Atrial fibrillation echocardiography or ultrasound: Difference between revisions

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{{Template:Atrial fibrillation}}
{{Template:Atrial fibrillation}}
{{CMG}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
 
'''Associate Editor-In-Chief:''' {{CZ}}
 
'''Synonyms and related keywords''': AF, Afib, fib


==[[Echocardiogram|Echocardiography]]==
==[[Echocardiogram|Echocardiography]]==
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===Transesophageal echocardiography (TEE)===
===Transesophageal echocardiography (TEE)===
A normal [[echocardiography]] (transthoracic or TTE) has a low sensitivity for identifying [[thrombus|thrombi]] (blood clots) in the heart. If this is suspected - e.g. when planning urgent electrical [[cardioversion]] - a [[Echocardiogram#Transesophageal echocardiogram|transesophageal echocardiogram]] (TEE) is preferred.<ref name="pmid16908781"/>
A normal [[echocardiography]] (transthoracic or TTE) has a low sensitivity for identifying [[thrombus|thrombi]] (blood clots) in the heart. If this is suspected - e.g. when planning urgent electrical [[cardioversion]] - a [[Echocardiogram#Transesophageal echocardiogram|transesophageal echocardiogram]] (TEE) is preferred.<ref name="pmid16908781">Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16908781 ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.] ''Circulation'' 114 (7):e257-354. [http://dx.doi.org/10.1161/CIRCULATIONAHA.106.177292 DOI:10.1161/CIRCULATIONAHA.106.177292] PMID: [http://pubmed.gov/16908781 16908781]</ref>


The TEE has much better visualization of the [[left auricular appendix|left atrial appendage]] than transthoracic echocardiography.  This structure, located in the [[left atrium]], is the place where thrombus most commonly is formed in the setting of atrial fibrillation or flutter.  TEE has a very high sensitivity for locating thrombus in this area and can also detect sluggish bloodflow in this area that is suggestive of thrombus formation.
The TEE has much better visualization of the [[left auricular appendix|left atrial appendage]] than transthoracic echocardiography.  This structure, located in the [[left atrium]], is the place where thrombus most commonly is formed in the setting of atrial fibrillation or flutter.  TEE has a very high sensitivity for locating thrombus in this area and can also detect sluggish bloodflow in this area that is suggestive of thrombus formation.
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===Transthoracic echocardiography (TTE)===
===Transthoracic echocardiography (TTE)===
A transthoracic [[echocardiogram]] is generally performed in newly diagnosed [[AF]], as well as if there is a major change in the patient's clinical state. This ultrasound-based scan of the heart may help identify [[valvular heart disease]] (which may increase the risk of [[stroke]] manifold), left and right atrial size (which indicates likelihood that [[AF]] may become permanent), left ventricular size and function, peak right ventricular pressure ([[pulmonary hypertension]]), presence of left ventricular hypertrophy and pericardial disease.<ref name="pmid16908781">
A transthoracic [[echocardiogram]] is generally performed in newly diagnosed [[AF]], as well as if there is a major change in the patient's clinical state. This ultrasound-based scan of the heart may help identify [[valvular heart disease]] (which may increase the risk of [[stroke]] manifold), left and right atrial size (which indicates likelihood that [[AF]] may become permanent), left ventricular size and function, peak right ventricular pressure ([[pulmonary hypertension]]), presence of left ventricular hypertrophy and pericardial disease.<ref name="pmid16908781">Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16908781 ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.] ''Circulation'' 114 (7):e257-354. [http://dx.doi.org/10.1161/CIRCULATIONAHA.106.177292 DOI:10.1161/CIRCULATIONAHA.106.177292] PMID: [http://pubmed.gov/16908781 16908781]</ref>


Significant enlargement of both the left and right atria is associated with long-standing [[atrial fibrillation]] and, if noted at the initial presentation of [[atrial fibrillation]], suggests that the [[atrial fibrillation]] is likely of a longer duration than the individual's symptoms.
Significant enlargement of both the left and right atria is associated with long-standing [[atrial fibrillation]] and, if noted at the initial presentation of [[atrial fibrillation]], suggests that the [[atrial fibrillation]] is likely of a longer duration than the individual's symptoms.
==Guideline Resources==
*[http://content.onlinejacc.org/cgi/reprint/48/3/e1.pdf The ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation] <ref name="pmid16908781">Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16908781 ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.] ''Circulation'' 114 (7):e257-354. [http://dx.doi.org/10.1161/CIRCULATIONAHA.106.177292 DOI:10.1161/CIRCULATIONAHA.106.177292] PMID: [http://pubmed.gov/16908781 16908781]</ref>
*[http://circ.ahajournals.org/content/123/10/e269.full.pdf 2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation] <ref name="pmid21382897">Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2011) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21382897 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.] ''Circulation'' 123 (10):e269-367. [http://dx.doi.org/10.1161/CIR.0b013e318214876d DOI:10.1161/CIR.0b013e318214876d] PMID: [http://pubmed.gov/21382897 21382897]</ref>


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Electrophysiology]]
[[Category:Electrophysiology]]
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[[Category:Emergency medicine]]
[[Category:Emergency medicine]]


[[de:Vorhofflimmern]]
[[fr:Fibrillation auriculaire]]
[[it:Fibrillazione atriale]]
[[nl:Boezemfibrilleren]]
[[ja:心房細動]]
[[no:Atrieflimmer]]
[[pl:Migotanie przedsionków]]
[[ro:Fibrilaţia Atrială]]
[[fi:Eteisvärinä]]
[[zh:心房颤动]]
[[tr:Atriyal fibrillasyon]]


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Revision as of 14:15, 29 October 2011

Atrial Fibrillation Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Atrial Fibrillation from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Special Groups

Postoperative AF
Acute Myocardial Infarction
Wolff-Parkinson-White Preexcitation Syndrome
Hypertrophic Cardiomyopathy
Hyperthyroidism
Pulmonary Diseases
Pregnancy
ACS and/or PCI or valve intervention
Heart failure

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

EKG Examples
A-Fib with LBBB

Chest X Ray

Echocardiography

Holter Monitoring and Exercise Stress Testing

Cardiac MRI

Treatment

Rate and Rhythm Control

Cardioversion

Overview
Electrical Cardioversion
Pharmacological Cardioversion

Anticoagulation

Overview
Warfarin
Converting from or to Warfarin
Converting from or to Parenteral Anticoagulants
Dabigatran

Maintenance of Sinus Rhythm

Surgery

Catheter Ablation
AV Nodal Ablation
Surgical Ablation
Cardiac Surgery

Specific Patient Groups

Primary Prevention

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Supportive Trial Data

Cost-Effectiveness of Therapy

Case Studies

Case #1

Atrial fibrillation echocardiography or ultrasound On the Web

Most recent articles

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CME Programs

Powerpoint slides

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Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Atrial fibrillation echocardiography or ultrasound

CDC on Atrial fibrillation echocardiography or ultrasound

Atrial fibrillation echocardiography or ultrasound in the news

Blogs on Atrial fibrillation echocardiography or ultrasound

Directions to Hospitals Treating Atrial fibrillation echocardiography or ultrasound

Risk calculators and risk factors for Atrial fibrillation echocardiography or ultrasound

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Echocardiography

Overview

Performing an echocardiogram is essential to identify;

  • Valvular heart disease
  • Left and right atrial size
  • LV size and function
  • Peak RV pressure (pulmonary hypertension)
  • LV hypertrophy
  • LA thrombus (low sensitivity)
  • Pericardial disease

Transesophageal echocardiography (TEE)

A normal echocardiography (transthoracic or TTE) has a low sensitivity for identifying thrombi (blood clots) in the heart. If this is suspected - e.g. when planning urgent electrical cardioversion - a transesophageal echocardiogram (TEE) is preferred.[1]

The TEE has much better visualization of the left atrial appendage than transthoracic echocardiography. This structure, located in the left atrium, is the place where thrombus most commonly is formed in the setting of atrial fibrillation or flutter. TEE has a very high sensitivity for locating thrombus in this area and can also detect sluggish bloodflow in this area that is suggestive of thrombus formation.

If no thrombus is seen on TEE, the incidence of stroke immediately after cardioversion is performed is very low.

Transthoracic echocardiography (TTE)

A transthoracic echocardiogram is generally performed in newly diagnosed AF, as well as if there is a major change in the patient's clinical state. This ultrasound-based scan of the heart may help identify valvular heart disease (which may increase the risk of stroke manifold), left and right atrial size (which indicates likelihood that AF may become permanent), left ventricular size and function, peak right ventricular pressure (pulmonary hypertension), presence of left ventricular hypertrophy and pericardial disease.[1]

Significant enlargement of both the left and right atria is associated with long-standing atrial fibrillation and, if noted at the initial presentation of atrial fibrillation, suggests that the atrial fibrillation is likely of a longer duration than the individual's symptoms.

Guideline Resources

References


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