Resumen

VALENCIA SANCHEZ, Jesús Salvador; ARRIAGA NAVA, Roberto; NAVARRO ROBLES, José Refugio  y  MARTINEZ ENRIQUEZ, Agustín. Echocardiography as a guidance for electrical cardioversion in patients with AF. Arch. Cardiol. Méx. [online]. 2001, vol.71, n.1, pp.28-33. ISSN 1665-1731.

We studied 80 patients to evaluate the safety of the transesophageal echocardiography (TEE) as a guidance to identify spontaneous echo contrast or atrial thrombosis in patients with atrial fibrillation (AF). 34 out of these patients were men and 46 women, with a mean age of 61 ± 12 years. Five were not candidates due to the presence of risk factors. 75 patients have undergone electric cardioversion. The duration of AF was < 2 weeks in 61 > 2 and < 6 weeks 13, and > 6 weeks and < 1 year 6; 24 patients received previous anticoagulant therapy. The echocardiographic findings revealed left atrial dimension 45 ± 8.4 mm ejection fraction of left ventricle 61 ± 7.5%, SEC absent in the left atrium of 35, mild in 40 and severe in 5 patients, flow in left atrial appendage in 78 patients, thrombi in 2. EC was performed with 200 Joules in all patients and it was successful in 74. The study lasted 8.7 ± 5.7 months; 11 patients were recurrent. The predictors were: left atrial dimension > 50 mm (p > 0.05), > 2 EC performed (p = 0.02), > 200 joules (p = 0.05) and in patients with AF < 2 weeks. We concluded that the TEE is beneficial to detect risk factors in patients with AF, and it helps when deciding to perform the EC early and safely without previous anticoagulation.

Palabras llave : Atrial fibrillation; Electric cardioversion; Transesophageal echocardiography.