Abstract
Background Preprocedural transesophageal echocardiography (TEE) is used to reduce the stroke during atrial fibrillation (AF) ablation. This study evaluated whether routine preprocedural TEE in addition to multidetector computed tomography (MDCT) is necessary to prevent periprocedural stroke in AF ablation. Methods Each patient underwent MDCT and TEE (group 1, n = 247) or MDCT alone (group 2, n = 103) for the initial evaluation before AF ablation. In group 2, TEE was performed only in patients who had left atrial (LA) thrombus or blood stasis in MDCT. Results There was no difference in sex, CHADS2 score, or LA dimension between the two groups. In group 1, a thrombus was detected in 12 (5%) and 6 (2%) patients by the MDCT and TEE, respectively. All (100%) patients, who were revealed to have thrombus in TEE, also had a thrombus in MDCT. In group 2, 3 (3%) patients exhibited LA thrombus in MDCT, among whom thrombus was observed in only one patient (1%) in TEE. AF ablation was not performed in patients with thrombus. While one patient had a periprocedural stroke in group 1, no patient had in group 2 (P = 0.52). Conclusion The overall periprocedural stroke rate was low (0.3%) in AF patients on anticoagulation therapy. The preprocedural MDCT detected all patients with the LA thrombus. In AF patients with low CHADS2 score, optimal anticoagulation and relatively preserved left ventricular ejection fraction, routine preprocedural TEE in addition to the MDCT might not be necessary to decrease the periprocedural stroke rate.
| Original language | English |
|---|---|
| Pages (from-to) | 1992-1996 |
| Number of pages | 5 |
| Journal | International Journal of Cardiology |
| Volume | 168 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2013 Oct 3 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Routine preprocedural transesophageal echocardiography might not be necessary for stroke prevention evaluation in AF patients on anticoagulation therapy. / Han, Jae Hyun; Shin, Dong Ho; Lee, Hye Jeong; Kim, Young Jin; Lee, Seung Hyun; Shim, Jaemin; Uhm, Jae Sun; Kim, Jong Youn; Chang, Hyuk Jae; Pak, Hui Nam; Lee, Moon Hyoung; Joung, Boyoung.
In: International Journal of Cardiology, Vol. 168, No. 3, 03.10.2013, p. 1992-1996.Research output: Contribution to journal › Article
TY - JOUR
T1 - Routine preprocedural transesophageal echocardiography might not be necessary for stroke prevention evaluation in AF patients on anticoagulation therapy
AU - Han, Jae Hyun
AU - Shin, Dong Ho
AU - Lee, Hye Jeong
AU - Kim, Young Jin
AU - Lee, Seung Hyun
AU - Shim, Jaemin
AU - Uhm, Jae Sun
AU - Kim, Jong Youn
AU - Chang, Hyuk Jae
AU - Pak, Hui Nam
AU - Lee, Moon Hyoung
AU - Joung, Boyoung
PY - 2013/10/3
Y1 - 2013/10/3
N2 - Background Preprocedural transesophageal echocardiography (TEE) is used to reduce the stroke during atrial fibrillation (AF) ablation. This study evaluated whether routine preprocedural TEE in addition to multidetector computed tomography (MDCT) is necessary to prevent periprocedural stroke in AF ablation. Methods Each patient underwent MDCT and TEE (group 1, n = 247) or MDCT alone (group 2, n = 103) for the initial evaluation before AF ablation. In group 2, TEE was performed only in patients who had left atrial (LA) thrombus or blood stasis in MDCT. Results There was no difference in sex, CHADS2 score, or LA dimension between the two groups. In group 1, a thrombus was detected in 12 (5%) and 6 (2%) patients by the MDCT and TEE, respectively. All (100%) patients, who were revealed to have thrombus in TEE, also had a thrombus in MDCT. In group 2, 3 (3%) patients exhibited LA thrombus in MDCT, among whom thrombus was observed in only one patient (1%) in TEE. AF ablation was not performed in patients with thrombus. While one patient had a periprocedural stroke in group 1, no patient had in group 2 (P = 0.52). Conclusion The overall periprocedural stroke rate was low (0.3%) in AF patients on anticoagulation therapy. The preprocedural MDCT detected all patients with the LA thrombus. In AF patients with low CHADS2 score, optimal anticoagulation and relatively preserved left ventricular ejection fraction, routine preprocedural TEE in addition to the MDCT might not be necessary to decrease the periprocedural stroke rate.
AB - Background Preprocedural transesophageal echocardiography (TEE) is used to reduce the stroke during atrial fibrillation (AF) ablation. This study evaluated whether routine preprocedural TEE in addition to multidetector computed tomography (MDCT) is necessary to prevent periprocedural stroke in AF ablation. Methods Each patient underwent MDCT and TEE (group 1, n = 247) or MDCT alone (group 2, n = 103) for the initial evaluation before AF ablation. In group 2, TEE was performed only in patients who had left atrial (LA) thrombus or blood stasis in MDCT. Results There was no difference in sex, CHADS2 score, or LA dimension between the two groups. In group 1, a thrombus was detected in 12 (5%) and 6 (2%) patients by the MDCT and TEE, respectively. All (100%) patients, who were revealed to have thrombus in TEE, also had a thrombus in MDCT. In group 2, 3 (3%) patients exhibited LA thrombus in MDCT, among whom thrombus was observed in only one patient (1%) in TEE. AF ablation was not performed in patients with thrombus. While one patient had a periprocedural stroke in group 1, no patient had in group 2 (P = 0.52). Conclusion The overall periprocedural stroke rate was low (0.3%) in AF patients on anticoagulation therapy. The preprocedural MDCT detected all patients with the LA thrombus. In AF patients with low CHADS2 score, optimal anticoagulation and relatively preserved left ventricular ejection fraction, routine preprocedural TEE in addition to the MDCT might not be necessary to decrease the periprocedural stroke rate.
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U2 - 10.1016/j.ijcard.2012.12.096
DO - 10.1016/j.ijcard.2012.12.096
M3 - Article
C2 - 23352487
AN - SCOPUS:84885648678
VL - 168
SP - 1992
EP - 1996
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 3
ER -