Ozcan Cetin et al reported the PALSE score evaluating the thromboembolic milieu for a patient with atrial fibrillation. The authors are from Ankara City Hospital and Etimesgut State Hospital in Anakara, Turkey.
PALSE may stand for protein, age, left atrial, SPAP and ejection fraction.
The thromboembolic milieu refers to any combination of left atrial thrombus and moderate/severe spontaneous echo contrast (SEC). Severe SEC was defined as intense echo density and a very slow swirling pattern in the left atrium and/or left atrial appendage.
Parameters:
(1) left atrial diameter in mm
(2) left ventricular ejection fraction (LVEF) in percent
(3) age
(4) systolic pulmonary artery pressure (SPAP) in mm Hg
(5) total protein in g/dL
|
Parameter
|
Finding
|
Points
|
|
age in years
|
<= 60 years
|
0
|
|
|
> 60 years
|
1
|
|
total protein
|
<= 7.3 g/dL
|
0
|
|
|
> 7.3 g/dL
|
1
|
|
LVEF
|
>= 40%
|
0
|
|
|
< 40%
|
1
|
|
LA diameter
|
<= 40 mm
|
0
|
|
|
> 40 mm
|
1
|
|
SPAP
|
<= 35 mm Hg
|
0
|
|
|
> 35 mm Hg
|
1
|
number of risk factors =
= SUM(points for all of the parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 5
• The greater the number of risk factors the greater thromboembolic milieu and therefore the risk of thromboemboli.
