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Atrial thrombi in elective patients considered for atrial fibrillation rhythm control: Risk factors and prognostic

Marcella Cabral Caires1, Roberto Muniz Ferreira1, Thaís Fonseca Rodrigues2

  • 1Federal University of Rio de Janeiro, Edson Saad Heart Institute, Rua Rodolpho Paulo Rocco 255, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil; Samaritano Hospital, Cardiology Department, Rua Bambina 98, Botafogo, Rio de Janeiro, RJ, 22251-050, Brazil.

Indian Heart Journal
|April 18, 2021
PubMed

Insights

Atrial thrombi (AT) in patients with atrial fibrillation (AF) undergoing rhythm control are linked to worse long-term survival. Obesity is a key predictor of AT, suggesting more severe atrial disease.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Atrial thrombi (AT) are a known complication in atrial fibrillation (AF).
  • The prognostic significance of AT in patients undergoing elective rhythm control strategies remains unclear.
  • Understanding predictors and outcomes of AT is crucial for patient management.

Purpose of the Study:

  • To investigate the prognostic value of atrial thrombi (AT) in patients with atrial fibrillation (AF).
  • To identify clinical predictors associated with the presence of AT.
  • To assess the impact of AT on long-term survival in patients undergoing elective AF cardioversion or ablation.

Main Methods:

  • Prospective study involving 205 patients with AF.
  • Transesophageal echocardiography (TEE) performed before elective cardioversion or ablation.
  • Correlation analysis of clinical variables with AT presence and long-term survival.

Main Results:

  • Atrial thrombi (AT) were detected in 7.8% of patients.
  • The presence of AT was significantly associated with reduced long-term survival.
  • Obesity was identified as the sole independent clinical predictor of AT (OR 4.27, p=0.03).

Conclusions:

  • Atrial thrombi (AT) in AF patients undergoing rhythm control are associated with adverse outcomes.
  • AT may indicate a more advanced stage of atrial cardiomyopathy.
  • Obesity is a significant risk factor for developing AT in this population.

Keywords:
Atrial fibrillationPrognosisRisk factors

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