Author + information
- Simbo M. Chiadika,
- Kassra Poosti,
- Robin Jacob,
- Syed H. Naqvi,
- Farzan Husain and
- Ijeoma A. Ekeruo
Direct current cardioversion (DCCV) is proven to restore sinus rhythm in patients with atrial fibrillation. Thrombus seen on transesophageal echocardiogram (TEE) however precludes the procedure. Though not indicative of a thrombus, spontaneous echo contrast (SEC) on TEE has been independently associated with a higher risk of cerebrovascular accidents (CVA). Despite this, there is insufficient study into the association of SEC and strokes post-DCCV. We assessed the incidence of CVA post DCCV in patients with SEC.
Retrospective chart review of patients presenting to Memorial Hermann TMC for DCCV following TEE from June 2005 through June 2015. Using electronic medical record review we assessed the incidence of strokes and death at 30 days and 6 months post DCCV.
125 patients who underwent DCCV following TEE were identified. 32 (26%) had SEC on TEE, read as mild (43.8%), moderate (37.5%) or severe (18.8%). The non- SEC and SEC groups were similar demographically, except for history of CVA which was significantly higher in the SEC group (5.4% vs 18.8%; p=0.033). The SEC group had significantly lower LAA velocities (40.5m/s vs. 32.5m/s; p=0.009). There was no significant difference in rates of stroke or death at either 30 days or at 6 month between the two groups (Table 1).
SEC on TEE was not associated with a higher rate of strokes at 30 days or 6 months following cardioversion, suggesting degree of “smoke” should not be a consideration in determining stroke risk following DCCV.
Poster Hall, Hall A/B
Saturday, March 10, 2018, 10:00 a.m.-10:45 a.m.
Session Title: Anticoagulation For the Appropriate Patient in Atrial Fibrillation
Abstract Category: 06. Arrhythmias and Clinical EP: Other
Presentation Number: 1101-015
- 2018 American College of Cardiology Foundation