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Updated: Oct 3, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Computed tomography findings associated with the reduction in left atrial appendage flow velocity in patients with
Kotaro Ouchi1, Toru Sakuma2, Takahiro Higuchi2
1Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan. kotaro-alex@jikei.ac.jp.
Insights
Reduced flow velocity in the left atrial appendage (LAAFV) in atrial fibrillation (AF) patients is linked to stroke risk. Cardiac CT can non-invasively predict low LAAFV using LAA volume and filling defects.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Reduced left atrial appendage flow velocity (LAAFV) in atrial fibrillation (AF) patients correlates with increased thromboembolic event risk.
- Limited studies have explored the relationship between LAAFV and cardiac computed tomography (CT) derived LAA features in AF.
- Accurate risk stratification for thromboembolic events in AF patients is crucial for effective management.
Purpose of the Study:
- To identify predictors of reduced LAAFV in patients with AF using cardiac CT findings.
- To investigate the association between LAA morphology, volume, filling defects, and LAAFV.
- To determine if CT-derived LAA parameters can non-invasively estimate LAAFV.
Main Methods:
- Retrospective analysis of cardiac CT scans from 440 AF patients who underwent transesophageal echocardiography prior to pulmonary vein isolation.
- Evaluation of LAA features including volume and filling defects on cardiac CT.
- Correlation of LAA features and clinical data (CHADS2 scores) with LAAFV measurements.
Main Results:
- Reduced LAAFV was significantly associated with higher CHADS2 scores (OR 1.52), early LAA filling defects (OR 3.36), and increased indexed LAA volume (OR 1.09).
- LAA morphological type and AF type were not significant predictors of reduced LAAFV.
- Increased LAA volume, early filling defects, and higher CHADS2 scores independently predicted reduced LAAFV in AF patients.
Conclusions:
- Cardiac CT findings, specifically LAA volume and filling defects, are independent predictors of reduced LAAFV in AF patients.
- CT-derived parameters may allow for non-invasive estimation of LAAFV, aiding in risk stratification.
- These findings can potentially improve the management and risk stratification of thromboembolic events in AF patients.
Abstract:
The reduction in flow velocity within the left atrial appendage (LAAFV) is associated with a high risk of thromboembolic events. There has been few reports using sufficient sample size about the relationship between LAAFV reduction and LAA features on cardiac computed tomography (CT), including LAA volume and filling defects, in patients with atrial fibrillation (AF). We evaluated the predictors of reduced flow velocity within the LAA using the findings of cardiac CT in patients with AF. We retrospectively analysed the cardiac CT findings of the LAA of 440 patients who underwent transoesophageal echocardiography prior to pulmonary vein isolation between 12 February, 2013 and 16 December, 2019 at our institution. We investigated the potential predictors of reduced LAAFV and the difference in LAAFV between the different morphological types of the LAA. The reduced flow velocity within the LAA was significantly correlated with higher CHADS2 scores [P = 0.001; odds ratio (OR), 1.52; 95% confidence interval (CI), 1.18-1.95], early filling defect in the LAA (P = 0.001; OR, 3.36; 95% CI 1.63-6.93), and increased indexed LAA volume (P = 0.036; OR, 1.09; 95% CI 1.01-1.19). The LAA morphological type and AF type were not significant predictors of the LAAFV reduction. Increased LAA volume, early filling defects in the LAA, and higher CHADS2 scores were independent predictors of LAAFV reduction in patients with AF. Our findings suggest that cardiac CT findings might allow non-invasive estimation of reduced LAAFV. These CT-derived parameters may provide additional information for the risk stratification and management of thromboembolic events in patients with AF.
