Atrial fibrillation in general practice: how useful is echocardiography in selection of suitable patients for anticoagulation?

All patients identified from records in two practices in West Lothian (n = 103) as having atrial fibrillation (AF) were offered a clinical examination, electrocardiogram (ECG), and echocardiography. Sixty-five patients attended the examinations. Of these, 26 (40%) were found to be in sinus rhythm. Many of those in AF were already on warfarin. Only eight who were found to have AF, who were not already on warfarin and who had no contraindications to it, had additional risk factors that suggested they be treated with warfarin. In no case did echocardiography alter management decisions.