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Updated: Apr 19, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
The left atrial appendage: anatomy, function, and noninvasive evaluation
Roy Beigel1, Nina C Wunderlich2, Siew Yen Ho3
1The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California; The Heart Institute, Sheba Medical Center, and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
The left atrial appendage (LAA) is crucial in atrial fibrillation (AF) due to thrombus formation risk. Understanding LAA anatomy and imaging is vital for managing cardioembolic complications in AF patients.
Area of Science:
- Cardiology
- Cardiac Imaging
- Electrophysiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia, increasing with age.
- Thrombus formation in the left atrial appendage (LAA) is frequent in AF patients, posing a risk for cardioembolic events.
- Assessing LAA thrombi is critical for AF management, especially before cardioversion and for transcatheter therapies.
Purpose of the Study:
- To review current data on left atrial appendage (LAA) anatomy, function, and imaging.
- To highlight the importance of LAA evaluation in patients with atrial fibrillation (AF).
- To discuss optimal noninvasive imaging techniques for LAA thrombus detection.
Main Methods:
- Review of current scientific literature and data.
- Analysis of noninvasive imaging modalities for LAA assessment.
- Synthesis of information on LAA anatomy and function in the context of AF.
Main Results:
- The LAA is a common site for thrombus formation in AF due to stasis and reduced contractility.
- Accurate LAA imaging is essential for risk stratification and guiding treatment decisions in AF.
- Various noninvasive imaging techniques are available for evaluating LAA morphology and function.
Conclusions:
- Understanding LAA anatomy and function is critical for managing AF-related cardioembolic risk.
- Optimal imaging techniques are necessary to identify or exclude LAA thrombi in AF patients.
- LAA evaluation is integral to current and emerging transcatheter therapies for AF.
Abstract:
The left atrial appendage (LAA) is a finger-like extension originating from the main body of the left atrium. Atrial fibrillation (AF) is the most common clinically important cardiac arrhythmia, occurring in approximately 0.4% to 1% of the general population and increasing with age to >8% in those >80 years of age. In the presence of AF thrombus, formation often occurs within the LAA because of reduced contractility and stasis; thus, attention should be given to the LAA when evaluating and assessing patients with AF to determine the risk for cardioembolic complications. It is clinically important to understand LAA anatomy and function. It is also critical to choose the optimal imaging techniques to identify or exclude LAA thrombi in the setting of AF, before cardioversion, and with current and emerging transcatheter therapies, which include mitral balloon valvuloplasty, pulmonary vein isolation, MitraClip (Abbott Laboratories, Abbott Park, Illinois) valve repair, and the implantation of LAA occlusion and exclusion devices. In this review, we present the current data regarding LAA anatomy, LAA function, and LAA imaging using the currently available noninvasive imaging modalities.
