title: Lower patent foramen ovale detection with transthoracic echocardiography in atrial fibrillation.
abstract: BACKGROUND
  Patent foramina ovale (PFO) are small defects within the atrial septum that may play a role in paradoxical embolism, stroke and migraines. The relationship between PFO and atrial fibrillation (AF) has not been formally studied. We prospectively studied patients with a history of AF, versus those without (controls), in order to compare PFO prevalence among them.
  
  
  METHODS
  Sixty-one patients with AF and forty-one controls completed the study, all undergoing transthoracic echocardiography using agitated saline microbubbles and a Valsalva maneuver.
  
  
  RESULTS
  In the control group, 12/41 participants (29.2%) had PFOs compared to 5/61 (8.2%) in the AF group (P < 0.01). PFO positive patients within the entire study population demonstrated greater leftward inter-atrial septal shifting (82% vs 49%, P < 0.05). There was also reduced leftward inter-atrial septal shift observed within the AF group compared to controls (32/61 (52%) vs 31/41 (76%), P < 0.05).
  
  
  CONCLUSIONS
  This study is the first to demonstrate an apparent lower rate of PFO in patients with AF, using bubble contrast echocardiography.
authors.affiliation: Sarver Heart Center, University of Arizona Affiliated Hospitals, Tucson, AZ, USA.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Attaran
authors.forename: Gary
authors.initials: G
authors.lastname: Baweja
authors.forename: Laura
authors.initials: L
authors.lastname: Foster
authors.forename: Sam
authors.initials: S
authors.lastname: Butman
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Sorrell
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004452:Echocardiography; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014636:Valsalva Maneuver