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Incidence of intracardiac thrombus formation prior to electrical cardioversion in respect to the mode of oral anticoagulation

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Incidence of intracardiac thrombus formation prior to electrical cardioversion in respect to the mode of oral anticoagulation. / Schaeffer, Benjamin; Rüden, Lea; Salzbrunn, Tim; Pinnschmidt, Hans O; Akbulak, Ruken Özge; Moser, Julia Magdalena; Jularic, Mario; Meyer, Christian; Eickholt, Christian; Sultan, Arian; Lüker, Jakob; Steven, Daniel; Willems, Stephan; Hoffmann, Boris Alexander.

In: J CARDIOVASC ELECTR, Vol. 29, No. 4, 04.2018, p. 537-547.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Schaeffer, B, Rüden, L, Salzbrunn, T, Pinnschmidt, HO, Akbulak, RÖ, Moser, JM, Jularic, M, Meyer, C, Eickholt, C, Sultan, A, Lüker, J, Steven, D, Willems, S & Hoffmann, BA 2018, 'Incidence of intracardiac thrombus formation prior to electrical cardioversion in respect to the mode of oral anticoagulation', J CARDIOVASC ELECTR, vol. 29, no. 4, pp. 537-547. https://doi.org/10.1111/jce.13447

APA

Schaeffer, B., Rüden, L., Salzbrunn, T., Pinnschmidt, H. O., Akbulak, R. Ö., Moser, J. M., Jularic, M., Meyer, C., Eickholt, C., Sultan, A., Lüker, J., Steven, D., Willems, S., & Hoffmann, B. A. (2018). Incidence of intracardiac thrombus formation prior to electrical cardioversion in respect to the mode of oral anticoagulation. J CARDIOVASC ELECTR, 29(4), 537-547. https://doi.org/10.1111/jce.13447

Vancouver

Schaeffer B, Rüden L, Salzbrunn T, Pinnschmidt HO, Akbulak RÖ, Moser JM et al. Incidence of intracardiac thrombus formation prior to electrical cardioversion in respect to the mode of oral anticoagulation. J CARDIOVASC ELECTR. 2018 Apr;29(4):537-547. https://doi.org/10.1111/jce.13447

Bibtex

@article{ceaa00bdc1764a03b5bd0d68e0570f6f,
title = "Incidence of intracardiac thrombus formation prior to electrical cardioversion in respect to the mode of oral anticoagulation",
abstract = "AIMS: To evaluate the incidence of newly diagnosed intracardiac thrombi (ICT) in respect to the mode of OAC in patients undergoing cardioversion (CV).METHODS AND RESULTS: We prospectively assessed transesophageal echocardiography (TEE) and OAC therapy prior to CV in AF patients with ≥48-hour duration scheduled for CV. A total of 60 first-time ICT (4.7%) were diagnosed in 1,286 TEE, with highest rate in patients without OAC (9.6% vs. OAC 4.1%, P = 0.009) and an apparently lower rate in nonvitamin K antagonist anticoagulants (NOAC) therapy compared to vitamin K antagonist (VKA) (2.5% vs. 5.3%, P = 0.02). VKA therapy control 4 weeks prior to CV was overall average (time in therapeutic range 60%) and patients showed more frequently clinical characteristics and TEE parameters associated with risk for ICT. Even among patients with effective OAC therapy (uninterrupted NOAC and VKA therapy with international normalized ratio (INR) ≥2.0 for 3 weeks), ICT occurred in 2.7%, but with no difference between both groups (P = 0.22). There was no difference between different types of NOAC. Independent predictors for ICT were history of embolism, hypertension, BMI, absence of OAC, renal function, reduced atrial appendage flow, and presence of spontaneous echo contrast.CONCLUSION: NOAC therapy seems favorable in the overall prevention of ICT, although this is likely to be caused by suboptimal VKA therapy control and differences in the overall health status between VKA and NOAC patients. ICT occurred even with effective OAC therapy suggesting individual TEE-guided cardioversion in patients at risk.",
keywords = "Journal Article",
author = "Benjamin Schaeffer and Lea R{\"u}den and Tim Salzbrunn and Pinnschmidt, {Hans O} and Akbulak, {Ruken {\"O}zge} and Moser, {Julia Magdalena} and Mario Jularic and Christian Meyer and Christian Eickholt and Arian Sultan and Jakob L{\"u}ker and Daniel Steven and Stephan Willems and Hoffmann, {Boris Alexander}",
note = "{\textcopyright} 2018 Wiley Periodicals, Inc.",
year = "2018",
month = apr,
doi = "10.1111/jce.13447",
language = "English",
volume = "29",
pages = "537--547",
journal = "J CARDIOVASC ELECTR",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "4",

}

RIS

TY - JOUR

T1 - Incidence of intracardiac thrombus formation prior to electrical cardioversion in respect to the mode of oral anticoagulation

AU - Schaeffer, Benjamin

AU - Rüden, Lea

AU - Salzbrunn, Tim

AU - Pinnschmidt, Hans O

AU - Akbulak, Ruken Özge

AU - Moser, Julia Magdalena

AU - Jularic, Mario

AU - Meyer, Christian

AU - Eickholt, Christian

AU - Sultan, Arian

AU - Lüker, Jakob

AU - Steven, Daniel

AU - Willems, Stephan

AU - Hoffmann, Boris Alexander

N1 - © 2018 Wiley Periodicals, Inc.

PY - 2018/4

Y1 - 2018/4

N2 - AIMS: To evaluate the incidence of newly diagnosed intracardiac thrombi (ICT) in respect to the mode of OAC in patients undergoing cardioversion (CV).METHODS AND RESULTS: We prospectively assessed transesophageal echocardiography (TEE) and OAC therapy prior to CV in AF patients with ≥48-hour duration scheduled for CV. A total of 60 first-time ICT (4.7%) were diagnosed in 1,286 TEE, with highest rate in patients without OAC (9.6% vs. OAC 4.1%, P = 0.009) and an apparently lower rate in nonvitamin K antagonist anticoagulants (NOAC) therapy compared to vitamin K antagonist (VKA) (2.5% vs. 5.3%, P = 0.02). VKA therapy control 4 weeks prior to CV was overall average (time in therapeutic range 60%) and patients showed more frequently clinical characteristics and TEE parameters associated with risk for ICT. Even among patients with effective OAC therapy (uninterrupted NOAC and VKA therapy with international normalized ratio (INR) ≥2.0 for 3 weeks), ICT occurred in 2.7%, but with no difference between both groups (P = 0.22). There was no difference between different types of NOAC. Independent predictors for ICT were history of embolism, hypertension, BMI, absence of OAC, renal function, reduced atrial appendage flow, and presence of spontaneous echo contrast.CONCLUSION: NOAC therapy seems favorable in the overall prevention of ICT, although this is likely to be caused by suboptimal VKA therapy control and differences in the overall health status between VKA and NOAC patients. ICT occurred even with effective OAC therapy suggesting individual TEE-guided cardioversion in patients at risk.

AB - AIMS: To evaluate the incidence of newly diagnosed intracardiac thrombi (ICT) in respect to the mode of OAC in patients undergoing cardioversion (CV).METHODS AND RESULTS: We prospectively assessed transesophageal echocardiography (TEE) and OAC therapy prior to CV in AF patients with ≥48-hour duration scheduled for CV. A total of 60 first-time ICT (4.7%) were diagnosed in 1,286 TEE, with highest rate in patients without OAC (9.6% vs. OAC 4.1%, P = 0.009) and an apparently lower rate in nonvitamin K antagonist anticoagulants (NOAC) therapy compared to vitamin K antagonist (VKA) (2.5% vs. 5.3%, P = 0.02). VKA therapy control 4 weeks prior to CV was overall average (time in therapeutic range 60%) and patients showed more frequently clinical characteristics and TEE parameters associated with risk for ICT. Even among patients with effective OAC therapy (uninterrupted NOAC and VKA therapy with international normalized ratio (INR) ≥2.0 for 3 weeks), ICT occurred in 2.7%, but with no difference between both groups (P = 0.22). There was no difference between different types of NOAC. Independent predictors for ICT were history of embolism, hypertension, BMI, absence of OAC, renal function, reduced atrial appendage flow, and presence of spontaneous echo contrast.CONCLUSION: NOAC therapy seems favorable in the overall prevention of ICT, although this is likely to be caused by suboptimal VKA therapy control and differences in the overall health status between VKA and NOAC patients. ICT occurred even with effective OAC therapy suggesting individual TEE-guided cardioversion in patients at risk.

KW - Journal Article

U2 - 10.1111/jce.13447

DO - 10.1111/jce.13447

M3 - SCORING: Journal article

C2 - 29377448

VL - 29

SP - 537

EP - 547

JO - J CARDIOVASC ELECTR

JF - J CARDIOVASC ELECTR

SN - 1045-3873

IS - 4

ER -