Transesophageal echocardiography (TEE) is performed routinely in patients with AF of >48h duration prior to cardioversion.
The purpose of this study was to assess the prevalence of LAA-T in patients with CHADS2 score 0-I.
Methods: Analysis of all TEEs performed for hospitalized AF patients prior to cardioversion. Excluded patients with significant valvular disease, hypertrophic cardiomyopathy and any prosthetic valve.
Results: Between 12/1994 and 6/2013 we performed 1504 TEEs prior to cardioversion, in AF patients without significant valvular or myocardial disease.
708 (47%) of the patients were females. The mean age of the patients was 73.8+11.3 years, mean CHADS2 score was 1.92±1.1. (median (interquartile range) was 2(1-3)). 162 (10.8%) were with CHADS2 score 0,393(26.1%) with score I and 949(63.1%) with CHADS2 score of II and more.
LAA-T was detected in 165 (11%) patients. None of the patients with CHADS2 0 had LAA-T, 19 (4.8%) patients with score I had LAA-T, and 146(15.4%) with score >2 had LAA-T.OR 5.1 95%CI (3.1-8.4), p<0.0001.
The risk for LAA-T was increased in patients with CHF (OR 3.3 95%CI :2.3-4.7, p<0.0001) , history of stroke (OR=2.2 95%CI: 1.5-3.4, p<0.0001) and diabetes (OR 1.8 95%CI:1.3-2.5, p<0.0001).
Conclusion: In our cohort no LAA-T was detected in patients with AF and CHADS2 score of 0. It might be reasonable to omit TEE as a screening examination prior to cardioversion in AF patients with CHADS2 score of 0. Patients with AF and CHADS2 score >1 require TEE prior to cardioversion.
