| Role of echocardiography in patients undergoing elective cardioversion of atrial fibrillation. | |
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MedLine Citation:
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PMID: 9714099 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Echocardiography has emerged as a fundamental tool in the evaluation of patients with atrial fibrillation (AF). Transthoracic echocardiography remains a primary tool for the evaluation and management of many patients presenting with their first episode of AF, but it is not adequate for exclusion of atrial thrombi. TEE offers excellent visualization of the atria and accurate identification or exclusion of thrombi. In concert with therapeutic anticoagulation, a TEE-guided approach to early cardioversion appears to have a safety profile similar to that of conventional therapy (1 month of precardioversion warfarin). The TEE-guided approach offers the advantages of simplified anticoagulation management and shorter duration of sustained AF, thereby allowing for a more rapid recovery of atrial mechanical function. Warfarin should be continued for 1 month after cardioversion to allow for more complete recovery of atrial function and for prophylaxis should the patient revert to AF. Cost-effectiveness models demonstrate that TEE-guided cardioversion represents a cost-effective strategy, but only if the transthoracic echocardiogram is omitted. For patients with a thrombus on the initial TEE, follow-up TEE (to document thrombus resolution) is recommended before cardioversion. |
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Authors:
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D I Silverman; W J Manning |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review |
Journal Detail:
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Title: Circulation Volume: 98 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1998 Aug |
Date Detail:
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Created Date: 1998-09-08 Completed Date: 1998-09-08 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 479-86 Citation Subset: AIM; IM |
Affiliation:
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Cardiology Division, John Dempsey Hospital and University of Connecticut Health Center, Farmington, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anticoagulants
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therapeutic use Atrial Fibrillation / therapy*, ultrasonography* Echocardiography* / methods Electric Countershock* Humans Risk Factors Time Factors Ultrasonography, Interventional / methods Warfarin / therapeutic use |
| Grant Support | |
ID/Acronym/Agency:
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M01-RR-06192/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 81-81-2/Warfarin |
| Comments/Corrections | |
Comment In:
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Circulation. 1999 Feb 23;99(7):977
[PMID:
10028014
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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