Prevalence of atrial thrombi in patients with atrial fibrillation/flutter and subtherapeutic anticoagulation prior to cardioversion

Abstract

Subtherapeutic levels of anticoagulation before elective ECV of AF may expose patients to post-ECV thromboembolic sequelae, especially in patients with lowest INR values. Current recommendations of a full course of therapeutic anticoagulation before ECV of persistent AF should be firmly observed.

Echocardiography in newly diagnosed atrial fibrillation patients: a systematic review and economic evaluation

“…111,113,117,122,123,125 At least one of the criteria was not satisfied in three studies, 28,114,116 the criteria were partially met in one study 115 and information was unclear in two studies. 112,120 …”

“…61 References excluded at the full paper screening stage (n = 15), with reason for exclusion, are presented in Appendix 9. There were 16 prevalence studies 28,[111][112][113][114][115][116][117][118][119][120][121][122][123][124][125] accepted into the review. Some of the studies investigated the prevalence of more than one pathology.…”

“…Of the 16 studies that provided data for the review of the prevalence of clinically significant pathologies in patients with AF, seven studies 28,112,114,115,119,121,124 were retrospective in design, eight 113,[116][117][118]120,122,123,125 were prospective studies, and one 111 was a case-control study.…”

“…Five studies did not report the methods used to verify the presence or history of AF in eligible patients 112,114,120,124,125 although one study gave details in a prior Additional relevant articles identified through other sources (n = 2) publication 98 and the others used candidates for cardioversion giving confidence in accuracy of diagnosis. Although two retrospective studies 28,121 used TOE and TTE in diagnosing the presence of ischaemic heart disease, the methods used to diagnose the presence of coexisting clinically significant cardiac pathologies were not detailed in three studies.…”

“…115,118,119 The remaining studies relied on TOE and provided information on diagnostic criteria for pathologies of interest. Detailed descriptions of the assessors evaluating eligible patients regarding pathologies of interest were reported in four studies; 113,114,116,123 for one of these studies, 113 the relevant information was reported in a separate publication. 127 In one study, 116 outcome data were incomplete; the reason was that TOE provided inadequate visualisation of the pathology of interest in a number of patients.…”