Cited by 151Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac tumors and thrombi

Prevalence of Thrombus, Spontaneous Echo Contrast, and Atrial Stunning in Patients Undergoing Cardioversion of Atrial Flutter: A Prospective Study Using Transesophageal Echocardiography

Irani, Waleed N., Grayburn, Paul A., Afridi, Imran·1997·Circulation

Abstract

BACKGROUND: Several studies have shown that patients undergoing cardioversion of atrial fibrillation have a high prevalence of of atrial thrombus and spontaneous echo contrast and frequently develop atrial stunning after restoration of sinus rhythm. These findings are strongly associated with increased risk of embolism in these patients. However, little is known about the prevalence of these markers of thromboembolism in patients undergoing cardioversion of atrial flutter. METHODS AND RESULTS: We performed transesophageal echocardiography in 47 consecutive, nonanticoagulated patients scheduled for elective cardioversion of atrial flutter. In patients who underwent successful cardioversion, mitral inflow velocity was recorded by transthoracic pulsed Doppler examination immediately after restoration of sinus rhythm. All patients were men (mean age, 65 +/- 10 years). Mean duration of flutter was 4 +/- 9 weeks. Atrial thrombus and/or spontaneous echo contrast were found in 16 patients (34%). Left atrial thrombus was seen in 5 patients (11%), either with (n = 4) or without spontaneous contrast. Of 40 patients with successful cardioversion, atrial mechanical activity was absent in 28% immediately after restoration of sinus rhythm. CONCLUSIONS: Our findings suggest that contrary to traditional teaching, atrial thrombus and spontaneous contrast are not uncommon in patients with atrial flutter and cardioversion may be associated with increased risk of thromboembolism.

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Crossref · 10.1161/01.cir.95.4.962

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Authors
Irani, W. N., Grayburn, P. A., & Afridi, I.
Affiliations
Dallas VA Medical Center (US)
Venue
Circulation
Published
1997-02-18
Volume
95
Issue
4
Pages
962-966
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2008429532
Cited by
151
References
27
Citations by year
2024: 3 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 6 · 2016: 5 · 2015: 4 · 2014: 1 · 2013: 4 · 2012: 3
FWCI
7.06
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac tumors and thrombi
Keywords
atrial flutter, cardioversion, atrial thrombus, spontaneous echo contrast, atrial stunning, thromboembolic risk, left atrial thrombus, mitral inflow velocity, transesophageal echocardiography
MeSH terms
Adult, Aged, Atrial Flutter, Echocardiography, Electric Countershock, Female, Heart Atria, Humans, Male, Middle Aged, Prospective Studies, Thrombosis, Prevalence, Echocardiography, Transesophageal, Myocardial Stunning, Echocardiography, Doppler, Pulsed

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