Resumo

VALENCIA SANCHEZ, Jesús Salvador; ARRIAGA NAVA, Roberto; NAVARRO ROBLES, José Refugio  e  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.

Palavras-chave : Atrial fibrillation; Electric cardioversion; Transesophageal echocardiography.

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