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March, 2026
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Athanasios Frydas: Is It Safe to Skip TEE Before Rhythm Control in Low Thromboembolic Risk Patients?
Mar 21, 2026, 16:59

Athanasios Frydas: Is It Safe to Skip TEE Before Rhythm Control in Low Thromboembolic Risk Patients?

Athanasios Frydas, Cardiologist at the German Heart Center at Charité (DHZC), shared on LinkedIn about a recent article he and his colleagues co-authored, adding:

”Excited to share our latest publication in Heart Rhythm Open.

Is it safe to omit transesophageal echocardiography (TEE) prior to elective rhythm control interventions in anticoagulated patients without risk factors for thromboembolism?

Current guidelines remain inconclusive, and clinical practice varies widely between centers.

In our retrospective analysis of 645 patients who underwent same-session transthoracic (TTE) and transesophageal echocardiography (TEE), we observed a surprisingly high prevalence of clinically relevant left atrial appendage findings—even among patients considered low risk.

Notably, left atrial strain emerged as the strongest parameter associated with thromboembolic substrate.

These findings suggest that assessing left atrial cardiomyopathy using TTE could play a key role in improving patient selection for TOE necessity prior to rhythm control interventions.

Many thanks to all the coauthors for their contribution.”

Title: Transthoracic signs of left atrial cardiomyopathy predict presence of left atrial thromboembolic substrate

Authors: Athanasios Frydas, Alice Sokour, Fabian Spinka, Victor Schweiger, Hong Ran, Florian Blaschke, Henryk Dreger, Leif-Hendrik Boldt, Abdul Shokor Parwani, Gerhard Hindricks, Daniel-Armando Morris, Ingo Hilgendorf, Matthias Schneider-Reigbert

Read the Full Article on Heart Rhythm O2

Athanasios Frydas: Is It Safe to Skip TEE Before Rhythm Control in Low Thromboembolic Risk Patients?

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