ABSTRACT
To investigate whether or not the CHA[2]DS[2] -VASc score predicts left atrial [LA] thrombus detected on pre-cardioversion transoesophageal echocardiography [TEE]. The medical records of patients who had undergone TEE were reviewed to assess the presence of LA thrombus prior to direct-current cardioversion for atrial fibrillation [AF]. The CHA[2]DS[2] -VASc score was calculated for each patient. Clinical TEE reports were reviewed for the presence of LA thrombus. Patients with a valve prosthesis or rheumatic mitral valve disease were excluded from this study. A total of 309 patients were identified. The mean age was 70.1 +/- 9.8 years and 151 [49%] patients were males and 158 [51%] were females. LA thrombus was seen in 32 [10.3%] of the 309 patients. Fifty [16.2%] patients had a low CHA[2]DS[2] -VASc score [0-1], 230 [74.4%] had an intermediate score [2-4] and 29 [9.4%] had a high score [5-9]. The incidence of LA thrombus in the low, intermediate and high CHA[2]DS[2] -VASc score groups was 0, 4.4 and 68.7%, respectively. The LA thrombus risk increased with increasing CHA[2]DS[2] -VASc scores. On multivariate logistic analysis, the CHA[2]DS[2] -VASc score [OR 3.26, 95% CI 2.3-4.65; p = 0.001] and age [OR 0.93, 95% CI 0.88-0.98; p = 0.004] were independent risk factors for LA thrombus in patients with non-valvular AF. A high CHA[2]DS[2] -VASc score was independently associated with the presence of LA thrombus in patients with non-valvular AF