Efficacy of the CHADS2 Scoring System to Assess Left Atrial Thrombogenic Milieu Risk Before Cardioversion of Non-Valvular Atrial Fibrillation

In this study, data from 2,369 consecutive patients in whom transesophageal echocardiography was performed for screening before direct-current cardioversion from 1999 to 2008 were analyzed. Left atrial (LA) or LA appendage (LAA) thrombogenic milieu (spontaneous echo contrast, sludge, and thrombus) was investigated. The results were correlated with CHADS2 score findings. The mean age was 66 ± 13 years, and the ratio of men to women was 2.2:1. CHADS2 scores of 0, 1, 2, 3, 4, 5 and 6 were present in 11%, 25%, 30%, 22%, 8%, 3%, and 1% of the studies, respectively. The prevalence of LA or LAA sludge or thrombus increased with increasing CHADS2 scores (2.3%, 7%, 8.5%, 9.9%, 12.3%, and 14.1% for scores of 0, 1, 2, 3, 4, and 5 or 6, respectively, p = 0.01). In a multivariate model, an ejection fraction ≤20% was the best predictor of LA or LAA sludge or thrombus (odds ratio 2.99, p
Source: The American Journal of Cardiology - Category: Cardiology Authors: Tags: Arrhythmias and Conduction Disturbances Source Type: research