Prevalence and predictors of left atrial thrombus in patients with atrial fibrillation: is transesophageal echocardiography necessary before cardioversion?

Background: Systemic embolization threatens patients with atrial fibrillation (AF). The risk is enhanced at the time of cardioversion. Transesophageal echocardiography (TEE) prior to cardioversion to screen for left atrial thrombus (LAT), a marker of high risk for embolization, is recommended for many patients with AF.

Reforming Cardiovascular Care in the United States towards High-Quality Care at Lower Cost with Examples from Model Programs in the State of Michigan.

Despite its status as a world leader in treatment innovation and medical education, a quality chasm exists in American health care. Care fragmentation and poor coordination contribute to expensive care with highly variable quality in the United States. The rising costs of health care since 1990 have had a huge impact on individuals, families, businesses, the federal and state governments, and the national budget deficit.

Transesophageal echocardiographic screening before atrial flutter ablation: is it necessary for patient safety?

Background: Transesophageal echocardiography (TEE) is commonly used before atrial flutter (AFl) ablation to detect atrial thrombus (AT) and thereby identify a heightened risk for systemic embolism both in patients with their initial episodes of AFl and in those with prior episodes whose anticoagulation has been inadequate. This treatment strategy has been extrapolated from guidelines for atrial fibrillation. In fact, limited data exist regarding the prevalence or clinical associations of AT and spontaneous echocardiographic contrast (SEC) in patients with AFl.

Resolution of hydronephrosis after uterine artery embolization for fibroids.

Purpose: To determine the prevalence, predisposing factors, and resolution of hydronephrosis among patients undergoing uterine artery embolization (UAE) for fibroids.

Materials And Methods: From October 2004 to May 2008, 1,114 patients underwent UAE at an academic medical center. Hydronephrosis was found on angiographic images in 101 patients.