heartrhythmjournal.com
Precardioversion assessment with computed tomography compared with transesophageal echocardiography in patients with atrial fibrillation or flutter
Transesophageal echocardiography (TEE) is an accepted standard to exclude left atrial appendage (LAA) thrombus before direct current cardioversion (DCCV) for treatment of atrial fibrillation (AF). Although TEE-guided DCCV is considered an efficacious means to expedite restoration of sinus rhythm, TEE requires sedation and carries a small procedural risk of esophageal trauma, bleeding, or perforation.1 In addition, some individuals have esophageal pathology for which TEE is contraindicated, or they may have a nondiagnostic TEE evaluation for exclusion of LAA thrombus secondary to variations in esophageal–cardiac orientation or acoustic artifacts.