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
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