Patent foramen ovale in patients with atrial fibrillation
International Journal of Cardiology(2020)
摘要
In this issue of the journal, Daher et al. [ [1] Daher G. Hassanieh I. Malhotra N. Mohammed K. Switzer M.P. Mehdirad A. Patent foramen ovale prevalence in atrial fibrillation patients and its clinical significance; a single center experience. Int. J. Cardiol. 2019; (in press)https://doi.org/10.1016/j.ijcard.2019.11.088 Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar ] report that among 178 patients undergoing pulmonary vein isolation procedures, a patent foramen ovale (PFO) was present in 57.3% of patients. This was determined because when a PFO was present, the catheter was advanced into the left atrium via the PFO, instead of performing a trans-septal perforation. A trans-esophageal echocardiogram (TEE) had detected a PFO in only 18.7% of the 75 patients who had a TEE prior to the PVI procedure. “The sensitivity and specificity of TEE in detection of PFO were 36.8% and 100%, respectively.” Although TEE is usually regarded as the “gold standard” for diagnosing PFO, this study confirms that it should not be so regarded. Indeed, the recent European position paper on the management of patients with PFO supports that PFO be diagnosed by transthoracic echocardiography and transcranial Doppler (TCD) saline study, rather than by TEE [ [2] Pristipino C. Sievert H. D’Ascenzo F. et al. European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism. Eur. Heart J. 2019; 40: 3182-3195 Crossref PubMed Scopus (120) Google Scholar ]. Patent foramen ovale prevalence in atrial fibrillation patients and its clinical significance; A single center experienceInternational Journal of CardiologyVol. 300PreviewPatent foramen ovale (PFO) has been reported in 25–30% of the general population. The most commonly used test for detecting PFO is a contrast enhanced transesophageal echocardiography (TEE). PFO presence can be confirmed during pulmonary vein isolation (PVI) procedure by passing the transseptal catheter assembly through the foramen ovale, crossing the septum from the right to the left atrium without using a trans-septal needle for puncture. Full-Text PDF
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