title: Transesophageal echocardiographic evaluation for mural thrombus following radiofrequency catheter ablation of accessory pathways.
abstract: BACKGROUND
  Catheter ablation of accessory pathways (APs) provides a definitive therapy for patients with Wolff-Parkinson-White Syndrome. The reported incidence of thrombus formation on ablation-induced injuries with direct current shock varies from 0%-20% in animal studies. The purpose of this study was to determine the prevalence of mural thrombus following catheter ablation with radiofrequency current of accessory pathways in humans.
  
  
  RESULTS
  Radiofrequency current (30-35 watts) was applied through a catheter electrode placed against the mitral or tricuspid annulus guided by catheter recordings of AP potentials. Transthoracic (TTE) and transesophageal echocardiography (TEE) were performed in 95 of 111 patients, at 18 +/- 6 hours following catheter ablation. After ablation, no thrombus was identified at or near the ablation site in any patient. Two out of 95 patients had a mural thrombus at a remote site that was detected by TEE but not by TTE. No new wall motion abnormality was detected in any patient. No significant regurgitant valvular lesion was found in any patient.
  
  
  CONCLUSIONS
  Intracardiac thrombus was not identified at the site of catheter ablation, possibly owing to the small lesions produced by radiofrequency energy and high blood flow normally present in those areas. However, patients may be at small risk for mural thrombus at a remote site from prolonged placement of catheters.
authors.affiliation: Cardiovascular Section, University of Oklahoma and Health Science Center, Oklahoma City.
authors.forename: V D
authors.initials: VD
authors.lastname: Goli
authors.forename: R
authors.initials: R
authors.lastname: Prasad
authors.forename: K
authors.initials: K
authors.lastname: Hamilton
authors.forename: K P
authors.initials: KP
authors.lastname: Moulton
authors.forename: M
authors.initials: M
authors.lastname: Tyler
authors.forename: P
authors.initials: P
authors.lastname: Logan
authors.forename: R
authors.initials: R
authors.lastname: Lazzara
authors.forename: W M
authors.initials: WM
authors.lastname: Jackman
mesh_terms: D000328:Adult; D004452:Echocardiography / Q000379:methods*; D004564:Electrocoagulation / Q000009:adverse effects*; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015995:Prevalence; D011446:Prospective Studies; D011846:Radio Waves; D012307:Risk Factors; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D014927:Wolff-Parkinson-White Syndrome / Q000601:surgery*