title: Conventional oral anticoagulation may not replace prior transesophageal echocardiography for the patients with planned catheter ablation for atrial fibrillation.
abstract: BACKGROUND
  Preablation transesophageal echocardiography (TEE) is dispensable for the patients with planned catheter ablation for atrial fibrillation (AF) and having received at least a 3-week oral anticoagulation therapy according to the recommendations of the Venice Consensus. But the role of prior TEE and the effect of preablation short-term oral anticoagulation drugs (OACs) under the circumstance are still unclear.
  
  
  RESULTS
  A total of 188 patients with planned catheter ablation for AF and without previous long-term oral anticoagulation, whose duration of AF exceeded 48 h, were randomly divided into receiving 3-week OACs (OACs group) before heparin bridging or receiving no prior OACs (N-OACs group). Follow-up was performed until a TEE had been performed on all the cases before ablation. Consequently, the prevalence of atrial thrombi is 6.3% and 11.7%, respectively (P < 0.05), and the prevalence of minor bleeding is 5.3% and 0%, respectively (P < 0.05), in OACs and N-OACs group. There was no thrombotic event, major hemorrhage, in both groups.
  
  
  CONCLUSIONS
  After a 3-week effective oral anticoagulation, atrial thrombi could be resolved partly but not completely in the patients with AF who had not received long-term oral anticoagulation previously. To ensure safety, prior TEE may be necessary for the patients with planned catheter ablation for AF.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Anzhen Li, Chaoyang District, Beijing 100029, People's Republic of China. hehua430@163.com
authors.forename: Hua
authors.initials: H
authors.lastname: He
authors.forename: Junping
authors.initials: J
authors.lastname: Kang
authors.forename: Hailong
authors.initials: H
authors.lastname: Tao
authors.forename: Bin
authors.initials: B
authors.lastname: Zhen
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
authors.forename: Deyong
authors.initials: D
authors.lastname: Long
authors.forename: Jianzeng
authors.initials: J
authors.lastname: Dong
mesh_terms: D000284:Administration, Oral; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D017548:Echocardiography, Transesophageal / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011292:Premedication / Q000706:statistics & numerical data*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control*; D016896:Treatment Outcome