Choice of anticoagulant preparation to cardioversion in patients with persistent atrial fibrillation basedon the echocardiogaphic left atrial appendage predictors
Combination of left ventricle ejection fraction decrease < 50% and left atrium size increase > 42 mm by transthoracic echocardiography in patients with persistent atrial fibrillation enhances risk of left atrial appendage thrombosis (sensitiveness 65%, specificity 81%). Peak flow velocity decrease under 0,341 m/s by transesophageal echocardiography leads to certain increase of left atrial appendage thrombus risk (sensitiveness 77%, specificity 87%). In patients with increased left atrial appendage thrombus it is recommended transesophageal echocardiography. In case of thrombus exclusion accelerated anticoagulant preparation with heparin and following cardioversion.