How is echocardiography used following the diagnosis of atrial fibrillation (Afib) (AF)?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

Echocardiography may be used to evaluate for valvular heart disease, left and right atrial size, left ventricular (LV) size and function, left ventricular hypertrophy (LVH), and pericardial disease. Transthoracic echocardiography has low sensitivity in detecting left atrial (LA) thrombus, and transesophageal echocardiography is the modality of choice for this purpose. [54]

Transthoracic echocardiography (TTE) is helpful for making the following determinations:

  • Evaluate for valvular heart disease

  • Evaluate atrial and ventricular chamber and wall dimensions

  • Estimate ventricular function and evaluate for ventricular thrombi

  • Estimate pulmonary systolic pressure (pulmonary hypertension)

  • Evaluate for pericardial disease

Transesophageal echocardiography (TEE) is helpful for making the following determinations:

  • Evaluate for atrial thrombus (particularly in the LA appendage)

  • To guide cardioversion (if thrombus is seen, cardioversion should be delayed)

  • When TEE is planned, the concurrent use of TTE may increase cost without providing significant additional information.


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