Predictors of thrombus development and severe SEC on TEE at repeat ablation
Among the patients examined by TEE at repeat ablation, 8 and 6 patients showed SEC grades 3 and 4, respectively. No patients developed thromboembolic events among those without screening by any imaging modality prior to the repeat ablation. Univariate logistic regression analysis demonstrated that a history of heart failure, LVEF at repeat ablation, history of thrombus detection before the initial ablation, repeat ablation performed >180 days, and non-paroxysmal status of atrial arrhythmias after the first session were associated with the development of thrombus and severe SEC. Multivariate analysis showed that repeat ablation >180 days (odds ratio [OR] 13.0, 95% confidence interval [CI] [1.68–100.9], p = 0.014), non-paroxysmal atrial arrhythmia after the first session (OR 3.89, 95% CI [1.36–11.1], p = 0.011), and lower LVEF (OR 0.94, 95% CI [0.90–0.99], p = 0.012) were independent predictors of thrombus development and severe SEC at repeat ablation (Table 8).