Transesophageal Echocardiography for Thrombus Screening Prior to Left Atrial Catheter Ablation

Background: Transesophageal echocardiography (TEE) is useful for detecting left atrial (LA) thrombus prior to percutaneous LA catheter ablation in patients with atrial fibrillation (AF). This study was designed to evaluate clinical predictors of LA thrombus and determine indications for TEE screening prior to LA ablation. Methods and Results: The study consisted of 446 patients with drug-resistant AF who were scheduled to undergo initial LA ablation (age 59±11 years, 312 males, 136 persistent AF). TEE was performed in all cases within 24 h before ablation. We assessed clinical parameters including CHADS2 score and echocardiographic parameters. LA thrombus was detected in 13 cases (2.9%) prior to LA ablation (67±8 years, 10 males, 12 persistent AF). In multiple logistic regression analysis, advanced age (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.0-1.2; P