Right atrial spontaneous echo contrast and thrombi in atrial fibrillation: A transesophageal echocardiography study

Mohammad Bashir, Craig R. Asher, Mario J. Garcia, Ibrahim Abdalla, Susan E. Jasper, R. Daniel Murray, Richard A. Grimm, James D. Thomas, Allan L. Klein

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Previous studies have reported the clinical and echocardiographic findings of patients with left atrial spontaneous echo contrast (SEC) and thrombi. We sought to study these characteristics in patients with right atrial SEC and thrombi. Methods: We reviewed 580 consecutive patients from the ACUTE (Assessment of Cardioversion Using Transesophageal Echocardiography) Registry and found 79 patients (14%, aged 67 ±13 years, 67 male) with transesophageal echocardiography (TEE) findings of right atrial SEC or thrombi (group 1). This group was compared with a control group of 75 consecutive patients (group 2) (aged 68 ± 13 years, P = not significant; 49 male, P < .005) from the registry with no TEE findings of SEC or thrombi in the left or right atrium. Results: Atrial fibrillation was present in 60 of 79 group I patients (76%). Five right atrial (6%) and 11 left atrial (14%) thrombi were identified. Both left ventricular ejection fraction (39% ± 16% versus 47% ± 14%; P = .0005) and presence of right ventricular dysfunction (n = 44 versus 18; P = .0001) differed significantly between groups I and 2, respectively. Right atrial area (24 ± 6 cm 2 versus 22 ± 6 cm 2; P = .02) was larger in patients in group 1. Left atrial SEC was present in 68 of 79 group I patients (86%). Patients with right atrial thrombi and right atrial SEC had a longer duration of arrhythmia (524 ± 812 days versus 147 ± 368 days, P < .05) than patients with right atrial SEC only. Conclusions: Right atrial SEC has a prevalence of 14% in patients with atrial arrhythmia who undergo TEE-guided cardioversion. Right atrial thrombi are a rare finding and were seen in fewer than 1% (5/580) of patients with atrial arrhythmia. Right atrial thrombi among patients on anticoagulation therapy were not associated with clinically significant pulmonary embolism.

Original languageEnglish (US)
Pages (from-to)122-127
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume14
Issue number2
StatePublished - 2001
Externally publishedYes

Fingerprint

Transesophageal Echocardiography
Atrial Fibrillation
Thrombosis
Patient Rights
Cardiac Arrhythmias
Electric Countershock
Heart Atria
Registries
Right Ventricular Dysfunction
Pulmonary Embolism
Stroke Volume
Control Groups

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Right atrial spontaneous echo contrast and thrombi in atrial fibrillation : A transesophageal echocardiography study. / Bashir, Mohammad; Asher, Craig R.; Garcia, Mario J.; Abdalla, Ibrahim; Jasper, Susan E.; Murray, R. Daniel; Grimm, Richard A.; Thomas, James D.; Klein, Allan L.

In: Journal of the American Society of Echocardiography, Vol. 14, No. 2, 2001, p. 122-127.

Research output: Contribution to journalArticle

Bashir, M, Asher, CR, Garcia, MJ, Abdalla, I, Jasper, SE, Murray, RD, Grimm, RA, Thomas, JD & Klein, AL 2001, 'Right atrial spontaneous echo contrast and thrombi in atrial fibrillation: A transesophageal echocardiography study', Journal of the American Society of Echocardiography, vol. 14, no. 2, pp. 122-127.
Bashir, Mohammad ; Asher, Craig R. ; Garcia, Mario J. ; Abdalla, Ibrahim ; Jasper, Susan E. ; Murray, R. Daniel ; Grimm, Richard A. ; Thomas, James D. ; Klein, Allan L. / Right atrial spontaneous echo contrast and thrombi in atrial fibrillation : A transesophageal echocardiography study. In: Journal of the American Society of Echocardiography. 2001 ; Vol. 14, No. 2. pp. 122-127.
@article{4e57be8587ea42f6963b81c49fc21ae4,
title = "Right atrial spontaneous echo contrast and thrombi in atrial fibrillation: A transesophageal echocardiography study",
abstract = "Background: Previous studies have reported the clinical and echocardiographic findings of patients with left atrial spontaneous echo contrast (SEC) and thrombi. We sought to study these characteristics in patients with right atrial SEC and thrombi. Methods: We reviewed 580 consecutive patients from the ACUTE (Assessment of Cardioversion Using Transesophageal Echocardiography) Registry and found 79 patients (14{\%}, aged 67 ±13 years, 67 male) with transesophageal echocardiography (TEE) findings of right atrial SEC or thrombi (group 1). This group was compared with a control group of 75 consecutive patients (group 2) (aged 68 ± 13 years, P = not significant; 49 male, P < .005) from the registry with no TEE findings of SEC or thrombi in the left or right atrium. Results: Atrial fibrillation was present in 60 of 79 group I patients (76{\%}). Five right atrial (6{\%}) and 11 left atrial (14{\%}) thrombi were identified. Both left ventricular ejection fraction (39{\%} ± 16{\%} versus 47{\%} ± 14{\%}; P = .0005) and presence of right ventricular dysfunction (n = 44 versus 18; P = .0001) differed significantly between groups I and 2, respectively. Right atrial area (24 ± 6 cm 2 versus 22 ± 6 cm 2; P = .02) was larger in patients in group 1. Left atrial SEC was present in 68 of 79 group I patients (86{\%}). Patients with right atrial thrombi and right atrial SEC had a longer duration of arrhythmia (524 ± 812 days versus 147 ± 368 days, P < .05) than patients with right atrial SEC only. Conclusions: Right atrial SEC has a prevalence of 14{\%} in patients with atrial arrhythmia who undergo TEE-guided cardioversion. Right atrial thrombi are a rare finding and were seen in fewer than 1{\%} (5/580) of patients with atrial arrhythmia. Right atrial thrombi among patients on anticoagulation therapy were not associated with clinically significant pulmonary embolism.",
author = "Mohammad Bashir and Asher, {Craig R.} and Garcia, {Mario J.} and Ibrahim Abdalla and Jasper, {Susan E.} and Murray, {R. Daniel} and Grimm, {Richard A.} and Thomas, {James D.} and Klein, {Allan L.}",
year = "2001",
language = "English (US)",
volume = "14",
pages = "122--127",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Right atrial spontaneous echo contrast and thrombi in atrial fibrillation

T2 - A transesophageal echocardiography study

AU - Bashir, Mohammad

AU - Asher, Craig R.

AU - Garcia, Mario J.

AU - Abdalla, Ibrahim

AU - Jasper, Susan E.

AU - Murray, R. Daniel

AU - Grimm, Richard A.

AU - Thomas, James D.

AU - Klein, Allan L.

PY - 2001

Y1 - 2001

N2 - Background: Previous studies have reported the clinical and echocardiographic findings of patients with left atrial spontaneous echo contrast (SEC) and thrombi. We sought to study these characteristics in patients with right atrial SEC and thrombi. Methods: We reviewed 580 consecutive patients from the ACUTE (Assessment of Cardioversion Using Transesophageal Echocardiography) Registry and found 79 patients (14%, aged 67 ±13 years, 67 male) with transesophageal echocardiography (TEE) findings of right atrial SEC or thrombi (group 1). This group was compared with a control group of 75 consecutive patients (group 2) (aged 68 ± 13 years, P = not significant; 49 male, P < .005) from the registry with no TEE findings of SEC or thrombi in the left or right atrium. Results: Atrial fibrillation was present in 60 of 79 group I patients (76%). Five right atrial (6%) and 11 left atrial (14%) thrombi were identified. Both left ventricular ejection fraction (39% ± 16% versus 47% ± 14%; P = .0005) and presence of right ventricular dysfunction (n = 44 versus 18; P = .0001) differed significantly between groups I and 2, respectively. Right atrial area (24 ± 6 cm 2 versus 22 ± 6 cm 2; P = .02) was larger in patients in group 1. Left atrial SEC was present in 68 of 79 group I patients (86%). Patients with right atrial thrombi and right atrial SEC had a longer duration of arrhythmia (524 ± 812 days versus 147 ± 368 days, P < .05) than patients with right atrial SEC only. Conclusions: Right atrial SEC has a prevalence of 14% in patients with atrial arrhythmia who undergo TEE-guided cardioversion. Right atrial thrombi are a rare finding and were seen in fewer than 1% (5/580) of patients with atrial arrhythmia. Right atrial thrombi among patients on anticoagulation therapy were not associated with clinically significant pulmonary embolism.

AB - Background: Previous studies have reported the clinical and echocardiographic findings of patients with left atrial spontaneous echo contrast (SEC) and thrombi. We sought to study these characteristics in patients with right atrial SEC and thrombi. Methods: We reviewed 580 consecutive patients from the ACUTE (Assessment of Cardioversion Using Transesophageal Echocardiography) Registry and found 79 patients (14%, aged 67 ±13 years, 67 male) with transesophageal echocardiography (TEE) findings of right atrial SEC or thrombi (group 1). This group was compared with a control group of 75 consecutive patients (group 2) (aged 68 ± 13 years, P = not significant; 49 male, P < .005) from the registry with no TEE findings of SEC or thrombi in the left or right atrium. Results: Atrial fibrillation was present in 60 of 79 group I patients (76%). Five right atrial (6%) and 11 left atrial (14%) thrombi were identified. Both left ventricular ejection fraction (39% ± 16% versus 47% ± 14%; P = .0005) and presence of right ventricular dysfunction (n = 44 versus 18; P = .0001) differed significantly between groups I and 2, respectively. Right atrial area (24 ± 6 cm 2 versus 22 ± 6 cm 2; P = .02) was larger in patients in group 1. Left atrial SEC was present in 68 of 79 group I patients (86%). Patients with right atrial thrombi and right atrial SEC had a longer duration of arrhythmia (524 ± 812 days versus 147 ± 368 days, P < .05) than patients with right atrial SEC only. Conclusions: Right atrial SEC has a prevalence of 14% in patients with atrial arrhythmia who undergo TEE-guided cardioversion. Right atrial thrombi are a rare finding and were seen in fewer than 1% (5/580) of patients with atrial arrhythmia. Right atrial thrombi among patients on anticoagulation therapy were not associated with clinically significant pulmonary embolism.

UR - http://www.scopus.com/inward/record.url?scp=0035132475&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035132475&partnerID=8YFLogxK

M3 - Article

C2 - 11174446

AN - SCOPUS:0035132475

VL - 14

SP - 122

EP - 127

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

SN - 0894-7317

IS - 2

ER -