Vorhofflimmern: Bedeutung der Transosophagealen Echokardiographie

Transesophageal echocardiography is superior to transthoracic echocardiography in detection of left atrial thrombi and spontaneous echocardiographic contrast, particularly in patients with atrial fibrillation and spontaneous echocardiographic contrast, thrombus formation is likely. In addition to the morphology, Doppler-echocardiography can be used to access left atrial appendage function. In patients with lone atrial fibrillation, reduced velocity was found in 60%, and no flow was detected in the left atrial appendage in 40%. These patients had a higher risk for spontaneous echocardiographic contrast and thrombus formation. As left atrial thrombi are found in 12% of patients, transesophageal echocardiography can be used to avoid cardioversion in these patients, which may lead to cerebral or peripheral emboli. Despite ruling out left atrial thrombi, embolism occurred after cardioversion when anticoagulation was insufficient or not performed. Current investigations are undertaken in order to demonstrate the clinical benefit of transesophageal echocardiography in patients with left atrial fibrillation.