MAY 10, 2001 | ALLAN L. KLEIN, M.D., RICHARD A. GRIMM, D.O., R. DANIEL MURRAY, PH.D., CAROLYN APPERSON-HANSEN, M.STAT., RICHARD W. ASINGER, M.D., JAN W. BLACK, M.D., RAVIN DAVIDOFF, M.B., B.C.H., RAIMUND ERBEL, M.D., JONATHAN L. HALPERIN, M.D., DAVID A. ORSINELLI, M.D., THOMAS R. PORTER, M.D., AND MARCUS F. STODDARD, M.D., FOR THE ASSESSMENT OF CARDIOVERSION USING TRANSSESOPHAGEAL ECHOCARDIOGRAPHY INVESTIGATORS*
The study evaluated the effectiveness of using transesophageal echocardiography (TEE) to guide cardioversion in patients with atrial fibrillation. A total of 1222 patients were enrolled and randomly assigned to either a TEE-guided treatment group or a conventional treatment group. The primary endpoint was a composite of cerebrovascular accidents, transient ischemic attacks, and peripheral embolism within eight weeks. Secondary endpoints included functional status, successful restoration and maintenance of sinus rhythm, hemorrhage, and death.
The results showed no significant difference between the two groups in the rate of embolic events (0.8% in the TEE group vs. 0.5% in the conventional group). However, the TEE group had a significantly lower rate of hemorrhagic events (2.9% vs. 5.5%). Patients in the TEE group also had a shorter time to cardioversion (mean 3.0 ± 5.6 days vs. 30.6 ± 10.6 days) and a higher rate of successful restoration of sinus rhythm (71.1% vs. 65.2%). At eight weeks, there were no significant differences between the groups in the rates of death or maintenance of sinus rhythm or in functional status.
The study concluded that using TEE to guide cardioversion may be a clinically effective alternative to conventional therapy for patients with atrial fibrillation who are planned for elective cardioversion.The study evaluated the effectiveness of using transesophageal echocardiography (TEE) to guide cardioversion in patients with atrial fibrillation. A total of 1222 patients were enrolled and randomly assigned to either a TEE-guided treatment group or a conventional treatment group. The primary endpoint was a composite of cerebrovascular accidents, transient ischemic attacks, and peripheral embolism within eight weeks. Secondary endpoints included functional status, successful restoration and maintenance of sinus rhythm, hemorrhage, and death.
The results showed no significant difference between the two groups in the rate of embolic events (0.8% in the TEE group vs. 0.5% in the conventional group). However, the TEE group had a significantly lower rate of hemorrhagic events (2.9% vs. 5.5%). Patients in the TEE group also had a shorter time to cardioversion (mean 3.0 ± 5.6 days vs. 30.6 ± 10.6 days) and a higher rate of successful restoration of sinus rhythm (71.1% vs. 65.2%). At eight weeks, there were no significant differences between the groups in the rates of death or maintenance of sinus rhythm or in functional status.
The study concluded that using TEE to guide cardioversion may be a clinically effective alternative to conventional therapy for patients with atrial fibrillation who are planned for elective cardioversion.