Role of the CHADS2 Score in the Evaluation of Thromboembolic Risk in Patients With Atrial Fibrillation Undergoing Transesophageal Echocardiography Before Pulmonary Vein Isolation
Sarinya Puwanant, MD*, ,
Brandon C. Varr, BS*,
Kevin Shrestha, AB*,
Sarah K. Hussain, MD*,
W.H. Wilson Tang, MD*,
Ruvin S. Gabriel, MD*,
Oussama M. Wazni, MD*,
Mandeep Bhargava, MD*,
Walid I. Saliba, MD*,
James D. Thomas, MD*,
Bruce D. Lindsay, MD* and
Allan L. Klein, MD*,*
* Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
Division of Cardiology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand
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Figure 2 LAA Sludge Identified on Pre-PVI TEE in a Patient With a CHADS2 Score of 1
Multiplane transesophageal echocardiogram (TEE) at 65° demonstrates left atrial appendage (LAA) sludge (arrowheads). The shape of precipitous echodensity is dynamically changed and transformed into different patterns during the cardiac cycle (A to D). This patient (Patient #4) (Table 3) had persistent atrial fibrillation and a CHADS2 score of 1. Unfortunately, the patient suffered from stroke immediately after pulmonary vein isolation (PVI). LA = left atrial; LV = left ventricle.
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Figure 3 LAA Thrombus Identified on Pre-PVI TEE in a Patient With a CHADS2 Score of 1
Multiplane TEE at 63° demonstrates an LAA thrombus (arrows). This patient (Patient #7) (Table 3) had persistent atrial fibrillation and a CHADS2 score of 1. Abbreviations as in Figure 2.
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