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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

34.6K

Complex left atrial appendage morphology and left atrial appendage thrombus formation in patients with atrial

Masayoshi Yamamoto1, Yoshihiro Seo, Naoto Kawamatsu

  • 1Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.

Circulation. Cardiovascular Imaging
|February 14, 2014
PubMed

Insights

Complex left atrial appendage (LAA) morphology, particularly multiple lobes, is linked to thrombus formation in atrial fibrillation (AF) patients. This suggests LAA shape may be a congenital risk factor for blood clots.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Thrombosis Research

Background:

  • Atrial fibrillation (AF) commonly leads to thrombus formation in the left atrial appendage (LAA).
  • The relationship between LAA anatomical structure and thrombus presence remains unclear.

Purpose of the Study:

  • To investigate the association between left atrial appendage (LAA) morphology and the occurrence of LAA thrombus in patients with atrial fibrillation (AF).
  • To identify morphological predictors of LAA thrombus formation.

Main Methods:

  • Prospective enrollment of 564 patients undergoing catheter ablation for AF.
  • 3D transesophageal echocardiography (TEE) to assess LAA morphology (volume, lobes) and detect LAA thrombus.
  • Multivariate analysis to identify independent predictors of thrombus formation.

Main Results:

  • LAA thrombus was observed in 6.4% of patients.
  • An increased number of LAA lobes (≥3) was strongly associated with LAA thrombus (94.4% of thrombus patients had ≥3 lobes).
  • CHADS2 score, LVEF, spontaneous echo contrast, LA volume, and LAA lobe number were independent predictors of thrombus.

Conclusions:

  • Complex LAA morphology, specifically a higher number of lobes, is independently associated with LAA thrombus in AF patients.
  • LAA morphology may represent a congenital risk factor for thrombus development in the LAA.
  • These findings highlight the importance of LAA structure in AF-related embolism risk.
Abstract

Keywords:
anticoagulantsatrial appendageatrial fibrillationcatheter ablationechocardiographystrokethrombosis

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