A comparison of intracardiac and transesophageal echocardiography to detect left atrial appendage thrombus in a swine model.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
Mathew D HutchinsonDavid J Callans

Abstract

Transesophageal echocardiography (TEE) is the gold standard in the evaluation for left atrial appendage (LAA) thrombus in patients with atrial fibrillation (AF) and is often performed prior to AF ablation. We routinely use intracardiac echocardiography (ICE) to assist in AF ablation; however, standard right atrial views do not provide adequate visualization of the LAA. As the incidence of thrombus in this population is relatively low, TEE incurs additional risk, cost, and patient discomfort. Novel views of the LAA with ICE may obviate the need for TEE in this population. We tested the hypothesis that due to their proximity, imaging the LAA from the pulmonary artery (PA) would provide equivalent sensitivity and specificity to TEE in detecting LAA thrombus in a swine model. Five domestic swine were utilized. Baseline images of the LAA with TEE were obtained. An 8Fr ICE catheter was placed in the left main PA, and imaging of the LAA was repeated. After transseptal puncture, an admixture of 2 cm(3) blood and 1,000 IU of thrombin was injected into the LAA, and imaging of the LAA was repeated. Two blinded, independent reviewers experienced in ICE assessed the images and adjudicated both the presence of thrombus and the subjective ima...Continue Reading

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Citations

Oct 1, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Sebastian StecPiotr Kułakowski
Oct 13, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Jose L Merino
Jun 26, 2013·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Geng-Hua YiJuan F Granada
Jul 8, 2010·Current Cardiology Reports·Melissa R Robinson, Mathew D Hutchinson
Jan 1, 2012·Journal of Medical Ultrasonics·Kazuko YoshimotoAtsushi Ueki
May 7, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Mike SajiD Scott Lim
Jul 19, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Elad AnterWarren J Manning
Aug 5, 2015·Progress in Cardiovascular Diseases·Tomos E WaltersJonathan M Kalman
Dec 16, 2010·Circulation. Arrhythmia and Electrophysiology·Mathew D Hutchinson, David J Callans
Jul 27, 2020·JACC. Clinical Electrophysiology·Diego PenelaAntonio Berruezo
May 16, 2021·Cardiac Electrophysiology Clinics·Nicholas PalmeriEduardo B Saad

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