John de Heide

DOACs in elective electrical cardioversion 33 Appendix A. Detailed overview of patients with left atrial appendage thrombus Patient Indication TEE Findings TEE Type of oral anticoagulation Age (years)/ sex CHA2DS2VASc score Management 1 INR 1.7 at day of admission Thrombus Acenocoumarol 70/M 4 Increase lower rate biventricular ICD to improve biventricular pacing, AF accepted. 2 INR 1.3 at day of admission Possible thrombus Acenocoumarol 62/M 3 Postponement ECV, 1 month later successful ECV. No complications within 60 days after ECV. 3 Inadequate INR in past 3 weeks Thrombus Acenocoumarol 65/M 3 Postponement ECV, increase target INR to 2.53.5. 2 months later successful TEEguided ECV. No complications within 60 days after ECV. 4 Inadequate INR in past 3 weeks Possible thrombus Fenprocoumon 63/M 2 Postponement ECV, CT scan 1 month later demonstrated no LAA thrombus. Successful nonTEE-guided ECV. No complications within 60 days after ECV. 5 Interrupted DOAC in past 3 weeks Thrombus Apixaban 62/M 2 Postponement ECV, CT scan 1 month later demonstrated no LAA thrombus. Successful nonTEE-guided ECV. No complications within 60 days after ECV. Abbreviations: CT= computerized tomography, DOAC = direct oral anticoagulant, ECV = electrical cardioversion, INR = International Normalized Ratio, TEE= transoesophageal echocardiogram. 2

RkJQdWJsaXNoZXIy MTk4NDMw