| Transesophageal echocardiography (TEE) in atrial fibrillation. | |
| | |
MedLine Citation:
|
PMID: 11236168 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Transesophageal echocardiography has given new insight into the pathogenesis of the thromboembolic sequelae of AF and expanded the available therapeutic options. Studies to date indicate that TEE-guided cardioversion is a safe and reasonable approach when the clinical situation warrants prompt restoration of sinus rhythm. Whether widespread use of this strategy offers further benefit remains to be established, although there are theoretical advantages to such an approach. The potential for earlier cardioversion using a TEE-guided approach may facilitate the achievement and maintenance of sinus rhythm. In the long term, earlier restoration of sinus rhythm prevents adverse atrial remodeling, lowers embolic risk, and may improve cardiac performance and functional status. Thromboembolic sequelae (either cardioversion-related or as a result of chronic AF) remain the most devastating complications of AF. Every attempt to minimize this risk should be pursued aggressively. Information gathered from TEE has helped to elucidate the mechanisms responsible for postcardioversion embolism and has emphasized the importance of anticoagulation during and after the restoration of sinus rhythm. TEE also has the potential to further risk stratify patients with AF. Ultimately, a subset of patients may be identified who require more intense anticoagulation (i.e., those with dense SEC or thrombus, or persistent thrombus after prolonged anticoagulation) or in whom cardioversion may be deferred entirely. Likewise, TEE also may prove to be useful in identifying patients with a low-clinical risk profile who may be treated with aspirin alone and patients in whom warfarin may be superior. The results of the ACUTE study should help to further define the role of TEE in the management of patients with AF. Additional clinical studies are needed to address some of the issues that have been raised and to allow for optimal use of TEE in this patient population. |
| | |
Authors:
|
M Thamilarasan; A L Klein |
Related Documents
:
|
20491018 - Baseline characteristics of patients from poland enrolled in the global registry of pat... 2591988 - A comparative prospective study of self-poisoned patients in trondheim, norway between ... 17765618 - Vagal responses induced by endocardial left atrial autonomic ganglion stimulation befor... 6269038 - Oral contraceptives and postmolar trophoblastic disease. 9531408 - A comparison of patients with different types of syndactyly. 11353938 - Which patients with chronic reflex sympathetic dystrophy are most likely to benefit fro... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Cardiology clinics Volume: 18 ISSN: 0733-8651 ISO Abbreviation: Cardiol Clin Publication Date: 2000 Nov |
Date Detail:
|
Created Date: 2001-03-09 Completed Date: 2001-05-17 Revised Date: 2005-11-16 |
Medline Journal Info:
|
Nlm Unique ID: 8300331 Medline TA: Cardiol Clin Country: United States |
Other Details:
|
Languages: eng Pagination: 819-31 Citation Subset: IM |
Affiliation:
|
Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Atrial Fibrillation
/
therapy*,
ultrasonography* Echocardiography, Transesophageal* Electric Countershock* / adverse effects Heart Atria / ultrasonography Humans Myocardial Stunning / etiology Risk Assessment |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Aortic dissection.
Next Document: Transesophageal echocardiography (TEE) in the evaluation of the coronary arteries.