Feasibility of TEE-guided stroke risk assessment in atrial fibrillation-background, aims, design and baseline data of the TIARA pilot study

T. Dinh*, L. H. B. Baur, R. Pisters, O. Kamp, Freek W. A. Verheugt, J. L. R. M. Smeets, E. C. Cheriex, R. G. Tieleman, M. H. Prins, H. J. G. M. Crijns

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Web of Science)


Background Antithrombotic management in atrial fibrillation (AF) is currently based on clinical characteristics, despite evidence of potential fine-tuning with transoesophageal echocardiography (TEE). This open, randomised, multicentre study addresses the hypothesis that a comprehensive strategy of TEE-based aspirin treatment in AF patients is feasible and safe. Methods Between 2005 and 2009, ten large hospitals in the Netherlands enrolled AF patients with a moderate risk of stroke. Patients without thrombogenic TEE characteristics were randomised to aspirin or vitamin K antagonists (VKA). The primary objective is to show that TEE-based aspirin treatment is safe compared with VKA therapy. The secondary objective tests feasibility of TEE as a tool to detect echocardiographic features of high stroke risk. This report compares randomised to non-randomised patients and describes the feasibility of a TEE-based approach. Results In total, 310 patients were included. Sixty-nine patients were not randomised because of non-visualisation (n=6) or TEE risk factors (n=63). Compared with non-randomised patients, randomised patients (n=241) were younger (65 11 vs. 69 9 years, p=0.004), had less coronary artery disease (9 vs. 20%, p=0.018), previous TiA (1.7 vs. 7.2%, p=0.029), AF during TEE (25 vs. 54%, p
Original languageEnglish
Pages (from-to)214-222
JournalNetherlands Heart Journal
Issue number5
Publication statusPublished - May 2011


  • Atrial fibrillation
  • Stroke risk
  • Antithrombotic treatment

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