JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 2001; 37:691-704
© 2001 by the American College of Cardiology Foundation
This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Klein, A. L.
Right arrow Articles by Grimm, R. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Klein, A. L.
Right arrow Articles by Grimm, R. A.

Role of transesophageal echocardiography-guided cardioversion of patients with atrial fibrillation

Allan L. Klein, MD, FACCa, R. Daniel Murray, PhDa and Richard A. Grimm, DO, FACCa

a Cardiovascular Imaging Section, Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA



View larger version (120K):

[in a new window]
  		Figure 1 Transesophageal echocardiographic image of a mobile and protruding thrombus (arrow) located in the left atrial appendage of a patient with AF scheduled to undergo DC cardioversion. Cardioversion was postponed in this patient. AF = atrial fibrillation; DC = direct current.

 


View larger version (57K):

[in a new window]
  		Figure 2 Precardioversion (left) and postcardioversion (right) images of the left atrial appendage (LAA) using TEE. After DC cardioversion, left atrial appendage function diminishes and spontaneous echocardiographic contrast intensifies. DC = direct current; LA = left atrium; LV = left ventricle; TEE = transesophageal echocardiography. (Reprinted with permission from the American College of Cardiology, 1994.)

 


View larger version (20K):

[in a new window]
  		Figure 3 Protocol design of the ACUTE multicenter study. Enrolled patients are randomly assigned to either the TEE-guided group or the conventional group for an eight-week study period. (Reprinted with permission from Excerpta Medica, Inc., 1998.) ACUTE = Assessment of Cardioversion Using Transesophageal Echocardiography; DCC= direct current cardioversion; TEE = transesophageal echocardiography.

 


View larger version (87K):

[in a new window]
  		Figure 4 Pitfalls in TEE screening for thrombi using the TEE-guided approach to cardioversion, including pectinate muscles (arrows) in the left atrial appendage (A), multilobed appendage (arrows) (B) and viscous spontaneous echocardiographic contrast, or "sludge" (C). Pectinate muscle tissue, multilobed appendage or sludge can be mistaken for thrombi, rendering a false positive TEE screening result. TEE = transesophageal echocardiography.

 




HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2001 by the American College of Cardiology Foundation.