What is the advantage of NOACs in the TEE-guided approach over VKA?
The advantage of NOACs is that their mode of action is quicker than VKA, and therefore there is no delay in waiting for a therapeutic INR. However, the need for strict adherence to the NOAC therapy must be emphasized to patients, particularly in the post-cardioversion period. Individuals who are very symptomatic due to AF may gain greatest benefit from the TEE-guided approach since cardioversion can be expedited by a thrombus- negative TEE.