Background: According to current guidelines, non-vitamin K antagonist oral anticoagulants (NOACs) should be used at least 3 weeks before planned ECV. In accordance with international atrial fibrillation (AF) guidelines, transoesophageal echocardiography (TOE) is a pre-procedural examination recommended as an alternative to the adequate oral anticoagulation. Hypothesis: The strategy related to qualifying patients treated with NOACs for pre-procedural TOE differs in individual centers. Therefore, it is necessary to create an algorithm that will standardize estimation of left atrial appendage thrombus (LAAT) prevalence risk and thereby qualify NOAC treated patients to TOE in the most effective way. Methods: We assessed the available studies on LAAT predictors. Results: Risk factors for LAAT formation are not necessarily the same as the risk factors for thromboembolic events in patients with AF. The main risk factor for LAAT are: previous intracardiac thrombus, irregular use of NOAC, inappropriate dose reduction of NOAC, previous stroke, CHA2DS2-VASc score ≥ 3 points, GFR <60 ml/min/1.73m2, reduced left ventricular ejection fraction or left atrial enlargement. Conclusion: Based on available evidence, we proposed algorithm guarantees more systematic approach to performing TOE in patients undergoing ECV.