What are the current clinical practices for TEE to guide cardioversion and anticoagulation duration post-cardioversion for Afib/flutter in patients following left atrial appendage closure?  

Right now, there is not a great deal of data to guide us to answer this question. In general, the safest thing from a stroke prevention standpoint would be to adhere to the same guidelines that we would for patients without left atrial appendage occlusion devices. However, of course, most of these p...

I do TEE for all patients with LAA closure undergoing CV, especially if the CHA2VASC2 score is elevated or in patients with known prior thrombus or stroke. While the appendage is the most common source of clots, we all know that thrombus can still form in areas other than the LAA. In particular, it ...

At our institution, we perform a TEE-guided CV in our LAA closure device patients regardless of implant date followed by 28 days of AC if no clots seen (conservative approach). Agree with the need for more study.

I agree with Dr. @Mason's response. Following percutaneous LAA closure (watchman/amulet) we obtain reimaging at 45 days, which will inform whether an appendage is completely sealed and if there is a DRT (device-related thrombosis). If there is a complete seal, the device does tend to endothelialize,...