Prevalence of Left Atrial Thrombus Detection by Transesophageal Echocardiography: A Comparison of Continuous Non-Vitamin K Antagonist Oral Anticoagulant Versus Warfarin Therapy in Patients Undergoing Catheter Ablation for Atrial Fibrillation.

JACC. Clinical Electrophysiology
Daniel FrenkelJim W Cheung

Abstract

The purpose of this study is to determine whether patients on ≥4 weeks of continuous non-vitamin K antagonist oral anticoagulant (NOAC) therapy require transesophageal echocardiography (TEE) before catheter ablation of atrial fibrillation (AF) or atrial flutter and to compare rates of left atrial (LA) thrombus and dense spontaneous echocardiographic contrast (SEC) in patients on NOAC versus warfarin therapy. The impact of NOAC therapy on the rates of LA thrombus detection by TEE in patients undergoing catheter ablation of AF is unknown. Initial TEEs for 388 patients (median age, 65 years; 74% male) on ≥4 weeks of continuous NOAC (n = 183) or warfarin therapy (n = 205) undergoing catheter ablation of AF and flutter were reviewed. After ≥4 weeks of therapy, the prevalence of LA thrombus and LA thrombus/dense SEC among patients on NOACs was 4.4% and 6.0%, respectively, which was comparable with that of patients on warfarin. LA thrombus rates among patients on dabigatran, rivaroxaban, and apixaban were 5.4%, 4.8%, and 0%, respectively (p = 0.46). Predictors of LA thrombus were congestive heart failure (odds ratio [OR]: 5.38; 95% confidence interval [CI]: 1.79 to 16.2; p = 0.003); and persistent AF (OR: 3.27; 95% CI: 1.06 to 10.2; p...Continue Reading

References

Aug 1, 2007·Journal of Thrombosis and Haemostasis : JTH·J Ansell
Nov 20, 2008·Journal of Cardiovascular Electrophysiology·Daniel ScherrJoseph E Marine
Mar 23, 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·James W McCreadyAnthony W Chow
May 11, 2010·Circulation Journal : Official Journal of the Japanese Circulation Society·Eiji YamashitaShigeru Oshima
Dec 28, 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·N CalvoM Sitges
May 31, 2012·Journal of Thrombosis and Thrombolysis·Alejandro Vidal, Gabriel Vanerio
Jan 26, 2013·Thrombosis and Haemostasis·Christoph HammerstinglGeorg Nickenig
Mar 19, 2013·Journal of the American College of Cardiology·Jonathan P PicciniUNKNOWN ROCKET AF Steering Committee & Investigators
Jun 26, 2014·BMJ Case Reports·Shintaro DobashiTakanori Ikeda

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Citations

Aug 6, 2018·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Michael S WuJim W Cheung
Sep 14, 2018·Current Cardiology Reports·Rocco J Cannistraro, James F Meschia
Sep 20, 2019·Heart·Sina Jame, Geoffrey Barnes
Jul 31, 2019·Journal of Cardiovascular Medicine·Alberto CrestiAnna C Maltagliati
Feb 10, 2017·Circulation Journal : Official Journal of the Japanese Circulation Society·Mihoko KawabataKenzo Hirao
Aug 14, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Masahide HaradaYukio Ozaki
Oct 10, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Hideharu Okamatsu, Ken Okumura
Mar 2, 2019·World Journal of Cardiology·Hoyle L WhitesideGyanendra K Sharma
Nov 28, 2020·Frontiers in Cardiovascular Medicine·Ziliang SongXu Liu
May 17, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Meng ZhangAijun Ma

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