Department of Cardiology, AO dei Colli, Monaldi Hospital, 80131 Naples, Italy.
Institute of Biostructure and Bioimaging, National Council Research, 80131 Naples, Italy.
Medicina (Kaunas). 2019 Aug 21;55(9):511. doi: 10.3390/medicina55090511.
Atrial fibrillation is the most common cardiac arrhythmia and is associated with an increased risk of stroke and thromboembolic complications. A rhythm control strategy with both electrical and pharmacological cardioversion is recommended for patients with symptomatic atrial fibrillation. Anticoagulant therapy for 3-4 weeks prior to cardioversion is recommended in order to avoid thromboembolic events deriving from restoring sinus rhythm. Transesophageal echocardiography has a pivotal role in this setting, excluding the presence of left atrial appendage thrombus before cardioversion. The aim of this review is to discuss the epidemiology and risk factors for left atrial appendage thrombosis, the role of echocardiography in the decision making before cardioversion, and the efficacy of different anticoagulant regimens on the detection and treatment of left atrial appendage thrombosis.
心房颤动是最常见的心律失常，与中风和血栓栓塞并发症的风险增加有关。对于有症状的心房颤动患者，建议采用电复律和药物复律的节律控制策略。在电复律前建议进行 3-4 周的抗凝治疗，以避免因恢复窦性节律而导致血栓栓塞事件。经食管超声心动图在这种情况下具有关键作用，可在电复律前排除左心耳血栓的存在。本综述的目的是讨论左心耳血栓形成的流行病学和危险因素，超声心动图在电复律前决策中的作用，以及不同抗凝方案在左心耳血栓形成的检测和治疗中的疗效。
