Choice of anticoagulant preparation to cardioversion in patients with persistent atrial fibrillation basedon the echocardiogaphic left atrial appendage predictors
Combination of left ventricle ejection fraction decrease  42 mm by transthoracic echocardiography in patients with persistent atrial fibrillation enhances risk of left atrial appendage thrombosis (sensitiveness 65%, specificity 81%). Peak flow velocity decrease under 0,341 m/s by transesophageal echocardiography leads to certain increase of left atrial appendage thrombus risk (sensitiveness 77%, specificity 87%). In patients with increased left atrial appendage thrombus it is recommended transesophageal echocardiography. In case of thrombus exclusion accelerated anticoagulant preparation with heparin and following cardioversion.