Document Detail

Usefulness of transesophageal echocardiography using a combined probe when converting atrial fibrillation to sinus rhythm.
MedLine Citation:
PMID:  15325931     Owner:  NLM     Status:  MEDLINE    
We studied the feasibility and efficacy of transesophageal echocardiography (TEE) combined with transesophageal cardioversion (TEC). Secondary aims were to study left atrial flow velocities before and 1 and 5 minutes after TEC, biochemical markers of myocardial damage, and patient tolerability. TEC after a short period of anticoagulation and exclusion of a clot with TEE was safe. TEC was well tolerated and efficacious. The use of a combined probe for TEE and TEC therefore can save time and be more effective. A custom-made probe for combined TEE plus TEC was used. TEC was performed with a step-up protocol (20 J to between 30 and 50 J) and with biphasic shocks. Presence of spontaneous echo contrast was scored. Cumulative energy needed to achieve sinus rhythm was calculated. Discomfort was scored on a scale of 0 to 10. Twenty-six patients underwent combined TEE/TEC. Sinus rhythm was achieved in 24 of 26 patients (92%) with a mean cumulative energy of 42.3 J. Sixteen of 26 patients were cardioverted with a 20-J shock, and 6 of these patients had early recurrence of atrial fibrillation. All biochemical markers were unaffected, and TEE/TEC was well tolerated. Left atrial appendage velocity decreased significantly after TEC. Thus, the use of a TEE/TEC probe offers effective cardioversion with low energy levels, is well tolerated, and hemodynamics during and immediately after cardioversion can be monitored. Early cardioversion after exclusion of a clot with this combined probe is time saving and cost effective.
Marcoen F Scholten; Andrew S Thornton; Luc J Jordaens; Jos R Roelandt; Richard E Kerber; Itzhak Kronzon
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  94     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-24     Completed Date:  2004-09-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  470-3     Citation Subset:  AIM; IM    
Clinical Electrophysiology Unit, Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
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MeSH Terms
Aged, 80 and over
Atrial Appendage / ultrasonography
Atrial Fibrillation / therapy*,  ultrasonography
Blood Flow Velocity / physiology
Echocardiography, Transesophageal / instrumentation*
Electric Countershock / instrumentation*
Feasibility Studies
Heart Atria / ultrasonography
Middle Aged
Patient Acceptance of Health Care
Thrombosis / ultrasonography
Treatment Outcome

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