BACKGROUND Echocardiographic parameters for predicting cardioversion outcome in patients with non-valvular atrial fibrillation are not accurately defined. OBJECTIVE To evaluate the role of left atrial appendage flow velocity detected by transoesophageal echocardiography for prediction of cardioversion outcome in patients with non-valvular atrial fibrillation enrolled in a prospective. multice...

OBJECTIVE To determine whether echocardiographic markers thromboembolic risk differ between patients with pure atrial flutter and patients with atrial flutter and intermittent atrial fibrillation. DESIGN Patients with atrial flutter were followed up prospectively for 12 months to identify intermittent atrial fibrillation. After the follow up period, transthoracic and multiplane transoesophage...

OBJECTIVE To determine whether there is significant atrial or atrial appendage enlargement or functional remodelling as a result of one to two months of sustained atrial fibrillation, a duration similar to that experienced by patients undergoing warfarin anticoagulation before elective cardioversion. METHODS To test the hypothesis that left atrial and left atrial appendage enlargement develop...

Oral anticoagulation with warfarin is a cornerstone in the prevention of systemic thromboembolism in patients with atrial fibrillation. It reduces the risk of stroke by 67% compared with no antithrombotic therapy and by 36% compared with aspirin. The downside of anticoagulation is increased risk of major bleeding which amounts to 1% per year. Therefore, careful selection of patients for oral an...

pacing-induced atrial fibrillation. Eur Heart J 1999; 20 (Abstr Suppl): 226 (abstr.). [10] Levy S, Breithardt G, Campbell RWF et al. On behalf of the Working Group on Arrhythmias of the European Society of Cardiology. Atrial fibrillation: current knowledge and recommendations for management. Eur Heart J 1998; 19: 1294– 1320. [11] Roijer A, Eskilsson J, Olsson B. Transoesophageal echocardiograph...

A 64-year-old white woman with moderately severe rheumatic mitral stenosis complicated by atrial fibrillation and recurrent systemic embolisation to the brain was found at operation to have a large 'free-floating' left atrial thrombus, as well as multiple left atrial appendage thrombi. These had not been detected by echocardiography. She also had significantly reduced left ventricular contracti...

A 32-year-old woman with a past medical history of paroxysmal atrial fibrillation, long QT syndrome, and implantation of an automatic iimplantable cardioverter-defibrillator (AICD) following cardiac arrest presented with disabling symptoms of paroxysmal atrial fibrillation due to recurrent AICD shocks. Before curative ablation, transesophageal echocardiography was performed to assess for existi...

An 82-year-old woman with a history of previous cerebral infarction and atrial fibrillation was hospitalized with aphagia. Brain magnetic resonance imaging showed a dot-like high signal intensity in the left occipital subcortex. With a working diagnosis of acute cerebral infarction due to cardiac emboli, trans-thoracic echocardiography (TTE) was performed. The TTE showed an oval shaped, mobile ...

AIMS Left atrial appendage device occlusion is an increasingly accepted therapy for stroke prevention in atrial fibrillation. The feasibility and safety of left atrial catheter ablation procedures in the presence of a left atrial appendage device implant is unclear. We report on 10 cases of successful left atrial catheter ablation therapy for atrial fibrillation in patients with an implanted Wa...

In this issue of iJACC, Martinez et al. (1) report their experience with cardiac computed tomography (CCT) to detect left atrial appendage thrombi in patients with atrial fibrillation undergoing pulmonary vein radiofrequency ablation. Atrial fibrillation is one of the most common cardiovascular disorders, carrying significant morbidity, including cardio-embolic stroke and heart failure. Slow fl...