Role of the CHADS2 score in the evaluation of thromboembolic risk in patients with atrial fibrillation undergoing transesophageal echocardiography before pulmonary vein isolation

Journal of the American College of Cardiology
Sarinya PuwanantAllan L Klein

Abstract

The goals of this study were to determine: 1) if low-risk patients assessed by a CHADS(2) score, a clinical scoring system quantifying a risk of stroke in patients with atrial fibrillation (AF), require a routine screening transesophageal echocardiogram (TEE) before pulmonary vein isolation (PVI); and 2) the relationship of a CHADS(2) score with left atrial (LA)/left atrial appendage (LAA) spontaneous echo contrast, sludge, and thrombus. There is no clear consensus of whether a screening TEE before catheter ablation of AF should be performed in every patient. Initial TEEs for pre-PVI of 1,058 AF patients (age 57 +/- 11 years, 80% men) were reviewed and compared with a CHADS(2) score. CHADS(2) scores of 0, 1, 2, 3, 4, 5, and 6 were present in 47%, 33%, 14%, 5%, 1%, 0.3%, and 0% of patients, respectively. The prevalence of LA/LAA thrombus, sludge, and spontaneous echo contrast were present in 0.6%, 1.5%, and 35%. The prevalence of LA/LAA thrombus/sludge increased with ascending CHADS(2) score (scores 0 [0%], 1 [2%], 2 [5%], 3 [9%], and 4 to 6 [11%], p < 0.01). No patient with a CHADS(2) score of 0 had LA/LAA sludge/thrombus. In a multivariate model, history of congestive heart failure and left ventricular ejection fraction <35% w...Continue Reading

References

Jan 1, 1986·Journal of the American College of Cardiology·W AschenbergW Bleifeld
May 11, 2001·The New England Journal of Medicine·A L KleinUNKNOWN Assessment of Cardioversion Using Transesophageal Echocardiography Investigators
Jun 13, 2001·JAMA : the Journal of the American Medical Association·B F GageM J Radford
Apr 8, 2003·American Heart Journal·Marcus F StoddardRita A Longaker
Aug 14, 2003·Pacing and Clinical Electrophysiology : PACE·Niranjan SeshadriAndrea Natale
Feb 3, 2004·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·M E Josephson
Mar 17, 2004·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·J S Gill
Jan 10, 2006·The American Journal of Cardiology·Carlo Pappone, Vincenzo Santinelli
May 13, 2006·Current Problems in Cardiology·Michael J Riley, Nassir F Marrouche
Jul 5, 2006·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Mohamed H KanjAndrea Natale
Nov 23, 2006·Journal of the American College of Cardiology·Oussama M WazniAllan L Klein
Feb 17, 2007·Pacing and Clinical Electrophysiology : PACE·Jean ChampagneGilles O'hara
Mar 6, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Mohamed KanjAndrea Natale
Jun 15, 2007·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Valerie J RaderMichael L Main
Nov 5, 2008·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·Ruvin S Gabriel, Allan L Klein

❮ Previous
Next ❯

Citations

May 5, 2011·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·T DinhUNKNOWN TIARA pilot study group
Jul 27, 2012·European Heart Journal Cardiovascular Imaging·Anita C BoydLiza Thomas
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
Jun 10, 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·Freek W A VerheugtRobert K Riezebos
Aug 19, 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·Lorne J GulaAllan C Skanes
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
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
Feb 24, 2011·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·J Christoph Geller, Michele Brunelli
Aug 27, 2011·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·Rui ProvidênciaAntónio Leitão-Marques
Mar 6, 2012·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·Hugh CalkinsDavid Wilber
Jun 5, 2013·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·Carina Blomström LundqvistUNKNOWN European Society of Cardiac Radiology
Sep 15, 2011·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·H J HongJ H Heo
Oct 7, 2011·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·M-J ChaJ H Heo
Feb 25, 2014·Herzschrittmachertherapie & Elektrophysiologie·Matthias AntzWolfgang Vocke
Aug 13, 2014·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Bum Joon KimSun U Kwon
Dec 14, 2011·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·B Oude VelthuisM F Scholten
Aug 31, 2014·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·Bernhard MeierUNKNOWN Document Reviewers
Dec 3, 2014·Cardiology Clinics·Faisal F SyedSamuel J Asirvatham
Jan 13, 2011·Current Cardiology Reports·Cindy J Fuller, Mark Reisman
Nov 28, 2013·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Jae-Hyung ChoiJae-Taeck Huh
Oct 1, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Irfan M KhurramHugh Calkins
Aug 13, 2013·Cardiology Clinics·Creighton W DonMark Reisman
Jul 10, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·T Jared BunchJohn D Day
Jun 25, 2013·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Rui ProvidênciaSérgio Barra
Dec 21, 2012·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Fausto BiancariOlli-Pekka Kangasniemi
Dec 21, 2012·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Howard J WillensMauro Moscucci
Sep 1, 2012·Cardiac Electrophysiology Clinics·Antonio RossilloSakis Themistoclakis
Sep 1, 2012·Cardiac Electrophysiology Clinics·Tara BourkeKalyanam Shivkumar
Jun 30, 2012·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Hirad YarmohammadiAllan L Klein
Jul 4, 2012·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Sakima A SmithDavid A Orsinelli
Jul 5, 2011·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Andrew C Y ToAllan L Klein
Mar 29, 2011·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Srilatha AyiralaDavid I Silverman
Sep 3, 2010·Journal of the Neurological Sciences·Nadzeya Kuzniatsova, Gregory Y H Lip
Mar 13, 2016·Heart Failure Clinics·Faisal F SyedSamuel J Asirvatham
Oct 12, 2011·Journal of Cardiovascular Electrophysiology·Peter R Kowey
Nov 8, 2012·Journal of Cardiovascular Electrophysiology·J David BurkhardtAndrea Natale
Oct 17, 2012·Journal of Cardiovascular Electrophysiology·Mariana FloriaErwin Schroeder
Feb 27, 2013·Journal of Cardiovascular Electrophysiology·Mariana FloriaErwin Schroeder

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.