What is the recommended approach to anticoagulation in patients with atrial thrombus seen on TEE?
A risk-based approach to anticoagulation can be recommended with respect to TEE, with individualization of therapy on a case-by-case basis. However, there is no direct evidence to guide decision-making about long-term management of anticoagulation in patients who appear to be in sinus rhythm at 4 weeks after cardioversion. Indirect evidence suggests strongly that long-term anticoagulation should be based on the risk of stroke rather than the apparent success of the cardioversion procedure.