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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Left atrial appendage function assessment and thrombus identification.

Jacek Kurzawski1, Agnieszka Janion-Sadowska1, Marcin Sadowski1,2

  • 1Świętokrzyskie Cardiology Center, Kielce, Poland.

International Journal of Cardiology. Heart & Vasculature
|June 16, 2017
PubMed
Summary
This summary is machine-generated.

Diagnosing left atrial appendage thrombus in atrial fibrillation (AF) patients is challenging. New Doppler methods show lower left lateral ridge strain rate may identify thrombi in AF patients.

Keywords:
AppendageAtrial fibrillationSinus rhythmStrainStrain rateThrombus

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Left atrial appendage (LAA) thrombus diagnosis in persistent atrial fibrillation (AF) can be inconsistent due to variable morphology.
  • Advanced Doppler-derived methods may improve thrombus identification.
  • This study quantifies mechanical function differences in LAA basal segments.

Purpose of the Study:

  • To evaluate quantitative mechanical function differences in LAA basal segments.
  • To compare tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE) parameters.
  • To differentiate patients with and without LAA thrombus in non-valvular AF.

Main Methods:

  • Transesophageal echocardiography in 80 patients (40 SR, 40 AF with/without LAA thrombus).
  • Analysis of LAA basal segments: left lateral ridge (LLR) and baso-medial appendage segment (BMAS).
  • Quantitative analysis of peak velocity, average velocity, strain, strain rate, and deformation.

Main Results:

  • Lower LLR strain rate was the sole significant STE parameter differentiating AF patients with and without LAA thrombi (-0.9 vs. -1.6 s⁻¹, p=0.004).
  • Sinus rhythm (SR) patients showed significantly better velocity, strain, strain rate, and deformation than AF patients (p<0.001).

Conclusions:

  • The LLR is a suitable site for measuring Doppler-derived parameters.
  • LLR strain rate may serve as a novel parameter for detecting LAA thrombus in AF patients.