{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:10:16Z","timestamp":1787015416455,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,9,5]],"date-time":"2021-09-05T00:00:00Z","timestamp":1630800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transesophageal echocardiography (TEE) is variably performed before atrial fibrillation (AF) ablation to evaluate left atrial appendage (LAA) thrombus. We describe our experience with transitioning to the pre\u2010ablation cardiac computed tomography (CT) approach for the assessment of LAA thrombus during the COVID\u201019 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied consecutive patients undergoing AF ablation at our center. The study cohort was divided into pre\u2010 versus post\u2010COVID groups. The pre\u2010COVID cohort included ablations performed during the 1 year before the COVID\u201019 pandemic; pre\u2010ablation TEE was used routinely to evaluate LAA thrombus in high\u2010risk patients. Post\u2010COVID cohort included ablations performed during the 1 year after the COVID\u201019 pandemic; pre\u2010ablation CT was performed in all patients, with TEE performed only in patients with LAA thrombus by CT imaging. The demographics, clinical history, imaging, and ablation characteristics, and peri\u2010procedural cerebrovascular events (CVEs) were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 637 patients (pre\u2010COVID\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009424, post\u2010COVID\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009213) were studied. The mean age was 65.6\u2009\u00b1\u200910.1 years in the total cohort, and the majority were men. There was a significant increase in pre\u2010ablation CT imaging from pre\u2010 to post\u2010COVID cohort (74.8% vs. 93.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u2009.01), with a significant reduction in TEEs (34.6% vs. 3.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u2009.01). One patient in the post\u2010COVID cohort developed CVE following negative pre\u2010ablation CT. However, the incidence of peri\u2010procedural CVE between both cohorts remained statistically unchanged (0% vs. 0.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.33).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementation of pre\u2010ablation CT\u2010only imaging strategy with selective use of TEE for LAA thrombus evaluation is not associated with increased CVE risk during the COVID\u201019 pandemic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.15227","type":"journal-article","created":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:34:15Z","timestamp":1630110855000},"page":"3125-3134","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Transition from transesophageal echocardiography to cardiac computed tomography for the evaluation of left atrial appendage thrombus prior to atrial fibrillation ablation and incidence of cerebrovascular events during the COVID\u201019 pandemic"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3471-6704","authenticated-orcid":false,"given":"Tauseef","family":"Akhtar","sequence":"first","affiliation":[{"name":"Division of Cardiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3662-2832","authenticated-orcid":false,"given":"Ryan","family":"Wallace","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-5564","authenticated-orcid":false,"given":"Usama A.","family":"Daimee","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Hart","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Arbab\u2010Zadeh","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5035-5342","authenticated-orcid":false,"given":"Joseph E.","family":"Marine","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7427-6750","authenticated-orcid":false,"given":"Ronald","family":"Berger","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9262-9433","authenticated-orcid":false,"given":"Hugh","family":"Calkins","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9190-9804","authenticated-orcid":false,"given":"David","family":"Spragg","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.03.028"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.05.012"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.06.124"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.10.028"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07172-2"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-008-9243-0"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.09.002"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.01.026"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13353"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-010-9505-5"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.08.004"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2008.09.011"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.07.048"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.07.016"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjco.2020.12.012"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.04.036"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.0693"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1998.tb00086.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2015.10.009"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2016.09.011"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(96)00551-7"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.15227","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.15227","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.15227","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T04:49:07Z","timestamp":1693198147000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.15227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,5]]},"references-count":22,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1111\/jce.15227"],"URL":"https:\/\/doi.org\/10.1111\/jce.15227","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.162265870.05900100\/v1","asserted-by":"object"}]},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,5]]},"assertion":[{"value":"2021-05-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}