Evaluation of patients who have undergone radiofrequency ablation in the absence of complications. Palpitation without corresponding arrhythmia or other cardiac signs or symptoms. Isolated premature ventricular contractions for which there is no clinical suspicion of heart disease. III Cardioversion for Patients With Atrial Fibrillation Echocardiography can help identify patients with atrial fibrillation who are most likely to maintain sinus rhythm after cardioversion. LV dysfunction argues against long-term success.
Atrial size is a more controversial prognosticator.
In subjects undergoing cardioversion for atrial fibrillation, it has been reported that exclusion of intra-atrial thrombus by TEE can obviate the need for extended precardioversion anticoagulation, allowing instead the use of heparin immediately before cardioversion and continuing coumadin for several weeks afterward until mechanical function of the atrium has been restored. Large multicenter trials are still ongoing to address this issue. It is also not clear how long atrial fibrillation must be present before the thrombus can form, so that there may be no difference in the danger of thrombus formation between recent-onset and chronic atrial fibrillation. Indications for Echocardiography Before Cardioversion Class 1. Patients who have had prior cardioembolic events thought to be related to intra-atrial thrombus.