Use of the CHA2DS2VASc score to reduce utilisation of transoesophageal echocardiography prior to ablation for atrial fibrillation
Autor: | Edmund B Gaisie, Charlotte Atkinson, Dhrubo Rakhit, Benoy N. Shah, Arthur M. Yue, Jonathan Hinton, Paul R. Roberts |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system Scoring system medicine.medical_treatment 030204 cardiovascular system & hematology Transoesophageal echocardiography ablation 03 medical and health sciences 0302 clinical medicine Left atrial Internal medicine Patient experience Medicine Radiology Nuclear Medicine and imaging atrial fibrillation 030212 general & internal medicine Thrombus anticoagulation Advanced and Specialized Nursing Radiological and Ultrasound Technology business.industry Retrospective cohort study Atrial fibrillation Ablation medicine.disease thrombusm lcsh:RC666-701 Cardiology transoesophageal echocardiography business |
Zdroj: | Echo Research and Practice, Vol 4, Iss 4, Pp 45-52 (2017) |
ISSN: | 2055-0464 |
Popis: | Transoesophageal echocardiography (TOE) is frequently performed prior to atrial fibrillation (AF) ablation to exclude left atrial appendage (LAA) thrombus. However, patients undergoing AF ablation are usually anticoagulated, thus making the presence of thrombus unlikely in most cases. This study aimed to determine whether the CHA2DS2VASc scoring system can be used to identify patients that do not require TOE prior to AF ablation. In this single-centre retrospective study, local institutional and primary care databases and electronic patient records were searched to identify patients that had undergone TOE prior to AF ablation. Patient demographics, CHA2DS2VASc score, TOE findings and anticoagulation status were collected for analysis. Over a 7-year period (2008-2014), 332 patients (age 57 ± 10 years; 74% male) underwent TOE prior to proposed AF ablation. CHA2DS2VASc scores of 0, 1, 2 and >2 were found in 39, 34, 15 and 12% of patients, respectively. The prevalence of LAA thrombus was 0.6% (2 patients) and these 2 patients had risk scores of 2 and 4. No patients with a score of 0 or 1 had LAA thrombus. Patients that are classed as low risk by the CHA2DS2VASc score do not require a pre-ablation TOE to screen for LAA thrombus provided they are adequately anticoagulated. This would lead to a significant reduction in health care expenditures by reducing unnecessary TOE requests and thereby improve patient experience. |
Databáze: | OpenAIRE |
Externí odkaz: |