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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

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Relations between left atrial appendage contrast retention and thromboembolic risk in patients with atrial

Xu Lu1,2,3, Tao Chen2, Ge Liu2

  • 1Medical School of Chinese PLA, 28 Fuxing Road, Haidian District, Beijing, 100853, China.

Journal of Thrombosis and Thrombolysis
|June 15, 2021
PubMed

Insights

Contrast retention in the left atrial appendage (LAA) is linked to a higher risk of LAA thrombus formation in patients with non-valvular atrial fibrillation. This finding highlights contrast retention as a potential indicator for thrombogenesis risk.

Area of Science:

  • Cardiology
  • Radiology
  • Thrombosis Research

Background:

  • The left atrial appendage (LAA) is a primary source of cardiac thrombus formation, particularly in patients with non-valvular atrial fibrillation.
  • Contrast retention (CR) in the LAA is frequently observed during left atrial appendage occlusion (LAAO) procedures and is associated with stroke history.

Purpose of the Study:

  • To investigate the relationship between LAA contrast retention and the risk of LAA thrombogenesis.
  • To identify factors associated with LAA thrombus formation in patients undergoing LAAO.

Main Methods:

  • Analysis of data from 132 patients who underwent LAAO, including computed tomography (CT), echocardiography (TTE, TEE), and blood samples.
  • Utilized univariate and multivariate logistic regression models to assess associations between CR, left atrial appendage thrombus (LAAT), and other clinical factors.

Main Results:

  • Contrast retention was observed in 25% of patients (33/132).
  • Patients with CR exhibited significantly larger left atrium dimensions, higher CHADS2 and CHA2DS2-VASc scores, increased prior stroke rates, more LAA lobes, and a substantially higher prevalence of LAAT (63.6% vs. 13.1%).
  • Independent predictors of LAAT included CR, LAA cauliflower morphology, and left ventricular ejection fraction (LVEF).

Conclusions:

  • LAA contrast retention is a significant independent predictor of left atrial appendage thrombus.
  • CR may serve as a crucial marker for thrombogenesis risk and potentially cardiogenic stroke in patients with non-valvular atrial fibrillation.

Keywords:
Atrial fibrillationContrast retentionLeft atrial appendageThrombosis

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