Transesophageal echocardiography for cardiovascular risk estimation in patients with sepsis and new-onset atrial fibrillation: a multicenter prospective pilot study

Annals of Intensive Care

Table 3 Description of 28-day arterial thromboembolic events

Variable	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5	Patient 6	Patient 7
CHA₂DS₂-VASc score	3	6	0	1	2	5	4
NOAF characteristics	Persistent	Sustained	Sustained	Sustained	Persistent	Sustained	Persistent
Time from NOAF onset, days	11	2	6	5	5	0	3
Initial TEE study
LV systolic function, LVEF (%)	45	50	5	56	70	60	22
LA/LAA dysfunction^a	No	No	No	No	No	No	Yes
Severe aortic atheroma	Yes	No	No	No	No	No	No
Management before arterial thromboembolic event
Therapeutic anticoagulation	Yes	No	Yes	Yes	Yes	No	Yes
Cardioversion attempt	Yes	Yes	Yes	Yes	No	No	No
Type	Ischemic stroke	Ischemic stroke	Ischemic stroke	Ischemic stroke	Ischemic stroke; LAA thrombus ^b	Non-CVTE	LAA thrombus^c
Mechanism^d
Causatives subtypes of ischemic stroke^e	Probable large artery atherosclerosis	Evident cardio-aortic embolism	Evident cardio-aortic embolism	Evident cardio-aortic embolism	Evident cardio-aortic embolism	–	–
Sources of embolism other than intracardiac thrombus^f	–	No	VA ECMO	No	No	Suspicion of endocarditis	–
Relation to NOAF	Definitely not	Definitely	Probably	Definitely	Definitely	Probably	–
Fatal ischemic stroke or non-CVTE	No	No	No	No	No	No	–

CHA₂DS₂-VASc congestive heart failure, hypertension, age ≥ 75 years (doubled), diabetes mellitus, prior stroke or transient ischemic attack or thromboembolism (doubled), vascular disease, age 65 to 74 years, sex category (female), CVTE cerebrovascular thromboembolism, LA left atrial, LAA left atrial appendage, LV left ventricular, LVEF left ventricular ejection fraction, NOAF new-onset supraventricular arrhythmia, TEE transesophageal echocardiography, VA ECMO veno-arterial extracorporeal membrane oxygenation
^aIncluding LA/LAA SEC and low LAA flow velocity
^bRevealed at a supplementary TEE performed 17 days after NOAF onset because of ischemic stroke
^cRevealed at the second TEE study performed in all patients with arterial thromboembolic event except patient 4
^dArterial thromboembolic mechanism was assessed by an independent committee
^eCausative subtype of ischemic stroke (large artery atherosclerosis, cardio-aortic embolism, small-artery occlusion, other cause, or unknown cause) was determined using the Stop Stroke Study Trial of ORG 10172 in Acute Stroke Treatment classification criteria [27]
^fAmong patients with non-cerebrovascular thromboembolism and those with evident cardio-aortic embolism as a causative subtype of ischemic stroke