{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:59:26Z","timestamp":1789750766424,"version":"4.0.1"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Practices regarding indications and timing for transoesophageal echocardiography (TOE) before cardioversion (CV) of atrial fibrillation (AF) or left atrial (LA) interventional procedures, and preferred imaging techniques and pharmacotherapy, in cases of thrombus resistant to chronic oral anticoagulation (OAC) treatment, are largely unknown. The European Heart Rhythm Association (EHRA) conducted a survey to capture contemporary clinical practice in those areas of AF care. A 22-item online questionnaire was developed and distributed among the EHRA electrophysiology research network centres. The survey contained questions regarding indications, type and timing of imaging before CV or LA procedures and management of LA appendage (LAA) thrombus with special emphasis on thrombus resistant to OAC. Of 54 responding centres 63% were university hospitals. Most commonly, TOE would be performed in cases of inadequate or unclear pre-procedural anticoagulation, even in AF lasting &amp;lt;48\u2009h (52% and 50%, respectively), and 15% of centres would perform TOE before AF ablation in all patients. If thrombus was diagnosed despite chronic OAC, the prevalent strategy was to change current OAC to another with different mechanism of action; 51% of centres would wait 3\u20134\u2009weeks after changing the OAC before using another imaging test, and 60% of centres reported two attempts to dissolve the thrombus. Our survey showed a significant utilization of TOE before CV or AF ablation in European centres, extending beyond AF guidelines-suggested indications. When thrombus was diagnosed despite chronic pre-procedural OAC, most centres would use another anticoagulant drug with different mode of action.<\/jats:p>","DOI":"10.1093\/europace\/euz257","type":"journal-article","created":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T15:15:45Z","timestamp":1566314145000},"page":"162-169","source":"Crossref","is-referenced-by-count":38,"title":["Diagnosis and management of left atrial appendage thrombus in patients with atrial fibrillation undergoing cardioversion or percutaneous left atrial procedures: results of the European Heart Rhythm Association survey"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1673-7712","authenticated-orcid":false,"given":"Michal M","family":"Farkowski","sequence":"first","affiliation":[{"name":"Heart Arrhythmia Ward, II Department of Coronary Artery Disease, Institute of Cardiology, Alpejska 42, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Jubele","sequence":"additional","affiliation":[{"name":"P. Stradins Clinical University Hospital, Riga Stradins University, Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Mar\u00edn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, University of Murcia, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Gandjbakhch","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9s, APHP, Institute of Cardiology ICAN, Piti\u00e9-Salp\u00eatri\u00e8re University Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel","family":"Ptaszynski","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Medical University of Lodz, Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose L","family":"Merino","sequence":"additional","affiliation":[{"name":"Unidad de Arritmias y Electrofisiolog\u00eda Robotizada, La Paz University Hospital, IDIPAZ, Universidad Autonoma de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radoslaw","family":"Lenarczyk","sequence":"additional","affiliation":[{"name":"First Department of Cardiology and Angiology, Silesian Centre for Heart Disease, Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana S","family":"Potpara","sequence":"additional","affiliation":[{"name":"School of Medicine, Belgrade University; Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,9,9]]},"reference":[{"key":"2020010703582363600_euz257-B1","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1093\/europace\/euw295","article-title":"2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS","volume":"18","author":"Kirchhof","year":"2016","journal-title":"Europace"},{"key":"2020010703582363600_euz257-B2","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/europace\/euy054","article-title":"The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary","volume":"20","author":"Steffel","year":"2018","journal-title":"Europace"},{"key":"2020010703582363600_euz257-B3","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1160\/th15-07-0532","article-title":"Prevalence of left atrial thrombus in patients with non-valvular atrial fibrillation. 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