Related Experiment Video

Updated: May 7, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

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

Published on: February 26, 2013

Relationship between left atrial appendage morphology and stroke in patients with atrial fibrillation

Irfan M Khurram1, Jane Dewire, Michael Mager

  • 1Department of Medicine/Cardiology.

Heart Rhythm
|October 1, 2013
PubMed

Insights

The extent of left atrial appendage (LAA) trabeculations and smaller LAA orifice diameter are linked to stroke risk in atrial fibrillation (AF) patients. These LAA characteristics may explain why certain LAA shapes are associated with stroke.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Neurology

Background:

  • Atrial fibrillation (AF) is a significant risk factor for stroke.
  • Effective stroke risk stratification in AF patients is crucial due to high morbidity and mortality.
  • Left atrial appendage (LAA) morphology and characteristics are of great interest for risk assessment.

Purpose of the Study:

  • To investigate the association between LAA morphology and specific LAA characteristics (trabeculations, orifice diameter, length) with prevalent stroke.
  • To gain mechanistic insights into stroke risk in patients with drug-refractory AF undergoing ablation.
  • To identify key LAA features predictive of stroke in a large patient cohort.

Main Methods:

  • A cohort of 1063 patients undergoing AF ablation (2003-2012) was reviewed.
  • Preprocedural cardiac computed tomography (CT) data from 678 patients were analyzed.
  • LAA morphology was categorized (chicken wing, cactus, windsock, cauliflower), and LAA size, trabeculations, orifice diameter, and length were assessed.

Main Results:

  • 10% of patients (65/678) had a history of stroke or transient ischemic attack.
  • Smaller LAA orifice diameter, shorter LAA length, and extensive LAA trabeculations were associated with prevalent stroke.
  • While LAA morphology itself was not associated with stroke, smaller orifice diameter and extensive trabeculations were independent predictors of thromboembolic events in multivariable analysis.

Conclusions:

  • Extensive LAA trabeculations and smaller LAA orifice diameter are significantly associated with prevalent stroke in AF patients.
  • These LAA characteristics may mediate the stroke risk associated with specific LAA morphologies, such as the cauliflower type.
  • Understanding these LAA features can improve stroke risk stratification in AF patients.
Abstract

Keywords:
AFAtrial fibrillationCICTComputed tomographyLALAALeft atrial appendage morphologyMPRORStrokeTIAThromboembolismTrabeculationsatrial fibrillationcomputed tomographyconfidence intervalleft atrial appendageleft atrium/atrialmultiplanar reconstructionodds ratiotransient ischemic attack

More Related Videos

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Related Concept Videos

Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...