Authors: Peter Bernhardt Harald Schmidt Thorsten Sommer Berndt Lüderitz Heyder Omran
Publish Date: 2006/01/12
Volume: 95, Issue: 3, Pages: 148-153
Abstract
Patients with atrial fibrillation AF have a risk of cerebral embolism Echocardiographic parameters elevate this risk significantly However there is little knowledge about the long–term fate and the rate of clinically silent cerebral embolism under continued oral anticoagulation The aims of our study were to assess prognosis of patients with AF and determine a high risk group with an increased risk of cerebral embolism under oral anticoagulationConsecutive patients with persistent or permanent AF and left atrial LA thrombi dense spontaneous echo contrast SEC and/or reduced LA appendage peak emptying velocities LAAv were included in the study N = 128 Patients with AF and without echocardiographic risk factors N = 114 served as controls All patients were examined with transesophageal echocardiography cranial magnetic resonance imaging and clinically during a period of three yearsDuring the three–year follow–up period 6 5 of the high risk patients had cerebral embolism with neurological deficits 4 3 patients died due to embolic events and 17 13 patients had silent embolism as documented on MRI In the control group 8 7 patients had embolic events n = 1 clinically apparent and n = 7 silent embolism documented on MRI one was clinically apparent Study patients with an event had more commonly previous thromboembolism p 00001
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