Lower patent foramen ovale detection with transthoracic echocardiography in atrial fibrillation

Abstract

This study is the first to demonstrate an apparent lower rate of PFO in patients with AF, using bubble contrast echocardiography.

Higher LA pressure may prevent opening of patent foramen ovale in acute ischemic stroke patients with atrial fibrillation

“…This finding was similar to that of Attaran et al [3]. We believe that there are three reasons to explain this low rate of RLS detection in AF patients.…”

“…Men comprised 52% of the AF group and 64% of the control group (p = 0.028). NIHSS score was higher in the AF group than in the control group (11 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] vs. 4 [2][3][4][5][6][7][8][9][10][11] In patients with AF, background and clinical characteristics of the RLS and non-RLS group are shown in Table 1. Past history of ischemic stroke was slightly more common in the RLS group.…”

“…In stroke patients with atrial fibrillation (AF), detection rate of rightto-left shunt (RLS) may be lower than in those without AF [3]. One reason for this is that the main mechanism of stroke in AF patients is left atrial thrombus (LA), and PFO may be less frequently associated with stroke onset in patients with AF compared with those without AF.…”

Presence of Atrial Fibrillation in Stroke Patients With Patent Foramen Ovale: Systematic Review and Meta-Analysis

“…The lower risk of AF in patients with PFO compared with those without is consistent with the general view that patients with PFO are not at an increased risk of arrhythmias compared with the general population (31). In addition, studies have also demonstrated that the presence of AF reduces the likelihood of right-to-left shunting through the PFO due to the elevation of left atrial pressure and the change in the pressure gradient across the PFO (32,33). This in turn reduces the likelihood of PFO and AF co-detection.…”

Point-of-care echocardiography for the evaluation of right-to-left cardiopulmonary shunts: a narrative review

“…This is because right atrial pressures may never exceed left atrial pressures, even in the presence of Valsalva augmentation. 48,95 Increased inferior vena cava flow may disrupt right atrial opacification, resulting in a false-negative bubble result. 35 In this scenario, blood flow through the inferior vena cava may be diminished by pressing firmly on the liver.…”