title: [Echocardiographic indicators of electric cardioversion in patients with atrial fibrillation].
abstract: We studied 80 patients to evaluate the safety of the transesophageal echocardiography (TEE) as a guidance to identify spontaneous echo contrast or atrial thrombosis in patients with atrial fibrillation (AF). 34 out of these patients were men and 46 women, with a mean age of 61 +/- 12 years. Five were not candidates due to the presence of risk factors. 75 patients have undergone electric cardioversion. The duration of AF was < 2 weeks in 61 > or = 2 and < 6 weeks 13, and > or = 6 weeks and < 1 year 6; 24 patients received previous anticoagulant therapy. The echocardiographic findings revealed left atrial dimension 45 +/- 8.4 mm ejection fraction of left ventricle 61 +/- 7.5%, SEC absent in the left atrium of 35, mild in 40 and severe in 5 patients, flow in left atrial appendage in 78 patients, thrombi in 2. EC was performed with 200 Joules in all patients and it was successful in 74. The study lasted 8.7 +/- 5.7 months; 11 patients were recurrent. The predictors were: left atrial dimension > 50 mm (p > 0.05), > 2 EC performed (p = 0.02), > 200 Joules (p = 0.05) and in patients with AF < or = 2 weeks. We concluded that the TEE is beneficial to detect risk factors in patients with AF, and it helps when deciding to perform the EC early and safely without previous anticoagulation.
authors.affiliation: Servicio de Urgencias, Hospital de Cardiología, CMN Siglo XXI, IMSS, México D.F.
authors.forename: J S
authors.initials: JS
authors.lastname: Valencia Sánchez
authors.forename: R
authors.initials: R
authors.lastname: Arriaga Nava
authors.forename: J R
authors.initials: JR
authors.lastname: Navarro Robles
authors.forename: A
authors.initials: A
authors.lastname: Martínez Enríquez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000628:therapy*; D017548:Echocardiography, Transesophageal; D004554:Electric Countershock; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged