Transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation

Abstract

Transesophageal echocardiography -guided anti-coagulation management of patients with atrial fibrillation undergoing cardioversion has evolved over the course of the past decade as an alternative to the conventional anticoagulation strategy. Its role expanded out of a need for a more predictable, dependable, and convenient approach to this difficult management dilemma, which has become increasingly prevalent in today's practice as a result of the increasing number of patients with atrial fibrillation. In addition to its utility in risk-stratifying patients scheduled to undergo cardioversion, this management strategy allows for early electrical cardioversion, which enables minimal delay in proceeding from the time of diagnosis to the institution of therapy. This paper reviews the recently published Assessment of Cardioversion Using Transesophageal Echocardiography (ACUTE) trial, which compared transesophageal echocardiography-guided anticoagulation of patients with atrial fibrillation undergoing cardioversion with the conventional anticoagulation strategy, and discusses possible future modifications to the strategy. © 2002 CVRR, Inc.