Effectiveness of Transesophageal Echocardiography in Preventing Thromboembolic Complications Before Cardioversion: A Narrative Review

Atrial fibrillation (AFib) is one of the most prevalent irregular heartbeats that doctors encounter. Clinicians typically pursue two main approaches for treatment, namely, controlling the heart rate and managing the heart rhythm. Under the rhythm control approach, AFib is addressed through cardiover...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-11, Vol.15 (11), p.e48149
Main Authors: Jain, Prateek, Patel, Vishwesh, Patel, Yashaswi, Rasool, Jawairiya, Gandhi, Siddharth Kamal, Patel, Priyansh
Format: Article
Language:English
Subjects:
Anticoagulants
Blood clots
Cardiac arrhythmia
Cardiology
Cardioversion
Flow velocity
Heart failure
Internal Medicine
Patient satisfaction
Preventive Medicine
Stroke
Success
Thromboembolism
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Summary:Atrial fibrillation (AFib) is one of the most prevalent irregular heartbeats that doctors encounter. Clinicians typically pursue two main approaches for treatment, namely, controlling the heart rate and managing the heart rhythm. Under the rhythm control approach, AFib is addressed through cardioversion, which is achieved either with medications termed pharmacological cardioversion (PCV) or via an electrical shock termed electric cardioversion (ECV). While ECV proves instrumental in AFib management, it carries its own risk factors, potentially leading to blood clot-related complications such as embolic strokes. To counteract this potential downside, a well-established strategy involves the utilization of transesophageal echocardiography (TEE) to identify possible embolic sources before initiating cardioversion. The goal of this systematic review is to highlight the role of TEE in preempting embolic occurrences following ECV during the management of AFib. After conducting a thorough search of databases, namely, PubMed, PubMed Central, and Medline, a total of 36 studies were selected for this review article. Following a comprehensive evaluation of these studies, it was concluded that TEE plays a pivotal role in preventing thromboembolic complications during ECV for AFib. However, it is important to note that further research is needed to delve deeper into this matter. While existing evidence underscores its efficacy, additional investigation is needed to address this subject matter comprehensively.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.48149