Transesophageal Echocardiography Following Left Atrial Appendage Electrical Isolation: Diagnostic Pitfalls and Clinical Implications.
Carola GianniJavier E SanchezQiong ChenDomenico Giovanni Della RoccaSanghamitra MohantyChintan TrivediAmin Al-AhmadMohamed A BassiounyJ David BurkhardtG Joseph GallinghouseRodney P HortonPatrick M HranitzkyJorge E RomeroLuigi Di BiaseMario J GarciaSanghamitra MohantyPublished in: Circulation. Arrhythmia and electrophysiology (2022)
Underdiagnosis of LAA mechanical dysfunction is common in TEEs performed following LAA electrical isolation, and it is associated with an increased risk of cerebrovascular events owing to oral anticoagulation discontinuation despite absent/reduced LAA contraction. Careful review of the TEE exam by an operator with specific expertise in LAA imaging and familiar with the functional implications of LAA isolation is necessary before interrupting oral anticoagulation in this cohort.