Pre- and post-cardioversion transesophageal echocardiography for brief anticoagulation therapy with enoxaparin in atrial fibrillation patients: a prospective study with a 1-year follow-up

Transthoracic Doppler echocardiography for the assessment of left atrial appendage size and blood flow velocity. A multicentre study

“…Owing to a systemic overestimation by TTE, higher cut-off values of LAA blood flow velocities were found, with an acceptable predictive accuracy for the validated TEE values. In the clinical setting, the identification of low (<20 cm/s) or high (>40 cm/s) LAA flow velocity at TEE reliably indicates a high and low risk status for embolic events, guiding antithrombotic or anticoagulation strategies before the cardioversion procedure [17] and one year postoperatively [18]. In the SPAF-III trial [19], in a large population of 721 patients with non-valvular atrial fibrillation, a LAA emptying flow velocity of <20 cm/s at TEE identified patients at higher risk of LAA spontaneous echo contrast, thrombi and cardioembolic stroke.…”

Anatomical remodeling of left atria in subjects with chronic and paroxysmal atrial fibrillation evaluated by multislice computed tomography

“…Morphological information is generally obtained using transthoracic echocardiogram (TTE) and TEE [1,2,11]. With TTE, the size of the LA can be measured and the internal structures, including the LAA, can be observed; in addition blood flow velocity can also be measured.…”

“…The gold standard for morphological evaluation of the left atria (LA) is the transesophageal echocardiogram (TEE) [1,2].…”

Antithrombotic Therapy in Atrial Fibrillation

“…256 Current data generally support the use of therapeutic LMWH (full DVT doses) as an alternative to unfractionated heparin prior to and post-cardioversion with regards to protection against post-cardioversion clinical thromboembolism. [257][258][259] Interestingly, for nonanticoagulated patients, the absence of an atrial thrombus on a prior TEE does not reduce the prevalence of finding an atrial thrombus when the patient presents with another episode of AF. 260…”