Critical appraisal of transesophageal echocardiography in cardioversion of atrial fibrillation

Malouf, Joseph F; Ammash, Naser M; Chandrasekaran, Krishnaswamy; Friedman, Paul A; Khandheria, Bijoy K; Gersh, Bernard J

« Previous Next »The American Journal of Medicine
Volume 113, Issue 7 , Pages 587-595, November 2002

Critical appraisal of transesophageal echocardiography in cardioversion of atrial fibrillation

Joseph F Malouf, MD
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Requests for reprints should be addressed to Joseph F. Malouf, MD, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA
Naser M Ammash, MD
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
Krishnaswamy Chandrasekaran, MD
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
Paul A Friedman, MD
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
Bijoy K Khandheria, MD
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
Bernard J Gersh, MBChB, DPhil
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA

Received 11 February 2002; accepted 5 August 2002.

Abstract

Atrial fibrillation is the most common sustained cardiac arrhythmia and an important health concern in the United States because of the increasing aging population. Cardioversion of atrial fibrillation to sinus rhythm to relieve symptoms and to reduce the incidence of thromboembolism is now common practice. Recently, transesophageal echocardiography (TEE)–facilitated cardioversion emerged as an acceptable therapeutic alternative owing to the assumption that early cardioversion can obviate many of the concerns and disadvantages associated with the conventional approach. We review the current standing of TEE-facilitated early cardioversion vis-à-vis the salient cardioversion issues and its potential future role amid evolving cardioversion paradigms.