[The value of transesophageal echocardiography for determination of tactics of cardioversion of atrial fibrillation].
Transesophageal echocardiography was carried out in 110 patients before cardioversion of nonvalvular atrial fibrillation which duration exceeded 2 days. Twenty thrombi were found in 18 patients (16.4%). Anticoagulant phenindione was given to these patients for 3 weeks. Patients without thrombus received intravenously amiodarone followed with procainamide. Sinus rhythm was restored in 39.3% of these cases. In 5.5% of patients atrial fibrillation terminated spontaneously. Control transesophageal echocardiography showed that after 3 weeks there remained 11 atrial thrombi but all of them lost motility. Electrical cardioversion was successful in 90.7% of patients receiving short term and in 80% of patients receiving 3-week anticoagulant therapy (p>0.05). All patients received phenindione for 4 weeks after cardioversion. There were no thromboembolic or hemorrhagic complications. Ability of transesophageal echocardiography to detect atrial thrombi allows to carry out early cardioversion and to identify patients with high risk of embolism.
Kanorskiĭ
S G
SG
Zingilevskiĭ
K B
KB
Mironenko
M Yu
MY
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000628:therapy*; D017548:Echocardiography, Transesophageal / Q000295:instrumentation*; D004554:Electric Countershock / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index