Evidence map›Paper›PMID 28228120›Full record

ArticleBMC cardiovascular disorders2017

Findings of transoesophageal echocardiogram in appropriately anticoagulated patients with persistent atrial fibrillation prior to planned cardioversion.

Jūratė Barysienė, Aistė Žebrauskaitė, Dovilė Petrikonytė, Germanas Marinskis, Sigita Aidietienė, Audrius Aidietis

Open access · goldAbstract readEvaluation Study
In one paragraph

Article in BMC cardiovascular disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Determinants of left atrium thrombi in scheduled cardioversion: an ENSURE-AF study analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2019
    Trial
  3. Review
  4. Review
  5. Observational
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Jūratė BarysienėCentre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Clinics, 2 Santariškių St., LT -08661, Vilnius, Lithuania.
Aistė ŽebrauskaitėCentre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Clinics, 2 Santariškių St., LT -08661, Vilnius, Lithuania. zebrauskaite.aiste@gmail.com.ORCID 0000-0003-4049-874X
Dovilė PetrikonytėCentre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Clinics, 2 Santariškių St., LT -08661, Vilnius, Lithuania.
Germanas MarinskisCentre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Clinics, 2 Santariškių St., LT -08661, Vilnius, Lithuania.
Sigita AidietienėCentre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Clinics, 2 Santariškių St., LT -08661, Vilnius, Lithuania.
Audrius AidietisCentre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Clinics, 2 Santariškių St., LT -08661, Vilnius, Lithuania.
Vilnius University · LT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo evaluate a diagnostic value of transoesophageal echocardiogram (TEE) in appropriately anticoagulated patients with a non-valvular atrial fibrillation (AF) and to establish possible additional indications for TEE; to evaluate the incidence of left atrial (LA) thrombi in appropriately anticoagulated patients in daily clinical practice.

methodsThis retrospective study analyses data of 432 patients who had been anticoagulated by means of oral anticoagulants (OACs) prior to planned cardioversion during the period from 2012 to 2015. Thromboembolic (TE) and bleeding risks were assessed using CHA2DS2-VASc and HAS-BLED scores. Transthoracic and transoesophageal echocardiograms were evaluated. TE complications during 30 days after discharge were assessed.

results432 patients were selected, aged from 22 to 89 years (mean 65.0 ±11.5), 277 (64.1%) males and 155 (35.9%) females, 306 (70.8%) on warfarin and 126 (29.2%) on non-vitamin K antagonist oral anticoagulants (NOAC). Mean CHA2DS2-VASc score was 3.5 ±1.5. TEE was performed for 120 (27.8%) patients, more frequently for patients on NOACs and for ones with III° LA enlargement. TEE revealed LA thrombi in seven (5.8%) of the patients. In warfarin and NOACs groups thrombi were revealed in five (7.0%) and two (4.1%) patients, respectively. TEE did not reveal any thrombi in patients with normal left ventricular (LV) function; however, thrombi were found in two (6.1%) patients with slightly decreased LV function, and in five (17.9%) patients with markedly decreased LV function. In patients with decreased left ventricular ejection fraction (LVEF) thrombi in LA were found more frequently than in patients with normal and slightly decreased LVEF (17.9% vs 2.2%, p=0.008). CHA2DS2-VASc score of all 7 patients was ≥5. None of the patients after cardioversion had TE complications 30 days after discharge.

conclusionsThe risk of LA thrombi in patients prepared for scheduled cardioversion in line with the guidelines is low. Higher risk of thrombi was present in patients with decreased LVEF (≤40%), CHA2DS2-VASc ≥5. In order to assess more accurately indications to perform TEE for appropriately anticoagulated patients prior to scheduled cardioversion a study with larger number of patients is required.

Indexed as

Echocardiography, TransesophagealElectric CountershockAdministration, OralAdultAgedAged, 80 and overAnticoagulantsAtrial FibrillationDrug Administration ScheduleFemaleHeart RateHumansMaleMiddle AgedPredictive Value of TestsRecovery of FunctionAnticoagulantsAnticoagulationAtrial fibrillationCardioversionNon-vitamin K antagonist oral anticoagulantsThromboembolismTransoesophageal echocardiogram

Identifiers

PMID28228120
PMCPMC5322653
OpenAlexW2589278081

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.