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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Left atrial thrombus and prognosis after anticoagulation therapy in patients with atrial fibrillation

Shota Fukuda1, Hiroyuki Watanabe, Kenei Shimada

  • 1Department of Medicine, Cardiovascular Division, Osaka Ekisaikai Hospital, 2-1-10 Honden, Nishi-ku, Osaka 550-0022, Japan.

Journal of Cardiology
|August 10, 2011
PubMed

Insights

Left atrial thrombus (LAT) prevalence was higher in patients with sub-therapeutic anticoagulation (8.8%) than sufficient anticoagulation (3.6%). LAT presence is linked to worse cardiovascular outcomes in atrial fibrillation (AF) patients.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Anticoagulation therapy significantly reduces thromboembolic events in atrial fibrillation (AF) patients.
  • The prevalence of left atrial thrombus (LAT) in AF patients undergoing anticoagulation therapy requires further investigation.

Purpose of the Study:

  • To determine the prevalence of LAT in patients with nonvalvular AF after initiating anticoagulation therapy.
  • To assess the impact of LAT on cardiovascular outcomes in these patients.

Main Methods:

  • A study involving 231 patients with nonvalvular AF.
  • Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) were performed over 3 weeks after anticoagulation initiation.
  • Clinical and echocardiographic characteristics were analyzed.

Main Results:

  • LAT was detected in 8.8% of patients with sub-therapeutic anticoagulation versus 3.6% with sufficient anticoagulation.
  • In sub-therapeutic anticoagulation, LAT correlated with higher CHADS(2) scores, reduced left atrial (LA) volume changes, and spontaneous echocardiographic contrast (SEC).
  • LAT patients with sufficient anticoagulation were characterized by male gender, permanent AF, impaired left ventricular function, dilated LA, and reduced appendage flow velocity.

Conclusions:

  • Left atrial thrombus (LAT) is a significant risk factor for adverse cardiovascular outcomes in AF patients.
  • LAT prevalence differs based on anticoagulation therapeutic levels, highlighting the importance of effective anticoagulation management.
Abstract

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