13th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 1998

January 24-31, 1998
Marilleva, Trento, Italy

RT-140

Atrial fibrillation and intra-atrial thrombi: clinical and echocardiographic correlations

Alberto Menotti, Ferdinando Imperadore, Giuseppe Vergara, Marcello Disertori*.
Department of Cardiology, Rovereto Hospital, Rovereto,
*Department of Cardiology, S. Chiara Hospital, Trento, Italy

Introduction

Atrial fibrillation is the commonest cardiac arrhythmia and predisposes a person to significant increase of systemic embolism^1-3. The risk of systemic embolism, particularly cerebral embolism, is present when arrhythmia is chronic but is higher at the moment of cardioversion to sinus rhythm when the resumption of mechanical activity of atrium and left atrium appendage can favour embolization of thrombus present in left atrium or left atrial appendage.

Cardioversion of atrial fibrillation is tied to a significant risk of embolism both after spontaneous or induced (pharmacological or electrical) restoration of sinus rhythm. The estimated incidence of thrombembolism varies in the studies between 0 and 7%^4-6. Variability of the incidence of thromboembolic episodes depends on the heterogeneity of the patients population; particularly etiology and duration of atrial fibrillation, presence, duration and intensity of anticoagulant therapy are different in the series.

We have investigated if some clinical and echocardiographic parameters can have a predictive value for the presence of atrial thrombosis that can be cause of embolism.