Left atrial thrombus and smoke resolution in patients with atrial fibrillation under chronic oral anticoagulation.
Atrial fibrillation
Atrial thrombus
Oral anticoagulation
Transesophageal echocardiography
Journal
Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
ISSN: 1572-8595
Titre abrégé: J Interv Card Electrophysiol
Pays: Netherlands
ID NLM: 9708966
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
06
01
2022
accepted:
22
02
2022
pubmed:
13
3
2022
medline:
16
9
2022
entrez:
12
3
2022
Statut:
ppublish
Résumé
The study aimed to explore the resolution of left atrial and left atrial appendage (LAA) spontaneous echo-contrast or thrombus in patients with nonvalvular atrial fibrillation/flutter (AF/AFL) under chronic oral anticoagulation (OAC). A single-center retrospective analysis of patients who underwent a transesophageal echocardiography (TOE) for an electrical cardioversion was conducted. Among 277 TOE performed, 73 cases (26%) of LAA echo-contrast or thrombus were detected, 53 patients with LAA/LA echo-contrast (19%) and 20 (7%) with a thrombus. All patients were under chronic anticoagulation with a VKA (65%) or with a NOAC (35%). The Echo-contrast Group maintained the same OAC strategy in 49 patients (93%). The Thrombus Group kept the same OAC strategy with a NOAC in 6 cases (30%) and changed the strategy in 14 patients (70%), titrating NOAC dose in 1 (5%) and the VKA dose in 4 (20%) and switching from NOAC to VKA in 5 (25%), from VKA to NOAC in 3 (15%), and from NOAC to NOAC in 1 (5%). Smoke resolution was observed in 4/40 cases (10%) of the smoke group and thrombus resolution in 8/15 (53%) of the thrombus group. Patients with thrombus resolution had a lower CHA2DS2-Vasc score (3.5 ± 2 vs 4 ± 1, p = 0.05), were more often under NOAC (37.5 vs 28%, p = 0.07), and had a longer anticoagulation time (7.5 vs 4 months, p = 0.08). Changing OAC strategy is associated with thrombus resolution in more than 50% of chronically anticoagulated patients.
Sections du résumé
BACKGROUND
BACKGROUND
The study aimed to explore the resolution of left atrial and left atrial appendage (LAA) spontaneous echo-contrast or thrombus in patients with nonvalvular atrial fibrillation/flutter (AF/AFL) under chronic oral anticoagulation (OAC).
METHODS
METHODS
A single-center retrospective analysis of patients who underwent a transesophageal echocardiography (TOE) for an electrical cardioversion was conducted.
RESULTS
RESULTS
Among 277 TOE performed, 73 cases (26%) of LAA echo-contrast or thrombus were detected, 53 patients with LAA/LA echo-contrast (19%) and 20 (7%) with a thrombus. All patients were under chronic anticoagulation with a VKA (65%) or with a NOAC (35%). The Echo-contrast Group maintained the same OAC strategy in 49 patients (93%). The Thrombus Group kept the same OAC strategy with a NOAC in 6 cases (30%) and changed the strategy in 14 patients (70%), titrating NOAC dose in 1 (5%) and the VKA dose in 4 (20%) and switching from NOAC to VKA in 5 (25%), from VKA to NOAC in 3 (15%), and from NOAC to NOAC in 1 (5%). Smoke resolution was observed in 4/40 cases (10%) of the smoke group and thrombus resolution in 8/15 (53%) of the thrombus group. Patients with thrombus resolution had a lower CHA2DS2-Vasc score (3.5 ± 2 vs 4 ± 1, p = 0.05), were more often under NOAC (37.5 vs 28%, p = 0.07), and had a longer anticoagulation time (7.5 vs 4 months, p = 0.08).
CONCLUSION (S)
CONCLUSIONS
Changing OAC strategy is associated with thrombus resolution in more than 50% of chronically anticoagulated patients.
Identifiants
pubmed: 35277775
doi: 10.1007/s10840-022-01169-1
pii: 10.1007/s10840-022-01169-1
doi:
Substances chimiques
Anticoagulants
0
Smoke
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
773-781Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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