Transesophageal echocardiography and cardioversion trends in patients with atrial fibrillation: A 10-year survey

Hirad Yarmohammadi, Tristan Klosterman, Gaganpreet Grewal, M. Chadi Alraies, Bruce D. Lindsay, Mandeep Bhargava, W. H Wilson Tang, Allan L. Klein

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Transesophageal echocardiography (TEE) has long been used to assess for left atrial thrombus (LAT) in patients undergoing direct-current cardioversion (DCC) for atrial fibrillation or flutter. However, little is known about its recent trends and current applications. Methods: In this retrospective study, 3,191 serial transesophageal echocardiographic studies in 2,705 unique patients (mean age, 66 ± 13 years; 68% men) with atrial fibrillation or atrial flutter who underwent TEE before DCC from 1999 to 2008 were identified using the Cleveland Clinic echocardiography database. Clinical data and information on the presence of spontaneous echocardiographic contrast, sludge, or LAT before DCC were obtained as well as the total number of transesophageal echocardiographic studies and DCC procedures performed in outpatient or inpatient settings. Results: Increasing trends of TEE-guided DCC were observed over the past 10 years (25% in 1999, 34% in 2008). TEE-guided DCC was also performed more often in the outpatient setting (21% in 1999, 37% in 2008). There was no yearly difference for the prevalence of LAT or sludge (8% overall; P = .12). Conclusions: Over the past 10 years, trends have suggested that the application of TEE-guided DCC compared with the conventional approach have consistently grown and that more DCC procedures are done in the outpatient setting. Given the high LAT or sludge detection rate of 8%, TEE-guided DCC has continued to be an important part of atrial fibrillation management.

Original languageEnglish (US)
Pages (from-to)962-968
Number of pages7
JournalJournal of the American Society of Echocardiography
Volume25
Issue number9
DOIs
StatePublished - Sep 1 2012

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Electric Countershock
antineoplaston A10
Transesophageal Echocardiography
Atrial Fibrillation
Thrombosis
Sewage
Atrial Flutter
Outpatients
Surveys and Questionnaires
Echocardiography
Inpatients
Retrospective Studies
Databases

Keywords

  • Atrial fibrillation
  • Direct current cardioversion
  • Transesophageal echocardiography
  • Trends

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Yarmohammadi, H., Klosterman, T., Grewal, G., Alraies, M. C., Lindsay, B. D., Bhargava, M., ... Klein, A. L. (2012). Transesophageal echocardiography and cardioversion trends in patients with atrial fibrillation: A 10-year survey. Journal of the American Society of Echocardiography, 25(9), 962-968. https://doi.org/10.1016/j.echo.2012.05.015

Transesophageal echocardiography and cardioversion trends in patients with atrial fibrillation : A 10-year survey. / Yarmohammadi, Hirad; Klosterman, Tristan; Grewal, Gaganpreet; Alraies, M. Chadi; Lindsay, Bruce D.; Bhargava, Mandeep; Tang, W. H Wilson; Klein, Allan L.

In: Journal of the American Society of Echocardiography, Vol. 25, No. 9, 01.09.2012, p. 962-968.

Research output: Contribution to journalArticle

Yarmohammadi, H, Klosterman, T, Grewal, G, Alraies, MC, Lindsay, BD, Bhargava, M, Tang, WHW & Klein, AL 2012, 'Transesophageal echocardiography and cardioversion trends in patients with atrial fibrillation: A 10-year survey', Journal of the American Society of Echocardiography, vol. 25, no. 9, pp. 962-968. https://doi.org/10.1016/j.echo.2012.05.015
Yarmohammadi, Hirad ; Klosterman, Tristan ; Grewal, Gaganpreet ; Alraies, M. Chadi ; Lindsay, Bruce D. ; Bhargava, Mandeep ; Tang, W. H Wilson ; Klein, Allan L. / Transesophageal echocardiography and cardioversion trends in patients with atrial fibrillation : A 10-year survey. In: Journal of the American Society of Echocardiography. 2012 ; Vol. 25, No. 9. pp. 962-968.
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abstract = "Background: Transesophageal echocardiography (TEE) has long been used to assess for left atrial thrombus (LAT) in patients undergoing direct-current cardioversion (DCC) for atrial fibrillation or flutter. However, little is known about its recent trends and current applications. Methods: In this retrospective study, 3,191 serial transesophageal echocardiographic studies in 2,705 unique patients (mean age, 66 ± 13 years; 68{\%} men) with atrial fibrillation or atrial flutter who underwent TEE before DCC from 1999 to 2008 were identified using the Cleveland Clinic echocardiography database. Clinical data and information on the presence of spontaneous echocardiographic contrast, sludge, or LAT before DCC were obtained as well as the total number of transesophageal echocardiographic studies and DCC procedures performed in outpatient or inpatient settings. Results: Increasing trends of TEE-guided DCC were observed over the past 10 years (25{\%} in 1999, 34{\%} in 2008). TEE-guided DCC was also performed more often in the outpatient setting (21{\%} in 1999, 37{\%} in 2008). There was no yearly difference for the prevalence of LAT or sludge (8{\%} overall; P = .12). Conclusions: Over the past 10 years, trends have suggested that the application of TEE-guided DCC compared with the conventional approach have consistently grown and that more DCC procedures are done in the outpatient setting. Given the high LAT or sludge detection rate of 8{\%}, TEE-guided DCC has continued to be an important part of atrial fibrillation management.",
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