Background .– Transesophageal echocardiography (TEE) parameters (left atrial appendage, LAA thrombus or spontaneous echocardiographic contrast (SEC), aortic atheroma (AAA) are powerful markers of thromboembolism (TE) in non-valvular atrial fibrillation (NVAF) patients. However, the prevalence and potential impact of these abnormalities have not been evaluated in patients at very low risk of TE. We evaluated TEE-detected LASEC, thrombus and AAA in AF patients referred for cardioversion and analyzed the subgroup of patients with a CHADS2 score = 0.
Patients .– Among 763 consecutive patients hospitalized for NVAF, prior to cardioversion, TEE was systematically performed within 24 h after admission; 205 patients had a CHADS2 score = 0. The following parameters were described: presence and severity of LASEC, LA thrombus, aortic atheroma (AAA).
Results .– Mean age was 54.5 ± 13.5 years. AF was paroxysmal in 101 patients (49.3%), persistent in 82 (40.0%) and permanent in 22 (10.7%). Transthoracic echocardiography showed LVEF < 40% in 12 (5.9%) and median of mean LA area was 18 (15–23) cm 2 . LA thrombus was found in one patient (0.5%), LASEC in 60 (29.3%), classified as mild in 43 (21.0%), moderate in 14 (6.8%) and severe in three (1.5%). AAA was present in six patients (2.9%). The Table 1 compares some baseline characteristics in patients with (LAASEC/thrombus or aortic atheroma ≥ 4 mm) or without TEE abnormalities, defined as an endpoint.
