What Is the Role of Echocardiography in the Management of Patients with Atrial Fibrillation?
A number of echocardiographic features have been proposed as predictors of thromboembolism in patients with atrial fibrillation. Features shown by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE) are predictive of this increased risk: left atrial enlargement, spontaneous echo contrast in left atri-um, left-ventricular dysfunction, increased left-ventricular mass, and mitral annular calcification. TEE consistently is superior to TTE in identifying left atrial thrombi and other features considered as important predictors of thromboembolic risk in patients with atrial fibrillation. Spontaneous echo contrast is the smoke-like signal detected in the atria of some patients with AF. This phenomenon indicates stasis and erythrocyte or platelet microaggregation. Spontaneous echo contrast is also associated with an increased prevalence of atrial thrombus and an important marker for thromboembolic risk. Patients with AF studied with TEE and TTE, have a spontaneous ec
