This article is more than 5 years old. Information may no longer be current.

Mobile thrombus detected with intracardiac echocardiography

Supple GE. Circulation. 2011;124:772-778.

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Mobile thrombi on CV implantable electronic device leads are readily identified with intracardiac echocardiography despite being under-recognized with transthoracic echocardiography, according to a study.

Using intracardiac echocardiography (ICE), researchers examined leads for thrombi and measured the pulmonary artery systolic pressure in patients with a CV implantable electronic device, such as a pacemaker or implantable cardioverter defibrillator, for ablation. ICE was used to examine the pacemaker and ICD leads before any ablation for the presence, location and size of thrombus. Researchers then correlated patient clinical characteristics, device type and lead characteristics with the presence of thrombi.

For all patients, routine transthoracic echocardiography (TTE) was obtained. TTE was performed in most patients within 3 days of ICE imaging. TTE reports were then viewed by researchers to determine whether lead thrombus was identified during that admission, and in a detailed follow-up review, the TTE images were reviewed in a blinded fashion to “determine whether a thrombus was identifiable.” Transesophageal echocardiographic reports and images were also reviewed when available.

Eighty-six patients with a prior CV implantable electronic device presenting for ablation with ICE were evaluated between February 2007 and November 2009. Ninety-three percent of the patients had an ICD and 85% had undergone ventricular tachycardia. ICE detected thrombi in 26 of 86 patients (30%), whereas TTE only detected thrombi in one of the 26 patients. Thrombi detected with ICE were mobile and more commonly identified in the right atrium than in the right ventricle, according to the study. In some cases, although thrombi were not being identified on ICE, they were seen on transesophageal echocardiogram. Researchers said these thrombi possibly developed in the intervening time between the two echocardiograms, which would explain why ICE did not detect the thrombi.

Disclosure: The Harlan Batrus Research Fund supported this study.

Follow CardiologyToday.com on Twitter.