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

January 24-31, 1998
Marilleva, Trento, Italy

RT-141

Effects of anticoagulation on atrial thrombi: a transesophageal echocardiographic study

Giovanni Corrado, Giorgio Tadeo, Sandro Beretta*, Giovanni Foglia Manzillo, Manuela Spata, Luca Mario Tagliagambe, Mauro Santarone.
Servizio di Cardiologia, *Divisione di Neurologia, Ospedale Valduce, Como, Italy

Introduction

Cardioversion of atrial fibrillation (AF) in nonanticoagulated patients may be associated with clinical thromboembolism in up to 7% of cases^1-3. The use of anticoagulation with warfarin for three to four weeks before cardioversion decreases the risk of cardioversion-related embolic events to less than 1.6%^1-3. The beneficial effect of anticoagulation has been attributed to organization and adherence of existing thrombus, thereby reducing the likelihood of dislodgment at the time of cardioversion^2,4,5. Transesophageal echocardiography (TEE) is a highly accurate method of detecting atrial thrombi^6-10 and allows the opportunity to serially evaluate left atrial thrombi before and after a given course of warfarin anticoagulation.