Transesophageal Echocardiography-Guided Cardioversion: Going for Broke?
Authors: Allan L. Klein
Journal: Annals of Internal Medicine (1997)

Letters15 October 1997Transesophageal Echocardiography-Guided Cardioversion: Going for Broke?Allan L. Klein, MD, R. Daniel Murray, PhD, and Richard A. Grimm, DOAllan L. Klein, MDThe Cleveland Clinic Foundation; Cleveland, OH 44195Search for more papers by this author, R. Daniel Murray, PhDThe Cleveland Clinic Foundation; Cleveland, OH 44195Search for more papers by this author, and Richard A. Grimm, DOThe Cleveland Clinic Foundation; Cleveland, OH 44195Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-8_Part_1-199710150-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In his recent editorial [1], Dr. Prystowsky discusses the ACUTE (Assessment of Cardioversion Using Transesophageal Echocardiography) Pilot Study [2]. His dissatisfaction with the study seems to stem from the stated limitations of conventional management, which include the delay of direct-current cardioversion (DCC), the increased risk for bleeding, the inconvenience of readmission for DCC, the occurrence of strokes despite anticoagulation, and the lack of controlled studies showing efficacy [2]. Prystowsky defends the conventional approach and asks “If it ain't broke, why fix it” [1].Prystowsky indicates that use of the conventional 3-week anticoagulation period is well founded and ...References1. Prystowsky EN. Management of atrial fibrillation: simplicity surrounded by controversy [Editorial]. Ann Intern Med. 1997; 126:244-6. Google Scholar2. Klein AL, Grimm RA, Black IW, Leung DY, Chung MK, Vaughn SE, et al. Cardioversion guided by transesophageal echocardiography: the ACUTE Pilot Study. A randomized, controlled trial. Ann Intern Med. 1997; 126:200-9. Google Scholar3. Schlicht JR, Davis RC, Naqi K, Cooper W, Rao BV. Physician practices regarding anticoagulation and cardioversion of atrial fibrillation. Arch Intern Med. 1996; 156:290-4. Google Scholar4. Klein AL, Grimm RA, Black IW, Orsinelli D, Manning W, Stoddard M, et al. Cost effectiveness of TEE-guided DCC with anticoagulation compared to conventional therapy in patients with atrial fibrillation [Abstract]. J Am Coll Cardiol. 1994; 128A. Google Scholar5. Seto TB, Taira DA, Tsevat J, Manning WG. Cost effectiveness of transesophageal echocardiographic-guided DCC: a decision analytic model for patients admitted to the hospital with atrial fibrillation. J Am Coll Cardiol. 1997; 29:122-30. Google Scholar Author, Article, and Disclosure InformationAffiliations: The Cleveland Clinic Foundation; Cleveland, OH 44195 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRole of transesophageal echocardiography-guided cardioversion of patients with atrial fibrillationTransesophageal Echocardiography-Guided Cardioversion of Atrial FibrillationDesign of a Clinical Trial for the Assessment of Cardioversion Using Transesophageal Echocardiography (The ACUTE Multicenter Study) 11This study was supported in part by grants from the American Medical Association Education and Research Foundation, Chicago, Illinois; and American Society of Echocardiography Outcomes Research, Raleigh, North Carolina. 15 October 1997Volume 127, Issue 8_Part_1Page: 652 Issue Published: 15 October 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...