{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:23:15Z","timestamp":1783470195425,"version":"3.55.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,8,22]],"date-time":"2019-08-22T00:00:00Z","timestamp":1566432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Daiichi Sankyo Pharma Development"},{"name":"Daiichi Sankyo Development, Ltd"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>ENSURE-AF (NCT 02072434) was the largest prospective randomized clinical trial of anticoagulation for cardioversion in atrial fibrillation (AF), which also provides the largest prospective dataset for transoesophageal echocardiography (TOE) prior to cardioversion. This ancillary analysis investigated determinants of TOE-detected left atrium thrombi (LAT) in patients scheduled for electrical cardioversion (ECV).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The ENSURE-AF multicentre PROBE evaluation trial compared edoxaban 60\u2009mg once daily (QD) with enoxaparin\/warfarin in 2199 subjects undergoing ECV of non-valvular AF. Patients were stratified by the use of TOE, anticoagulant experience, and selected edoxaban dose. Electrical cardioversion was cancelled or deferred when TOEdetected LAT. In total, 1183 subjects were stratified to the TOE arm and LAT was reported in 91 (8.2%). In univariate analysis, age \u226575\u2009years (26.4% vs. 16.9%, P\u2009=\u20090.0308), lower weight (86.5\u2009\u00b1\u200915.0 vs. 90.7\u2009\u00b1\u200918.0 kg, P\u2009=\u20090.0309), lower creatinine clearance (80.1\u2009\u00b1\u200930.6 vs. 93.2\u2009\u00b1\u200933.9\u2009mL\/min, P\u2009=\u20090.0007), heart failure (59.3% vs. 43.0%, P\u2009=\u20090.0029), and diuretic treatment (53.9% vs. 40.1%, P\u2009=\u20090.0141) were more prevalent in the LAT group. Non-significant trends were seen for higher mean CHA2DS2-VASc score (3.0\u2009\u00b1\u20091.41 vs. 2.7\u2009\u00b1\u20091.48, P\u2009=\u20090.0571) and more prevalent anticoagulation use prior to enrolment (60.4% vs. 50.3%, P\u2009=\u20090.0795) in the LAT group. In logistic regression analysis, age (P\u2009=\u20090.0202) and heart failure (P\u2009=\u20090.0064) were independently associated with LAT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Elective ECV is commonly cancelled or deferred due to TOE-detected LAT in patients with non-valvular AF. Age \u226575\u2009years and heart failure were associated with the presence of LAT.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euz213","type":"journal-article","created":{"date-parts":[[2019,8,7]],"date-time":"2019-08-07T15:13:14Z","timestamp":1565190794000},"page":"1633-1638","source":"Crossref","is-referenced-by-count":22,"title":["Determinants of left atrium thrombi in scheduled cardioversion: an ENSURE-AF study analysis"],"prefix":"10.1093","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1737-1903","authenticated-orcid":false,"given":"Jose L","family":"Merino","sequence":"first","affiliation":[{"name":"Arrhythmia and Robotic Electrophysiology Unit, Hospital Universitario La Paz, IDIPaz, Departamento de Medicina de la Universidad Autonoma de Madrid, P. Castellana, 261 (H. Gral, 1st Floor), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK"},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9301-8127","authenticated-orcid":false,"given":"Hein","family":"Heidbuchel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Antwerp University and University Hospital, Wijlrijkstraat 10, Antwerp, Edegem, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron-Ariel","family":"Cohen","sequence":"additional","affiliation":[{"name":"Service de cardiologie, INSERM 856 and H\u00f4pital Saint Antoine, H\u00f4pital Tenon; Sorbonne-Universit\u00e9 (Universit\u00e9 Pierre et Marie Curie, Paris VI), 1 rue Victor Cousin, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"De Caterina","sequence":"additional","affiliation":[{"name":"Chair of Cardiology, University of Pisa and Cardiology Division, Pisa University Hospital, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8122-7017","authenticated-orcid":false,"given":"Joris R","family":"de Groot","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC, University of Amsterdam, Heart Center, Meibergdreef 9, AZ, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"Ezekowitz","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Sidney Kimmel Jefferson Medical College at Thomas Jefferson University, 1025 Walnut St #100, Philadelphia, PA, USA; Lankenau Medical Center, 100 East Lancaster Avenue, Wynnewood, PA, USA and Bryn Mawr Hospital, 130 South Bryn Mawr Avenue Bryn Mawr, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Yves","family":"Le Heuzey","sequence":"additional","affiliation":[{"name":"Cardiology and Arrhythmology, Georges Pompidou Hospital, Ren\u00e9 Descartes University, 20 Rue Leblanc, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakis","family":"Themistoclakis","sequence":"additional","affiliation":[{"name":"Unit of Electrophysiology and Cardiac Pacing, Dell\u2019Angelo Hospital, Via Paccagnella, 11, Venice-Mestre, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Jin","sequence":"additional","affiliation":[{"name":"Daiichi Sankyo Pharma Development, 211 Mt Airy Rd, Basking Ridge, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Melino","sequence":"additional","affiliation":[{"name":"Daiichi Sankyo Pharma Development, 211 Mt Airy Rd, Basking Ridge, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M","family":"Winters","sequence":"additional","affiliation":[{"name":"Daiichi Sankyo, Inc., 211 Mt Airy Rd, Basking Ridge, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9la","family":"Merkely","sequence":"additional","affiliation":[{"name":"Semmelweis University Heart and Vascular Center, V\u00e1rosmajor u.68, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Goette","sequence":"additional","affiliation":[{"name":"St. Vincenz-Hospital, Paderborn, Am Busdorf 2, Paderborn, Nordrhein-Westfalen, Germany"},{"name":"Working Group: Molecular Electrophysiology, University Hospital Magdeburg, Leipziger Str. 44, Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,22]]},"reference":[{"key":"2019110403561580700_euz213-B1","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1160\/TH16-11-0876","article-title":"Stroke prevention in atrial fibrillation: past, present and future. 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