in this paper and cite their sources.
In patients with atrial fibrillation or flutter anticoagulated for at least 3 weeks, 30-day thromboembolic risk after elective electrical cardioversion is low without routine TEE, although TEE detected left atrial appendage thrombus in 14% of the prospective cohort.
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Petretić et al. (2026) conducted an observational in Atrial fibrillation or atrial flutter (n=420). Routine transesophageal echocardiography (TEE) prior to elective electrical cardioversion vs. Elective electrical cardioversion without routine transesophageal echocardiography was evaluated on Thromboembolic events (ischemic stroke or systemic embolism) within 30 days after elective electrical cardioversion (RR 5.22, 95% CI 0.27-100.41, p=0.264). Elective electrical cardioversion without routine TEE had a similar 30-day thromboembolic rate compared to TEE-guided cardioversion.
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