ATRIAL-FIBRILLATION - THE VALUE OF TRANSE SOPHAGEAL ECHOCARDIOGRAPHY

Transesophageal echocardiography is superior to transthoracic echocard iography in detection of left atrial thrombi and spontaneous echocardi ographic contrast, particularly in patients with atrial fibrillation a nd spontaneous echocardiographic contrast, thrombus formation is likel y. In addition to the morphology, Doppler-echocardiography can be used to access left atrial appendage function. In patients with lone atria l fibrillation, reduced velocity was found in 60%, and no flow was det ected in the left atrial appendage in 40%. These patients had a higher risk for spontaneous echocardiographic contrast and thrombus formatio n. As left atrial thrombi are found in 12% of patients, transesophagea l echocardiography can be used to avoid cardioversion in these patient s, which may lead to cerebral or peripheral emboli. Despite ruling out left atrial thrombi, embolism occurred after cardioversion when antic oagulation was insufficient or not performed. Current investigations a re undertaken in order to demonstrate the clinical benefit of transeso phageal echocardiography in patients with left atrial fibrillation.