Missault L, Jordaens L, Gheeraert P, Adang L, Clement D
Department of Cardiology, University Hospital, Gent, Belgium.
Eur Heart J. 1994 Sep;15(9):1279-80. doi: 10.1093/oxfordjournals.eurheartj.a060665.
Recent studies in patients with atrial fibrillation, not on anticoagulation, suggest that if transoesophageal echocardiography (TEE) excludes the presence of thrombi, early cardioversion can be performed safely without the need for anticoagulation before the procedure. Immediately after successful cardioversion, however, left atrium or left atrial appendage stunning may be present, potentially carrying a risk for de novo thrombus formation. Furthermore, the presence of spontaneous contrast is considered as a contraindication for unanticoagulated cardioversion since it has been associated with postcardioversion thromboembolism. We present a case in which stroke developed in relation to unanticoagulated cardioversion regardless of careful prior evaluation with TEE.
近期针对未接受抗凝治疗的房颤患者的研究表明，如果经食管超声心动图（TEE）排除血栓存在，早期复律可在无需术前抗凝的情况下安全进行。然而，成功复律后即刻，可能会出现左心房或左心耳顿抑，这有可能带来新发血栓形成的风险。此外，自发显影的存在被视为未抗凝复律的禁忌证，因为它与复律后血栓栓塞有关。我们报告一例病例，尽管术前已通过TEE进行了仔细评估，但未抗凝复律仍导致了卒中。
