Introduction: To evaluate indications for transoesophageal echocardiogram (TEE) in properly anticoagulated patients before direct current cardioversion (DCC).
Methods: Retrospective analysis of 251 patients with non-valvular AF, appropriate anticoagulation before scheduled DCC (3 weeks of oral anticoagulation prior to DCC with AF>48h) who underwent DCC, TEE in 2012-2014 was analysed. CHA2DS2VASc, HAS-BLED, TE complications in 30 days after DCC were assessed.
Results: Mean patients age 65.3yrs. ±10,6. There were 97 females (38.6%, mean age 70.4 yrs. ±7,5) 154 males (61.4%, mean age 62.3 yrs. ±11,1). Appropriate anticoagulation achieved using warfarin in 200 (79.7%) and dabigatran in 51 (20.3%) patients. TEE was performed for 76 (30.3%) patients. For 4 patients (5,3%) thrombi in the left atrium (LA) were detected (3 patients on warfarin, 1 on dabigatran). CHA2DS2VASc score in patients with LA thrombi was ?4. SR was restored for 247 patients (98,4%). There were no TE complications after DCC.
Conclusions: The risk of LA thrombi is present in properly anticoagulated patients. Further studies are required to assess more accurate indications for TEE