Improved Thrombus Assessment by Transesophageal Echocardiography: The DOLOP (Detection of Left Atrial Appendage Thrombosis Utilizing Optison) Study

Abstract

Transesophageal echocardiography (TEE) to assess for thrombus in the left atrial appendage (LAA) is an essential clinical tool prior to cardioversion or ablation in the setting of atrial fibrillation (AF) or flutter. While TEE is superior to transthoracic echo for LAA evaluation, noncontrast images can be limited by artifact and reverberation as well as spontaneous echo contrast (SEC).1 Use of ultrasound-enhancing agents (UEAs) can improve diagnostic accuracy;2 however, the only Food and Drug Administration–approved use of UEAs is left ventricle opacification.